LiveLongAgeWell

This article is dedicated to the many people who seem to get enough aerobic exercise, and eat a reasonable diet, but still have problems with excess fat. It will give you something else that might help your situation; something basic and super simple…

Have you observed that as far as general activity level is concerned, people tend to fall into one of two big categories: the people who tend to be “couch potatoes”, and those who are constantly moving? The first group just doesn’t seem to want to move much. They would rather wait for the elevator than take the stairs, even for one floor, and if they are sitting watching TV or at the computer, rather than jumping up and getting something they need from another room, they will call for help or at least just sit and wait until they have more motivation to actually get up and move.

Now the other group, we might call the “movers” or maybe “people who putter”, seem to be constantly moving, almost in a nervous way. But take a look at the body shapes of these two groups, and you might notice a pattern—the movers tend to be a lot trimmer than the people who don’t like to move. It makes a lot of sense, and now we have good scientific evidence that the movers are both thinner and healthier than the sedate group, but the reasons for this are a lot more complex than what you might think.

Studies comparing people in occupations requiring lots of sitting (such as bus drivers) with those who stand much of the day (for example train conductors), have shown a much higher rate of cardiovascular disease and fatal heart attack in those who sit most of the day.  Experimental studies have recently demonstrated that sitting a lot, even a few hours straight, lowers the activity of the enzyme lipoprotein lipase, which normally works to decrease the fat content in your blood. So even a few hours of sitting seems to alter your very fat metabolism.

A study of otherwise healthy men who became incapacitated and confined to bed rest showed that three weeks of bed rest had a bigger negative impact on their physical work capacity than 30 years of aging. Scientists (“inactivity physiologists”) are now more closely studying the physical changes during our “inactive” periods, but while we await more research, it seems clear that people who sit too much during the day face a host of problems, and to cut your risk of obesity, diabetes, and of heart attack, you need to, basically, “get off your butt” and move around more. For some people, even a good program of  regular aerobic exercise, combined with a reasonable diet, may not be enough to keep your weight under control if you sit much of the day.

•    Avoid sitting too long. You are at higher risk of serious metabolic problems if you spend hours watching TV or sitting in front of the computer at work or during your free time. As much as you can, just get up and walk or move around, if only for a minute or two at a time, that’s fine. If you can’t get up, at least shift in your chair regularly, and maybe shake/stretch your arms and legs occasionally. Try to change your mindset so that when you need something from another room, you see that as a good thing, not an irritation.

•    If you like video games, consider as an alternative to the standard (sitting) game something more active like the Nintendo Wii, which will get you up and moving, and allows you to play too. It’s great for both your body and your mind.

•    People who sit for long periods, for example on an airplane, suffer a higher risk of DVT or “deep vein thrombosis” a potentially life-threatening condition in which the blood stagnates in the deep veins in your legs to the point that a clot forms which breaks off and travels through to your lungs. Basic prevention involves getting up and moving around the plane occasionally, and flexing your calf muscles while seated to get the blood moving in your legs. Drinking water also helps to keep your blood from getting too thick and prone to clotting.

You may think that getting older means becoming less happy, but various studies, including this new one just released at the American Psychological Association (APA) meeting in Toronto, show just the opposite: most people actually become happier as they get older. Good news, especially as the fastest growing population segment—in the U.S. at least—is people over age 85.

This APA study from the University of California found two exceptions to the older=happier correlation. First are people dealing with dementia, and second are people stuck in a long-term stressful situation without escape, for example, a debilitating chronic disease.

Most of us, however, can look forward to greater happiness as we get older. The researchers felt that a main reason for that is that over time, we learn from experience what makes us stressed or unhappy, and we become better at avoiding or just ignoring those people or situations.

More from the APA Meeting

Two other interesting presentations at the APA …One a large Swedish study demonstrating that those adults who have a “strong social network” were 60% less likely to become demented over time.

The second one sounds obvious, yet is something frequently ignored—that many people who seem to be getting mentally slower are really not; it’s just that their hearing has slowly dropped, making them seem dim-witted. Be aware that many older folks are embarrassed to admit a hearing problem, so keep this in mind regarding your own family. If you notice someone losing sharpness over time, one of the first things to test is hearing.

“Sham” Vertebral Procedure and the Placebo Effect

The best possible research study is a “double-blind clinical trial”, and a typical trial like this involves splitting up a group of people into two equal groups, and giving one group an active drug, and the other group an inactive drug (placebo) and then comparing the outcome of the two groups over time. Unfortunately, since these studies are expensive and time-consuming, a majority of research studies are not true clinical trials, and surgical clinical trials involving placebo, or “sham” surgery, is exceedingly rare.

Sham surgery is complex in many ways; you can imagine trying to convince one half of a study group that they really had surgery, when in fact they had nothing more than an incision made, or an anesthetic shot given, rather than a full operation.

So I can’t recall the last time I read about a sham surgery clinical trial, but one was just completed by a team from Australia, Britain, and the U.S. The goal was to learn if vertebroplasty, a common back procedure (to decrease pain in vertebral fracture patients) was actually effective, or the improvement seen was just a placebo effect.

The researchers performed the full procedure on one half of the patients, involving an anesthetic shot and injecting bone cement into the fractured vertebra. The 50% of patients who had the sham procedure had the anesthetic shot but no cement was placed. To add realism to the sham group, the doctors had the cement in the room to give the same smell sensation as the real procedure.

The result was that the sham surgery group did just as well, with just as much improvement, as the ones who had the full procedure. For more details, look at this full summary in the New York Times. And if you have doubts about the efficacy of a procedure or operation your doctor suggests, you might ask “what clinical trials have been done, if any, to show this procedure is effective?” Your doc will be surprised, but should be able to answer.

Finally….it seems a number of research papers in the past decade have been “ghostwritten” by medical marketing companies rather than doctors. (This is probably no surprise to most doctors, but I suspect it might be for the general public.) In these cases the drug company hires a marketing company to write a paper with a positive spin on whatever they are selling or wanting to sell. Note that if the research did not turn out in their favor, they just wouldn’t publish it.

After the marketing writer finishes his favorable report, the doctor(s) may just look the paper over and make a few changes, but often the report is tailor-made to suit the drug company. Amazing how medicine has changed over the years, and how doctors can be bought off. Supposedly this practice, now exposed, will stop, but I doubt it.

Artificial Tanning Beds

Last month I covered sunscreens and sunless tanning lotions, and as a follow-up, there was a recent reclassification by the International Agency for Research on Cancer (IARC) that tanning beds should be raised to Group 1, that is, the highest risk level: “carcinogenic to humans”. While the artificial tanning bed industry has marketed their products as safer than the ultraviolet radiation from sunlight—and as not increasing the risk of melanoma (though they neglect to mention the increased risk of other forms of skin cancer)—the IARC reports a 75% greater risk of melanomas in people who start using tanning beds before the age of 30. Besides the cancer risks, while a tan might make you look better in the short run, in the long run you will end up more wrinkled. And though artificial tanning booths are dangerous, remember that sunless tanning lotions can be quite effective and safe.

Organic Food Not Worthwhile?

A headline from Reuters London caught my eye last week: “Organic food no healthier, study finds”. The author of the English study stated: “Our review indicates that there is currently no evidence to support the selection of organically over conventionally produced foods on the basis of nutritional superiority [italics mine].”  (Really, OK, maybe not proof, but no evidence at all?)

So a quick read might lead you to think it’s not worth the extra expense and trouble to seek out organic products. But this would be a false conclusion on at least two counts. First, the study only analyzed “nutritional content”; this is, what’s in the food, but most people choose organics because what’s NOT in them; i.e., pesticides and other organo-toxins (not addressed in this research). Second, if you look at what they consider “nutritional content”, you find they did not analyze antioxidant content, which is another reason to choose organic. While it’s true that there is not yet proof organics have a higher natural antioxidant content; for me, I’ll stick to organic products whenever I can. Unlikely any future research will find any health benefit whatsoever from eating foods with pesticides. It’s far more likely organic foods suffer less antioxidant loss during any processing, transport, and chemical additions.

Another Reason To Keep Your Cholesterol Below 200

If you know that your total cholesterol level is borderline or elevated, and you haven’t taken measures to change that, here’s another reason to take action. Published in the August Dementia and Geriatric Cognitive Disorders, researchers studied nearly 10,000 Northern California Kaiser Hospital members, and found that those who had total serum cholesterol levels over 200 mg/dL in their 40s, had a significantly great risk of dementia when they reached their 60s and 70s. The risk for either Alzheimer’s disease or vascular dementia was at least 50% percent greater in people with only mildly high levels—over 200. So take measures to keep your cholesterol in the normal range: whether it means a change in your diet and/or increased exercise, and if that doesn’t work, you should ask your doctor about possibly taking a “statin” drug to lower your lipid levels  (which—as logically follows from this study—have been shown may help prevent dementia.)

The H1N1 (swine) flu pandemic is dangerous, yes, but also fascinating as a study of how different countries are responding and how theories change quickly. Here in Brazil, where it is winter and prime flu season, the massive city São Paulo has pretty much closed down all schools for the next two weeks, affecting over 6 million students. And just a few weeks ago, public health officials were theorizing that obesity alone appeared to be a major risk factor for developing a serious case, or of dying of the influenza.

Many of the people with H1N1 in ICUs seem to be obese, and the United States—with the epidemic of obesity affecting, amazingly, about 34 percent of the population—has had a much higher death rate than Japan, for example, with less than 2% of the population obese.

Now, the U.S. Center for Disease Control has decided that obesity, on its own, doesn’t seem to be a risk factor. Still it’s worth remembering that fat cells, especially those deep in the abdomen, secrete substances that cause a chronic state of low-level of inflammation in the body, and as a result, obesity depresses your immune system making you more susceptible to most any infection, or even cancer.

So if you are living in the summer now but have worries about flu in the upcoming seasons, you would do well to get yourself in shape and try to lose as much fat as possible to keep your immune system functioning well. If you smoke, have a plan to quit before the fall. Besides that, you can markedly cut your risk of flu by three simple measures: keeping at least a meter (3 feet) away from anyone sick, washing your hands multiple times during the day (especially after you touch surfaces in public areas), and avoid touching your nose, eyes, or mouth, because that’s how you infect yourself.

Know that these influenza viruses, fortunately, don’t penetrate through your skin, and if you remember to always wash your hands well before touching your face, you are much less likely to become infected.

OK, now another way to keep healthy and fit—eat your “greens”…Here is Part II, How to eat greens! (last week was background information):

•    When you try greens and don’t love the taste right away, consider that kale, the king of the greens, contains about 10 times more of that fantastic anti-oxidant lutein as does broccoli. The high fiber content in greens will help you control your weight, your cholesterol, as well as your blood sugar. If you have a family history or particular concerns with breast, ovarian, or colon cancer, you should eat some greens every day. If you smoke, daily greens might give you some protection from the carcinogens in cigarettes. So these truly are superstar vegetables, and you can develop a taste for them.

•    Kale is probably the healthiest of the bunch, but collards are excellent as well, and the flavor tends to be a bit smoother. The plants harvested during cooler weather may taste better, and look for smaller leaves. Spinach is a green, and a good way to start, but you should venture forth and experiment with the more potent ones. You might slowly add bits of raw kale into your daily salad, or add finely-cut collards to soup. Kale comes in different colors and varieties. Mustard greens have somewhat of a spicy, racy taste. Over a few months try them all and see which you like the best.

•    When preparing, cut out any tough stems, and to make life easy, try frozen greens or find bags of pre-washed, cut greens. You can lightly sauté them in olive oil, and try adding lemon, pine nuts, and some red pepper flakes. Look at the DDD appendix for more hints on finding recipes. One note for those on blood thinning medication: the high vitamin K content in greens could interfere with your medication, but rather than avoiding greens, research suggests greens might help protect you from the bone-thinning effects of those medications, so discuss with your physician.