1. Building the Active Body

March 2, 2017 American Council on Exercise Off Natural Health News

Aging Strong and Gracefully

If you’re concerned about how old you look or how old you feel, you might be tempted to search for the fountain of youth in anti-aging supplements, face creams, or spa treatments. In truth, two of the most effective—and inexpensive—things you can do to hold on to the vigor of your youth are to move your body regularly and fuel it with nutrient-rich foods. While no one can completely stop the aging process, regular physical activity and healthy eating patterns can help postpone or minimize the development of chronic disease and disabling conditions as you grow older. There also is increasing evidence that regular exercise may provide significant emotional and brain health benefits. Ultimately, regular physical activity and good nutrition may help you maintain a higher quality of life as you age.

Maybe you don’t aspire to be a marathoner or a championship golfer at this point in your life (or maybe you do—if so, great!). Perhaps you’re more interested in being able to dance at your grandchild’s wedding, keep up with your garden, or travel the world. Maybe you’d just like more energy and want to keep your independence. Regardless, regular physical activity and proper fueling can help you reach these goals.

Move More

The current Physical Activity Guidelines for Americans, established in 2008, say point blank: “regular physical activity is essential to healthy aging.” It couldn’t be much clearer than this statement. Although factors such as hormonal and biological changes contribute to a gradual decline in most body systems over time, a significant portion of this decline can be slowed by regular physical activity, potentially counteracting the effects of 10 to 20 years’ worth of aging. Adults who are physically inactive tend to have a much more significant decline in heart and lung function, muscle strength, and bone mass with aging. Regular exercise, including aerobic exercise and strength training, can help put the brakes on these changes. This can result in greater independence and reduced risk of disease as you age.

The Physical Activity Guidelines for Americans, as well as guidelines from leading cardiovascular associations, advise that you strive to do at least 150 minutes a week (30 minutes at least 5 times a week) of moderate-intensity aerobic exercise (such as brisk walking or water aerobics) or 75 minutes a week of vigorous intensity aerobic exercise (such as jogging or swimming laps), if you’re able. Additionally, you should include muscle-strengthening activities at least twice a week. These guidelines will be explained in greater detail in Chapter 2.

Unfortunately, a national study of physical activity in the United States suggests that less than five percent of adults get at least 30 minutes of moderate- or vigorous-intensity exercise on most days of the week. A decline in physical activity starts as early as adolescence and tends to worsen the older we get. (See Box 1-1, “Percentage of Adults Meeting Physical Activity Guidelines.”)

Compared with less active people, those who are more physically active tend to live longer and have lower risk of many chronic diseases, such as heart disease, high blood pressure, stroke, type 2 diabetes, some cancers, and depression. (For additional benefits, see Box 1-2, “Benefits of Physical Activity for Adults and Older Adults.”) These benefits are due, in part, to the role of physical activity in weight control. Excess body fat increases risk of chronic diseases, and obesity is the greatest cause of disability as adults age. Regular physical activity also can be an important component of the treatment and management of numerous chronic diseases, as well as pain, stroke, constipation, cognitive (brain function) impairment, depression, and anxiety disorders.

Although it may seem surprising today, experts didn’t always recognize the importance of physical activity in reducing chronic disease risk and managing chronic disease. One of the earliest shifts in perspective was prompted by a 1953 study in which scientists compared cardiovascular disease rates between middle-age drivers and conductors of double-decker buses in London. All day long, conductors walked around the bus collecting people’s tickets, including walking up and down the stairs (amounting to about 600 stairs a day) connecting the two floors of the bus, while the bus drivers sat in their seats 90 percent of the workday. So who do you suppose had better health? The conductors. They were half as likely to die of a sudden heart attack as the bus drivers, yet they were in the same age group and social class. Since this study, research in more than 100,000 individuals shows that the higher the level of physical fitness, the less likely a person will die prematurely from cardiovascular disease. Based on this data, all major cardiovascular societies have made physical activity a key part of guidelines to prevent cardiovascular disease.

If you’ve been inactive for a while, are dealing with disease or disability, or have never had a formal exercise program, don’t let the physical activity guidelines overwhelm you. Just do what you can and slowly build up as you’re able. This report will help you get there. If you reach the minimum guidelines and can do more, keep going. More is generally better when it comes to physical activity for good health. You’ll notice the payoffs in ways such as improved stamina so you can work in your garden longer or keep up with others on a sightseeing tour, as well as increased strength so you can carry your grandchild or lift a bag of pet food without strain.

Sit Less

Beyond thinking about including formal exercise in your routine, a growing body of evidence suggests it’s also important to look for ways to simply sit less during the day. People spend countless hours sitting at desk jobs, watching TV, riding in cars, surfing the Internet, and so on. Research suggests that people who sit a lot and don’t exercise regularly are likely at the greatest risk of chronic disease and premature death. However, even if you have a regular workout routine and meet the minimum physical activity guidelines, sitting too much the rest of the time can take a toll on your health, increasing risk of obesity, type 2 diabetes, cardiovascular disease, and certain cancers, among other concerns. (For reasons why excess sitting may increase heart attack risk, see Box 1-3, “The Link Between Excess Sitting and Heart Disease.”) Additionally, research suggests too much sedentary time may reduce your ability to perform basic self-care tasks as you age (see Box 1-4, “Too Much Sitting Could Impair Self-Care Ability”).

Today, modern conveniences, such as remote controls, dishwashers, and cars, as well as electronic devices, such as computers, tablets, and smart phones, simply make activity less necessary. Not surprisingly, sedentary behavior has been increasing rapidly across the globe in all age groups. Sedentary jobs are of concern, in addition to sedentary leisure time.

The health risks of too much sitting are of such growing concern that some groups have developed specific guidelines on minimizing sitting. For example, the American College of Sports Medicine states that besides exercising regularly, there also are health benefits from reducing time spent in sedentary activities and in mixing short periods of standing and physical activity with sedentary activity. Similarly, Australia’s Physical Activity and Sedentary Behavior Guidelines specifically advise minimizing the amount of time spent in prolonged sitting and breaking up long periods of sitting as often as possible.

Unfortunately, research shows that as adults age, they generally spend the majority of their day in sedentary activities. As you might guess, watching television is the most prevalent sedentary activity among older adults. Research shows that nearly 90 percent of older adults in the United States watch television on a given day, and they do this for an average of nearly 5 hours daily. Maybe television isn’t such a lure for you, but perhaps computer time or some other sedentary activity is. Regardless, it’s important to get up and get moving frequently throughout the day to the best of your ability. For ideas on how to reduce sedentary time, see Box 1-5, “Ideas to Sit Less.”

Eating for Activity

Without the proper fuel, it’s difficult to be physically active. You wouldn’t expect your car to run on an empty tank or the wrong kind of fuel. Nor should you expect your body to have energy for activity if you don’t supply it with nutrient-rich foods. A single food won’t make or break your health and energy level; rather, it’s your overall pattern of eating, day in and day out, that has the biggest impact.

There are several models of healthy eating that can help guide your food choices and keep you nourished and energized. Two excellent models are Tufts’ MyPlate for Older Adults (see Box 1-6, “Tufts MyPlate for Older Adults,” on page 10), developed by nutrition scientists at Tufts’ Human Nutrition Research Center on Aging (HNRCA), based on the federal government’s MyPlate guide, and the Mediterranean-style diet.

Tufts’ Myplate for Older Adults

As you age, the number of calories you need tends to decline but vitamin and mineral needs do not and absorption of nutrients in the digestive tract is not as efficient, thus increasing requirements for certain nutrients. For example, requirements for vitamin B6 are higher in adults over age 50, and calcium and vitamin D requirements are higher in adults older than age 70 compared to younger adults. Additionally, risk of vitamin B12 deficiency increases with age due to impaired absorption.

In order to meet your nutritional needs but remain within your calorie limit, you should focus on eating the most nutrient-rich foods you can. Tufts’ MyPlate for Older Adults, updated in 2016 with support from the AARP Foundation, provides a simple guide to help you do that. It encourages you to choose from several different categories of foods at meals, which can help you take in a broader variety of vitamins, minerals, and other nutrients. Here’s an explanation of the different parts of the MyPlate graphic.

➧ Vegetables and fruits add color to your plate and are rich in vitamins, minerals, antioxidants, and other beneficial plant components that support health and activity. Such foods should make up half of your meals. Choosing an assortment of colorful produce, such as dark green, red, and orange, helps you get a wider array of nutrients. Frozen and canned produce can help stretch your budget, can be easier to prepare, and are good options when specific fresh fruits and vegetables are out-of-season. Opt for plain packaged produce that is low in sodium and packed in water or its own juices rather than salty sauces and sugary syrups, when possible. Use herbs and spices to add flavor to produce and other foods.

➧ Whole grains should make up one-fourth of your plate and include foods such as whole wheat bread, brown rice, barley, rye crackers, and oatmeal. They supply complex carbohydrates to help fuel your muscles, B vitamins to support metabolism, and fiber to help keep your digestive tract running smoothly. Smaller amounts of fortified refined grains, such as unsweetened fortified breakfast cereal, also can be included.

➧ Protein-rich foods also should make up one-fourth of your plate and include foods such as fish, chicken, turkey, eggs, lean red meat, legumes (beans), natural (unsweetened) nut butter, tofu, and dairy products, such as low-fat Greek yogurt and reduced-fat cheese.

➧ Plant-based oils, such as extra virgin olive oil, and soft spreads are shown in the center of the graphic and can be used in small amounts. They provide essential fatty acids (needed in small amounts) and some fat-soluble vitamins.

➧ Hydrating beverages are pictured above the plate to remind you to include these throughout the day. Top choices are water, tea, and low-fat (one percent) milk. You can include small amounts of coffee and 100-percent fruit juice, if desired. Soup also makes a substantial contribution to your fluid intake.

➧ Physical activity icons appear below the plate graphic because it also is important for good health and can help improve quality of life. Stay active by regularly walking, riding a bicycle, swimming, or doing other physical activities you enjoy.

Mediterranean-Style Eating Patterns

The Mediterranean-style diet is well-known for its healthfulness and features foods grown in countries surrounding the Mediterranean Sea—but they’re generally available at your local supermarket, too. A Mediterranean-style eating pattern is similar to MyPlate and focuses on vegetables, fruits, whole grains, legumes, seafood, herbs, spices, nuts, and healthy fats, while minimizing red meat and sweets. Some key ways to eat Mediterranean-style include:

➧ Favor whole and minimally processed foods, rather than foods in boxes or cans with a long list of additives. For example, instead of a snack of potato chips and sour cream dip, blend some garbanzo beans with olive oil, lemon juice, garlic, and spices to make a hummus dip for fresh vegetables. Instead of buying a boxed meal helper, stock your pantry with whole grain pasta in a variety of shapes and canned crushed tomatoes to use as the base for hearty entrees.

➧ Eat plenty of vegetables. Try to fill half of your plate with vegetables at lunch and dinner. For example, cut some vegetables, such as bell peppers, zucchini, and onions, into bite-size pieces, toss them with olive oil and herbs, and roast them in a 350ºF oven for 20 to 25 minutes or until tender, turning them halfway through the cooking time. Or simply cut up some vegetables for a salad and drizzle extra virgin olive oil and vinegar over them. Soups, stews, and vegetable pizza are other popular ways to enjoy vegetables.

➧ Cook more whole grains, including intact whole grains that haven’t been crushed or ground into flour. For example, try cooking whole kernels (berries) of farro (an ancient form of wheat), barley, or brown rice. Whole grains take longer to cook than refined varieties, so make extra and store them in your refrigerator to use throughout the week as the base for salads, soups, side dishes, and hot cereal.

➧ Minimize meat and eat more seafood. Rather than thinking of meat as the focal point of meals, treat it as a side dish or flavoring agent. For example, make barley soup with small pieces of leftover roast beef or top your salad with two ounces of chopped, grilled chicken. Eat seafood rich in omega-3 fats, such as salmon, sardines, and herring, at least twice a week. At least once a week, enjoy a completely meatless meal made of whole grains, vegetables, and legumes.

➧ Include dairy products for calcium and vitamin D (if fortified). Creamy nonfat, plain Greek yogurt is an easy, tasty snack when topped with berries and honey, or it can be swapped for mayonnaise in salads. Low-fat kefir (a fermented milk beverage) makes a great base for smoothies.

➧ Use healthy fats in cooking and salad dressing, especially extra virgin olive oil, which is naturally rich in heart-healthy antioxidants. Flavor salads and side dishes with small amounts of foods rich in healthful fats, including nuts, seeds, and chopped avocado.

➧ Eat fruit for dessert. For example, slice seedless grapes in half, cut up a honeydew melon, and toss the pieces with fresh-squeezed lime juice, honey, and fresh mint. Or, section a mandarin orange and toss the segments with pomegranate seeds (arils). Save rich sweets, such as cookies and cake, for special occasions.

➧ Enjoy wine, if desired, in moderation (up to one 5-ounce glass per day for women and two glasses per day for men) with meals.

Healthy Lifestyle Synergy

When you adopt regular exercise and a healthy eating pattern to fuel physical activity and support body structures, great things start happening inside your body. Some of the immediate physical benefits can include better blood sugar control and improved sleep. There can be immediate mental health benefits, too: Physical activity can help you relax, lift your mood, and reduce stress and anxiety. Studies also suggest a single session of aerobic exercise may produce short-term improvements in memory, attention, and reaction time.

Over the long-term, the payoffs grow. Your body’s ability to transport and use oxygen improves and that translates to better cardiovascular health and less fatigue. Body composition also improves. Body fat decreases, including harmful abdominal fat, and muscles grow stronger (see Box 1-7, “Exercise Helps Retain Muscle,” on page 12). Stronger muscles mean it’s easier to carry a heavy suitcase or climb a set of stairs. Exercise and good nutrition support improved bone mineral density, too, so you’re at less risk of breaking or fracturing a bone. Additionally, the stronger body that results from regular exercise helps you maintain independence as you get older, preserves flexibility, promotes balance, and reduces risk of falls.

Studies also suggest good nutrition and regular physical activity can help keep your brain functioning at its best. For example, certain nutrients, such as omega-3 fats and vitamins B6, B12, and folate play specific roles in keeping your mind sharp. Regular physical activity also may help postpone the decline in your ability to think quickly and may help improve reaction time. Additionally, exercise may aid your ability to shift quickly between activities and plan and organize tasks, such as going to the grocery store or cooking dinner. Some studies also suggest regular exercise may help reduce risk for Alzheimer’s disease. Studies in animals have found that exercise increases the number of small blood vessels that supply blood and nourishment to the brain, in addition to increasing the number of connections between nerve cells. Even if you’re starting to show early signs of memory loss, exercise may still help (see Box 1-8, “Improving Fitness May Help Protect Brain”).

Your Amazing Body

You may be wondering if it’s too late for you to start exercising and eat better. No matter your age, the answer is an absolute “No!”—it’s not too late. Studies show there is no age above which physical activity and good nutrition don’t have benefits in reducing disease risk or managing disease and disability. No matter how old you are, how inactive you’ve been, or what dietary indiscretions you may have committed, a healthy lifestyle can have a positive impact (see Box 1-9, “The Impact of Exercise,” on page 14). Given nutritious fuel and regular physical activity, your body can take you places you might not have imagined. Your potential is so much greater than you might think, and the aim of this report is to help you discover it.