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The Wellness Blueprint: With Dr. Caleb Davis
Welcome to The Wellness Blueprint with Dr. Caleb Davis, where we uncover the secrets to living a long, active, and pain-free life. Hosted by Dr. Caleb Davis, an orthopedic surgeon and fitness enthusiast, this podcast is your ultimate guide to musculoskeletal health, injury prevention, and wellness.
Dr. Davis combines his expertise as a shoulder and elbow specialist with a passion for empowering people to take charge of their health. From deep dives into cutting-edge restorative medicine to practical tips on avoiding surgery and optimizing recovery, The Wellness Blueprint offers valuable insights for anyone seeking to preserve their body and thrive at every stage of life.
Join us each week for professional guidance, fascinating medical discussions, and actionable strategies that help you move better, feel stronger, and stay functional for years to come. Whether you're an athlete, a weekend warrior, or someone looking to age gracefully, The Wellness Blueprint provides the tools to design a healthier you.
The Wellness Blueprint: With Dr. Caleb Davis
Episode 11: "Squat Strong, Live Long: The Science of Strength Training for Healthy Aging"
Can maintaining your muscle mass truly be the fountain of youth? Join Dr. Caleb Davis and Nicole Davis in an eye-opening episode of the Wellness Blueprint as we unravel the mystery of sarcopenia—a condition not just impacting the elderly but creeping into the lives of those in their 30s and 40s. Discover how strength training, essential for both genders and all ages, can be your key to preserving vitality. Delve into the intricate world of muscle fibers and learn how their decline affects your ability to maintain overall functionality.
We also shed light on the surprising connection between grip strength and longevity, offering insights into how this simple measure can be a window into your overall health. Understand the role of physical activity in preserving muscle mass, reducing fall risk, and extending quality of life. From the importance of walking speed to the impact of group activities like swim classes, we reveal practical ways to enhance your healthspan and stave off degenerative diseases. With guidance on nutrition, including the benefits of whole foods, protein intake, and select supplements, this episode is packed with actionable insights.
Lastly, we tackle the societal attitudes towards aging, emphasizing the critical importance of cognitive health and proactive health management. Explore intriguing assessments like the sit rise test and the single leg balance test, and learn how they can predict longevity and vitality. Wrapped with humor and wisdom, our conversation offers a fresh perspective on how cultural values shape our approach to aging and retirement. Don't miss out on expert tips and lighthearted anecdotes designed to inspire you to take charge of your health and lead a vibrant, active life.
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Hey everybody and welcome back to the Wellness Blueprint with Dr Caleb Davis. I'm your host, dr Caleb Davis, and today I'm joined again by Nicole Davis, my very favorite co-host, nicole, thanks for coming back.
Speaker 1:Yeah, thanks for having me, Dr Big Guy.
Speaker 2:Today, we're going to be talking about a topic called sarcopenia.
Speaker 1:I'm sorry, is that a Greek mythology creature?
Speaker 2:No, it's not any kind of monster lurking under your bed, although it might be a little bit more scarier than that. It's actually where people start to have a reduction in their muscle mass. That may seem like something a gym bro might worry about, but it's actually quite serious. Sarcopenia comes from the word sarcomere, which is the functional unit behind a muscle fiber, and penia denotes loss of something like osteopenia would be loss of bone. So we are starting to see a trend in loss of muscle mass and strength that people are able to produce as they get older. But we're actually starting to see it in younger patients too. It's been documented in people in their 30s and 40s as well. So this is not just something that grandma and grandpa are getting.
Speaker 1:Well, you don't have that problem, Dr. Big Guy.
Speaker 2:Thanks, Nicole, I appreciate that. You're always my biggest fan. But the reason I want to talk about today is because I think there's a cultural disconnect in thinking about the importance of muscle mass and I wanted to clear that up today and talk about how important it is for men and women of all ages to be doing strength training and all the benefits that come with it Along the way. We're going to talk about some tests that you can take to see where your strength may be and where your functional status may be and what that might indicate.
Speaker 2:So when talking about sarcopenia, we discuss the progressive loss of muscle mass, strength and function. This typically occurs with aging, but there's a lot of different things that can contribute. The number one thing that we think about when we're talking about sarcopenia is frailty, the decreased ability to perform daily functions and a higher risk of falls causing disability and mortality in older adults. I'm going to use the word mortality quite a bit in this episode, so that all I mean by that is death, Quite frankly, death. So we define sarcopenia as muscle mass loss, mostly type 2 muscle fibers, which are explosive, fast twitch, reactive muscle fibers.
Speaker 1:Okay, I think I'm going to need you to break that down, because I don't really know when I'm using those.
Speaker 2:Think about if you have to get up and run suddenly or do something with quite a bit of force all at once.
Speaker 1:Think of a giant bear chasing me.
Speaker 2:And you have to get up and run quick. Those are fast twitch fibers. Think of slow twitch fibers more as endurance based, so just muscles that let you walk for a sustained period of time. That would be more slow twitch. So the fast twitch fibers are muscles that are going to be producing a lot of force, rapidly and quickly. So, as you can imagine losing those, preferentially you can get up and walk, but now you're not going to lift up heavy objects or run and sprint and things like that.
Speaker 1:So not only are you more in danger of mortality just by losing those, but also you can't outrun a bear.
Speaker 2:Are you finding that you have to outrun a bear a lot?
Speaker 1:I mean, I don't know, there's that whole debate with women. Would you rather run into a bear or a dude in a forest?
Speaker 2:But either way you're running.
Speaker 1:Yeah, pretty much Okay.
Speaker 2:That's another reason for women to start focusing on strength training, so they don't have to do with sarcopenia, because no matter what they run into, they'll be able to run away.
Speaker 1:There you go.
Speaker 2:I like the way you think it's not just a loss of muscle mass, though. Even before the muscle starts to lose mass, you actually start losing strength before that even happens, and grip strength is often one of the tools that we use to diagnose sarcopenia. If you have a less than expected grip strength meaning how much force you can apply via your fist just by squeezing as hard as possible that's one of the diagnostic criteria. We also see impaired muscle function, like reduced mobility, meaning you aren't as flexible anymore, you lose balance and you lose endurance. So these are all hallmarks of sarcopenia. So what kind of things contribute to sarcopenia? One of the big things that we see is, in men specifically, we see a pretty sharp decline in testosterone. I think, just like in women, that they have menopause and they start losing their estrogen, which leads to osteoporosis. Men have a sharp decline in testosterone and they start to lose their muscle mass.
Speaker 1:Do you guys call it testopause?
Speaker 2:No, but maybe that could be a thing.
Speaker 1:Yeah, I mean, why don't you?
Speaker 2:Why do?
Speaker 1:we have our own term for females.
Speaker 2:I think it's because it's such a marked drop-off for women and it's pretty predictable too. It's very often in a very similar age range for women and the effects that are seen on your organ systems are pretty dramatic. With men. It's a little bit unpredictable and it's not such a sharp decline. It's more of a steady decline over time. Some people also have posited that chronic inflammation may be contributing to sarcopenia as well. We've talked a lot about inflammation on this podcast, and if you have low-grade chronic inflammation from lifestyle, diet choices, sleep habits that may also be contributing to sarcopenia, maybe even early in life. Sedentary lifestyle, which we've also discussed, will also contribute to this. If you're not losing the muscle, they tend to atrophy without stimulation. And then there's nutritional deficiencies. Having inadequate protein intake and vitamin D deficiencies have all been linked to increased muscle loss.
Speaker 1:Okay, yeah, but why don't you put this to bed for us, Dr Big Guy? How much protein do you think the average person should have throughout the day?
Speaker 2:There's a lot of debate on this and I tell people one and a half grams per kilogram of body weight.
Speaker 1:I guess we'll have to talk on a future episode about the difference between protein, carbs, fats and what their purposes are.
Speaker 2:We could do a whole episode on macronutrients and ratios.
Speaker 2:The thing that's so tricky about this topic is that everyone's got an opinion and they're all different opinions, so giving somebody a recommendation for how much protein they should eat is a difficult one.
Speaker 2:I would say that the one and a half grams per kilogram is probably a pretty good place to start, but if you find that it's easy to get there, that you would probably actually benefit from having even more than that. Protein tends to be one of the most satiating macronutrients that you can eat, meaning when you eat meals higher in protein and you eat the protein first, you tend to become more full more quickly and not want to eat starches and carbohydrates, and there's usually more of a thermic effect, meaning you actually increase your metabolism by consuming more protein. So in general, most Americans need more protein in their diet. So we talked about grip strength as a measuring unit. The reason grip strength is so easy is because a lot of physical therapists or doctor's offices may keep a grip strength tester in their office. Most people aren't going to have one lying around their house, but it's pretty easy to get if you're concerned that you might be suffering from sarcopenia.
Speaker 1:All right, but for those of us who don't have a grip strength thing lying around, and we just want to know real fast how we can test our grip strengths.
Speaker 2:Are you like trying to open up jars of jelly or are you trying to lift something? What do you think? I think lifting something heavy would be probably the best. If you know how much an item weighs, then if you can lift it up and then hold it, you're able to produce that much grip strength where you actually have, like you have to grip it rather than lifting with your arms, obviously so something that you could let hang but hold on with your hand.
Speaker 1:So like a dumbbell.
Speaker 2:Well, a dumbbell would be super easy. Yeah, that would be a super easy way to test.
Speaker 1:Kettlebell, maybe, mm-hmm, yeah, maybe a suitcase.
Speaker 2:Yeah, if you know how much the suitcase weighs.
Speaker 1:Yeah, you hold it by the handle.
Speaker 2:If you have a hard time lifting a 50-pound suitcase. Again, again, a lot of the numbers are in kilograms because doctors like to be fancy and use the metric system. So, men, you're expected to be able to produce 27 kilograms of force, and women is 16 kilograms of force 16 kilograms is what like 35 pounds? So 16 times 2.2 is 35 pounds. I think you said that.
Speaker 2:I did 27 kilograms for men, roughly 60 pounds. If you're not able to create a grip strength of 60 pounds, then you may be in the sarcopenia territory as a male and more like 35 for females. If you're elderly and you think you have a really weak grip and you're going to test your grip strength and say, okay, this is a really low grip strength, maybe that can be a wake-up call. Hey, maybe if you're younger and you have a really weak grip strength, that could be a wake-up call to you. I really weak grip strength. That could be a wake-up call to you. I'm not telling everyone that they need to go and get a grip strength tester. What I want to tell people is that if you have a weak grip, it actually predicts that you have a higher chance of mortality and not living as long. The theme that I'm building on here is that strength in general gives you a better chance of living. Now here's the funny thing. Do you think if you got a grip strength trainer on Amazon where you just squeeze something?
Speaker 1:Yeah, I used to have them to train my fingers back when I thought that my fingers had muscles in them which apparently they don't. They don't.
Speaker 2:Not in the fingers themselves. But do you think, just trading your grip over and over, if you just sat on a couch and did nothing but grip strength training and you developed these massive forms, do you think that would increase your lifespan?
Speaker 1:I'm going to guess no, just by the way you're phrasing that.
Speaker 2:Well, I'm going to guess. No too, I don't have an answer. But it's funny the way science works. You can study a question and in this study they looked at over 2 million people. They measured their grip strengths and higher grip strengths demonstrated a longer lifespan. So it's just an association. Is it causative? Not sure. My guess is that just training your grip strength to become stronger would not make you live longer. People who have grown stronger grip strength are generally more physically active and engage in physically demanding tasks, and that gives them stronger grip strength. I don't think the grip strength alone makes them live longer.
Speaker 1:Well, I know from personal experience like rock climbing requires a whole lot of body strength to be able to do that. You have to be able to use your legs to force yourself up the wall. So I can see that.
Speaker 2:Yeah, that's exactly the point. We also see a decrease in general walking speed. We talk about what is your average walking speed. If you were to go walk a block down the sidewalk, what is the average rate of speed? Speed if you were to go walk a block down the sidewalk. What is the average rate of speed?
Speaker 2:It's if you're less than a meter per second, you may be in that territory of sarcopenia. It may be an indicator that you're losing some functional capacity and muscle mass and muscle functionality. And then there's a number of different physical performance tests that have different scoring systems and we're going to get all into that stuff in this episode. That may be an indicator of how much strength and functional capacity that you have. It's estimated that up to 10 to 20% of adults older than 60 may have sarcopenia, and it's estimated that up to 50% of those who are over 80 have sarcopenia. Men tend to lose muscle mass more rapidly than women, but they may have a compensatory mechanism since they have more at baseline. So, if you think about it, they've got more in the bank to lose, but they do lose it faster once they start losing their testosterone.
Speaker 1:That was a really fancy statement. You just said compensatory mechanism Also could be a cool band name maybe. Yeah, yeah, let's shelve that. That'd be like a nerd rock band. Yeah, eric would love that.
Speaker 2:Yeah, all I'm saying is men have more muscle mass to lose, so even though they're losing it faster, it may take longer for them to reach that sarcopenia level than a female of the equivalent age. As an orthopedic surgeon, I take care of a lot of people who fall and unfortunately I see it all the time. So people are at a higher risk of falling when they're sarcopenic. They have reduced muscle strength. Their core muscles, their trunk muscles, legs, glutes, the muscles of the bottom, hamstrings, quadriceps, abs all these things are weaker and that gives them poor balance issues and less strength and they're not able to catch themselves and they tend to fall. That, in combination with osteoporosis meaning poor quality of the bone can have devastating effects. I was on call this weekend and I fixed four hip fractures this weekend. Very, very common Sarcopenia has also been independently linked to having a higher risk of all-cause mortality, meaning if you have sarcopenia, you just have a higher chance of dying for any reason.
Speaker 1:Like any reason.
Speaker 2:When they say all-cause mortality, it's just that you're going to have a higher chance of dying from a heart attack, from lung disease. If you have sarcopenia, you have just a higher chance of dying.
Speaker 1:Okay, Because I mean, if I took that statement to its full end, I could say if you have sarcopenia, then you're more likely to have a grand piano dropped on your head.
Speaker 2:Yeah, that's not really in the list of all-cause mortality typically, but I guess accidental trauma in the list of all-cause mortality typically. But I guess accidental trauma let's say, if you had a grand piano dropped on your head and you had sarcopenia, and I had a grand piano dropped on my head and I don't have sarcopenia, I would still have a better chance of surviving than you with sarcopenia. Okay, it still checks out, even with your pianos falling from the sky randomly. It also just leads to a reduced quality of life. You have a harder time taking care of yourself. You're not able to do things that you once enjoyed doing If you like to play golf or racquetball or pickleball, if you like playing pickleball with your friends and you're not able to maintain endurance anymore and you aren't able to balance anymore and you're afraid that you're going to fall and break a bone. You're not having these social events with people you used to enjoy and that can really reduce your quality of life.
Speaker 1:You can't pick up your grandbabies as often. You can't make it easily down the stairs so that you can get into your car. Getting in and out of your car seems to be a struggle for some elderly people.
Speaker 2:The one you said about picking up your grandchildren is a big one. I have patients complain all the time that they have a hard time taking care of their grandchildren and that they really want to Let that they have a hard time taking care of their grandchildren and that they really want to. Let's talk about some things that we can do to prevent this sarcopenia. Hopefully I've established that it's really important and it's something that we should all take seriously. Now, nicole, I don't know. You tell me it's something that I think about all the time. I think about all the time my patient's bone quality and muscle quality. Is this something that you would think about in your everyday life?
Speaker 1:the importance of muscle mass think about in your everyday life, the importance of muscle mass. No, no, definitely not. I mean, I try to think about it in terms of motivating myself to work out. I'm definitely not thinking about the average person's muscle mass or whatever.
Speaker 2:Okay, well, tell me this then, just in the few minutes that we've been talking about this do you take this seriously or do you think nah, this is something I'll worry about in 30 years.
Speaker 1:I've seen, I've spent a fair amount of time around people 30 plus years older than me. We're talking 65 plus.
Speaker 2:Nicole's 35.
Speaker 1:Okay, thanks, yeah, yeah, just for reference, I definitely see a market decline and what they're able to do. And even people who do try to attempt to keep their health a very important part of their lives. It seems like they inevitably decline despite their best efforts, and for those who have not attempted to keep their health in very serious ways, they are just rapidly declining. It's clear to me that you got to set yourself up for success. So if you want to be able to live healthier, longer lives, then you need to put in the effort now, because when things inevitably start to fall apart, you're going to have a better chance of not being as in a horrible dire straits if you put that effort in when you were 20, 30, 40, 50.
Speaker 2:I think you nailed it and I think rapid decline is what I'd focus on if I were talking to general people, where you can just hit a cliff and then people fall off that cliff, metaphorically speaking, and they're never expecting it. They thought they were healthy and functional and then they're not anymore and I'm really becoming more attracted. You want it in the bank so that when inevitably things start to decline, you have a slower fall because you have saved up by doing preventative things when you're younger.
Speaker 1:Yeah, that's a good analogy.
Speaker 2:It takes a lot of foresight. I think a lot of young people will just write this off because they don't take it seriously and because they don't spend time around elderly people like I do Sort of like not putting money in towards your retirement account.
Speaker 2:I think, pretty much right Not funding your IRA and your 401k and letting future self worry about that later on. We do that with our health, too. We take our health for granted and never think we're going to have problems. I am fortunate enough that I get to see it all the time, so it's something that I think about all the time that was kind of a strange strange you're fortunate that you get to see it all the time.
Speaker 2:Well, I'm fortunate because it gives me perspective. It's something that I think about all the time for myself, because I see it so in that way. Yes, I am fortunate. I have a glimpse into the future that a lot of people probably don't get. So I do think of that as fortunate, and I love to care for my patients, even though they are having all these problems. It's a privilege to be able to take care of them. I count myself very fortunate. So what are things that we can do to prevent sarcopenia, since this is this big, scary thing that's going to get us all? Yeah, like the minotaur or the bear, I would say, strength training. Okay, I think this is where this generational divide comes in. Think about 60 to 70 year old women.
Speaker 1:They're afraid that young women lift weights because you're going to look like a man.
Speaker 2:That's one you hear a lot and I think, thank God, we're getting more and more away from that. In the younger generations they understand that women lifting weights is not only perfectly fine, it's actually optimal and healthy for them, and maybe we'll see less sarcopenia and osteoporosis in the future because of this. But it's hard to say. We have so many chronic health problems now, even as young people. But this, but it's hard to say. We have so many chronic health problems now, even as young people. But maybe this is one of those trends that may improve over time with cultural shifts. But that's one of the things you hear is don't lift weights as a woman, you'll become bulky and manly and you'll have all these big muscles, and nothing can be further from the truth. For one thing, if you see a female bodybuilder who looks quote unquote masculine, that's because generally they're enhancing with artificial steroids and performance enhancing drugs to get that look, or they're working hours and hours a day.
Speaker 2:Yes, that's something I wish I could explain to people. I've been lifting weights consistently and vigorously since I was 18 years old. I'm 35 now as well, although I'm younger than Nicole by two months, and it has taken years and years of discipline, training, and you are keyed in on your diet and your nutrition and your sleep, and still you don't get as big and strong as what you'd think of as a professional bodybuilder. Even with all that effort, I don't look the way that a professional bodybuilder looks.
Speaker 2:So you picking up some weights, doing some squats and deadlifts and bench press isn going to make you look like a big manly man, and I know that this is becoming in the general public conversation because I see these jokes all the time. You'll see videos on Instagram where a girl picks up a weight and then it cuts to her boyfriend in her clothes, in a little tank top and shorts, like, just like, oh no, I picked up a weight and I became a man. That's pretty funny. So I know that people are starting to make fun of this, which is a good thing, but the question is how do you convince a 60 or 70 year old woman who's never lifted a weight in her life to start now. Older people generally don't like to try new things.
Speaker 1:I think group fitness classes, when a lot of elderly people get together and have that camaraderie, I think that goes a long way. Really, if you think about it, you as a single person can make a huge difference to a community of people just by inspiring them. You inspire them in positive ways or negative ways. We have one lady in our church who regularly does one of those swim classes at the gym and it tends to be older ladies and she invites other women to go with her and she has a great time. I think that's a really fantastic way. Or maybe they're going to the gym together and pairing up.
Speaker 2:I'm hoping that this podcast is our little piece of trying to encourage people that not only is it safe and fun and not going to make you manly, but it's actually really essential for your longevity Not only your longevity, but also just your quality of life. We discussed protein intake. We talked about how 1.5 and some studies even show up to two grams per kilogram of body weight is helpful, especially in older adults.
Speaker 1:Protein powder. Is that a decent supplement?
Speaker 2:Well, it's a decent supplement, but I would prefer people to get whole foods for the protein.
Speaker 1:I gotta admit I do wish that I could drink like eight protein shakes a day and just be done with it.
Speaker 2:If you're a busy professional and you travel a lot and your only option is to supplement with protein powder, I think more power to you. Go ahead and do it. You get to get your protein numbers up. But in an ideal world, you'd be eating whole foods that are not highly processed and that have high protein content. That's going to be more satiating as well. Imagine trying to eat a ribeye steak. Imagine trying to eat a ribeye steak. That's filling. Not only does it take work, it's also very filling and satiating. Versus chugging a protein shake Not nearly as satiating at all. So you'll probably want to eat more after that protein shake. Vitamin D and creatine supplementation has also been shown to actually help reduce sarcopenia risks as well, I think a lot of people are scared of creatine, but it's becoming really popular again.
Speaker 1:I don't even know what that is. Honestly, I see it in our pantry, though.
Speaker 2:Yeah, creatine is a supplement that's supposed to help muscular strength and endurance. It's one of the most studied supplements in the world and it's been used for a long time and it's actually quite safe in almost any setting. Now, if you have any concerns, speak to your doctor before using it. But the reason it's becoming really popular again now is because people are actually touting it for its cognitive enhancement. I mean, it might actually be able to improve memory. That's something that's being studied more and being discussed in all the big-name health podcasts, which is pretty interesting. But vitamin D is an easy one. I think almost everyone should be taking vitamin D. It occurred to me that a lot of times we talk about lifespan. You hear about the average lifespan of Americans. It's a political talking point. We're always looking to increase our lifespan. Have you noticed that?
Speaker 1:Yeah, for sure.
Speaker 2:And my thought was lifespan's important. But I also wanted to discuss a phrase called healthspan, and this idea is let's not focus so much on how long we're living, but the quality, meaning how long am I living without chronic illness and injury and debilitating dysfunction. Now with healthspan, I think, also comes lifespan. Let's say I lived to 95 years old, but 30 of those years are miserable and I'm unhealthy and I'm sick. I'm spending all that time in the doctor or in and out of the hospital. What kind of life is that?
Speaker 1:It seems like a lot of people have the expectation that they'll remain relatively healthy until about their early 60s, and then it's all super downhill from there and from then on out you hope to retire, you hope to travel the world, but inevitably you have things like heart attacks or you have to get a hip replacement or something starts to break apart. Maybe you have Alzheimer's diagnosis, dementia, something like that. So as a lay person, I've always just seen post 60 as like uh-oh, this is going to be a challenge.
Speaker 2:That does seem to be where things go downhill right Mid 60s.
Speaker 1:Yeah, and then. But if you see somebody who dies before the age of 65, it's generally like, oh, they were so young. But if you see that they die after the age of 65 is generally like, oh, they were so young. But if you see that they die after the age of 65, then you're like, oh well, yeah, I guess you could go anytime.
Speaker 2:The average lifespan in the United States is now roughly 76. I'd wager more than half of my patients are over the age of 65. Now that's somewhat selective, because a lot of people are falling and breaking their hips and I see them in the hospital. So that's somewhat selective, because a lot of people are falling and breaking their hips and I see them in the hospital. So I have an exposure to a much, much older patient population. This weekend alone I've fixed multiple broken hips while being on call at multiple hospitals. So it's something that I see all the time and a lot of my patients are over 80 years old, so I get a good exposure to that.
Speaker 2:So people who have lived longer than the average life expectancy. The real question is what is their quality of life? To answer that question is a little bit difficult, because what quality of life means is different to different people. Does it mean you're healthy? Does it mean you're pain-free, does it mean you're functional? And that can obviously be a relative and a subjective thing, but we're going to attempt to talk about objective measures and what that means. So a new concept that we're looking at to try to measure this is called health-adjusted life expectancy. So we're not just going to measure how long did I live. We're going to measure how long did I live without disabling diseases.
Speaker 1:Okay, so health-adjustment.
Speaker 2:Health-adjusted, health-adjusted life expectancy, or HALE. Okay, this is going to be a new score. Rather than just talking about the average life expectancy of 76. We're trying to come up with a number of what is the average health adjusted life expectancy. For example, you develop diabetes and you had a heart attack and survived. You are having chronic diseases that significantly alter your quality of life, and that happens to you, alter your quality of life and that happens to you at the age of 66, but then you live another 20 years.
Speaker 1:Those 20 years wouldn't count towards your health-adjusted life expectancy. Does that make sense? Sure, but if you are clinically obese by the time you're 40, does that also cut down on your HALE score?
Speaker 2:Well, I don't know exactly if that would cut down your health score, but with obesity after the age of 60 usually comes chronic health diseases. Obesity is rarely isolated by that age.
Speaker 1:Yeah, sure you know, I did have a thought pop into my head. When you talk about lifespan and life expectancy, we think about the average fruit fly, don't they? Only live about 24 hours.
Speaker 2:I don't know the exact number, but I know it's short-lived.
Speaker 1:Yeah, it's pretty short-lived and I just have to think to myself man, these fruit flies, they don't have to worry about stuff like this. They can just go about their day, kind of live, and it seems like it's a good time. But here we are, we have to worry about years and years.
Speaker 2:So you prefer the 24 hour, but like, just live hard, party hard, die hard is that? Is that the whole way?
Speaker 1:all I know is that when I see a fruit fly in my house, I don't worry too much about killing them quickly, because I'm like you know that that poor guy has only got 24 hours to live. I really feel like a monster I have a completely different take.
Speaker 2:My take is, during that 24 hours, that fruit fly is getting it on and making new fruit fluffs.
Speaker 1:Then they just entertain my cats.
Speaker 2:Yeah, well, you've got more fruit flies to worry about, no matter what the outcome. I think it's a little bit hard for people to conceptualize. You talk about things going downhill at 65. Usually, once you're past the age of 75, there's almost an acceptance of frailty and chronic diseases and disability. But before then, a lot of times people seem to be caught off guard. They're really surprised that it happened to them. They didn't see it around them in their older relatives growing up.
Speaker 1:I don't know. I feel like I hang around a fair amount of people who are above the age of 65 and overwhelmingly all they can talk about is their aches and pains. I think I have an awareness that it could happen to me. Like a car, I have to make sure I go in for my checkups I have to get my gears oiled, as it were and so I've been trying to do that by cutting back on inflammatory foods and taking my cardiovascular health seriously and going to yoga. Yoga is very, very helpful for my body. The general aches and pains that I feel just from poor posture, work I do on the computer, practicing cello, that kind of thing those all dissipate rapidly when I'm consistently practicing yoga, and so that means things like deep breathing and stretching.
Speaker 2:You had a lot of things that actually really hit home in that statement. You talked about oil change, just regular maintenance. That's perfect. That's something that everyone should be thinking about. They shouldn't think of this as well. If it happens to me, I'll address it when it happens. No, you got to change your oil before your engine throws a rod.
Speaker 2:You need to do this before it breaks down. The one thing that you said that caught my ear was if it happens to me. I would actually encourage you to think of when it happens to me. You should think about these diseases and debilitating problems as when it happens to me and think about okay, I know it's going to happen, what can I do to either minimize it or prevent it? Because if you do nothing and just go about living your life, you will get chronic disease and you will get debilitating, degenerative changes.
Speaker 1:I don't want to think to myself when I get type 2 diabetes, because then that's just giving myself permission to continue to eat the way that I desire to eat, and not move. I just like to sit on the couch.
Speaker 2:My viewpoint is, if you live in the United States and you live a traditional lifestyle and diet, you will develop type 2 diabetes. We're getting to the point that it's so prevalent that I think it's safe to assume that if you do not undergo intervention, lifestyle changes and mindful habit changes to prevent it, you will get it.
Speaker 1:Okay, if you live the average American lifestyle.
Speaker 2:Correct, correct. I'm not saying there's nothing you can do about it. I'm saying that you should view it as an inevitability if you don't make a change.
Speaker 2:Okay, I can get behind that, that's what I'd like the listeners of this show again maybe we're up to 12 listeners, I don't know the tens of people who are listening to this show to encourage them to understand that if we become complacent and don't make any changes, any very intentional changes, we will end up with these significant health problems that cause us significant disability, pain and limitations in our future. Just because we're all living longer now doesn't mean we're going to have great quality of life for the last 15 to 20 years of our lives, and I don't think anyone wants that. If I can get anybody to take home something from this episode today, it's that I want people to think about their health in the future and not take it for granted. If you're 30 or 40 and listening to this and you feel pretty good, don't take that for granted. It's not always going to be with you and you have to maintain it because if you don't use it you'll lose it, and it takes a lot of work and maybe that's not fair, maybe that's not how you want it to be, but unfortunately we start to degrade.
Speaker 2:Another one that we talk about is gait speed, meaning how fast we walk. There's a threshold for this where, let's say, you have somebody walk 10 meters, so around roughly 30 feet, you have an increased life expectancy. If that person you said okay, walk 10 meters, walk at your normal speed. What's your comfortable, normal walking speed that you would normally walk if you're walking down the sidewalk? If that walking speed is greater than 1 meter per second or 3 feet per second, that is associated with an increased life expectancy and less than that is associated with a higher chance of mortality. So when we look at elderly patients who have a slow, shuffling gait, that walk very slowly, those people have a higher chance of mortality.
Speaker 1:All I'm hearing here is that I got to keep hanging out with your family members because they all walk super fast.
Speaker 2:All right, we're going to get into some more ones that seem kind of outlandish. I think I've seen some patients who are younger who might have a hard time with this too some patients who are younger who might have a hard time with this too and all it is is you sit in a chair and then stand up and sit down, and stand up and sit down as many times as possible in 30 seconds. Again, this study is done mostly in people over the age of 60. The optimal threshold is that you can do this 15 times in a 30 second period.
Speaker 1:Okay, I was going to ask because I'm like trying to predict how much I could do. I think I could hit at least 15.
Speaker 2:Just to be clear, there are specific parameters for this test. Now we have a couch that just swallows you up, so I believe, like the chair, it has to be 17 inches off the ground and it's supposed to be a flat, firm chair, not like a comfy, cushy couch where you get sucked into it. I might have a hard time getting up and out of the couch sometimes but, like there are parameters where that you're supposed to meet when you're doing this test. But I'm sure that all of you who are listening have an older relative who you have seen struggle to get up out of a chair and have to use their arms to get up and aren't able to do it very quickly and struggle.
Speaker 1:I see those recliners that they sell that actually like lift up and they kind of push you out. But I'm wondering could you just do air squats, you know, for people who are like I have a really comfortable couch Like, could you just test this out using air squats?
Speaker 2:It wouldn't be exactly the same, but it'd be close, okay. So this next test is kind of fun. This is one I do all the time and actually it's funny. My mom and dad were over for Thanksgiving dinner and we all tried to do it at home, since I was telling them about the episode we were going to do, and this is called the sit rise test.
Speaker 2:Now, nicole, I think you've already seen this one, but essentially what you do is you're just standing and you sit on the floor. From a standing position, you squat down and sit with your bottom on the floor and then you stand back up. If you're able to successfully sit down, that's five points, and if you're able to successfully sit down, that's five points, and if you're able to successfully stand up, that's five points. So it's a total of 10 points. The best score possible is 10 points. If you have to use your knees or your hands or anything else to balance on your way down, you deduct one point for your hand or your knee or whatever to balance yourself. You deduct a point as you come up if you have to use your knees or hand as well, and so you can lose points.
Speaker 1:Okay. So just to make this a clear picture for people squat down on the floor and not just like fall onto the floor, I mean, I guess you could just fall onto the floor.
Speaker 2:You could squat down until your bottom almost touches this. Plop down. You're not using your hands or knees to balance. So the question is can you get back up on your feet without using anything?
Speaker 1:Yes, I tried it out and so I've got my legs crossed while I'm sitting on the floor and I push my feet together and then I'm trying to walk forward onto my feet and then lift up. I do a fair amount of squats, so I was a little embarrassed. I want to say that I don't really feel like I can get up onto my feet unless I first get up on my knees. If I first get up on my knees, If I first get up on my knees, then no problem, I don't need my hands or anything. I can just get up that way. But that would what deduct one or two points.
Speaker 2:Yeah, if you used a knee or a hand, that's one point each, Okay. The score between eight and 10 would correlate with a lower mortality risk, where a score under three would increase risk significantly of death. A study of 2,000 adults showed that you had a 21% reduction in mortality for each additional point that you earned on that test. That was in the European Journal of Preventative Cardiology in 2014. That study was published. Now I have a 10. I'm a perfect 10.
Speaker 1:Of course you are.
Speaker 2:On this particular test.
Speaker 1:Uh-huh, yeah, no, I mean, I think you're a perfect 10. Not in the Lutz department In a lot of ways.
Speaker 2:Oh, thank you. Yeah, Dr Big Ten I knew I could count on you. Yeah, but some people don't have a perfect 10. Actually, this is one of those tests where some young people don't have a perfect 10. Like me, I wasn't going to say it, I just admitted it. I wasn really super into yoga and so she's super into balance and stretching and flexibility, so she really loved this test. And this one is the single leg balance test. Nicole, tell us about this one, since I've been talking too much.
Speaker 1:Okay, so the single leg balance test. It sounds pretty much the way it's described.
Speaker 2:Yeah, us doctors aren't that imaginative when we're naming things.
Speaker 1:Well, that's probably a good thing. Basically, you just pick up one foot off the ground and you're completely relying on the other foot to allow you to remain upright and stable without putting your other foot down again and without using your hands to prop yourself up.
Speaker 2:This test has to be age adjusted. So if you're over the age of 60, a goal is for 10 seconds or more that you can stand on one leg and balance, and if you don't, it means you have pretty weak muscles or you have maybe some neurologic deficits that may cause you to have poor balance as well.
Speaker 1:Okay, let me tell you about this little challenge we just did with our friends Emily and Ryan. We were over at their house and we were talking about this test and Caleb said well, why don't you try it with your eyes closed, guys? Totally different story. When you close your eyes, that is like a. What did you call it? It was some sort of neurologic test.
Speaker 2:It's proprioception testing.
Speaker 1:Proprioception.
Speaker 2:Proprioception, the awareness of your body in space. That tests a whole different thing. You can be aware of your body in space based on how you see. So with your eyes open, you understand where your body is. When you close your eyes, you know where your body still is, where your fingers are, your hand, your wrist. And if you have poor proprioception, you're going to have a harder time staying balanced.
Speaker 1:I mean, I got to say I think I have poor proprioception even when my eyes are open, just by the amount of things I run into and get bruises on my legs.
Speaker 2:It's possible. I don't know if you're sensing a theme here, but a lot of the health and this is something that I'm trying to build up to this episode, maybe poorly A lot of our health, a lot of these things have to do with us having strong butts. I'm serious. I know it may sound silly, but have you picked up on this?
Speaker 1:No.
Speaker 2:So to be able to sit up and stand, strong butt, gluteus muscle. Strong butt To be able to sit all the way down on the floor, strong butt. Then get back up To be able to balance. Believe it or not, you use your gluteus muscle a whole lot To stand up on one leg. You'll feel it in your feet, kind of wobbling your foot up and down to balance. But you get to flex your butt to keep your pelvis even.
Speaker 1:It also helps a whole lot if you strengthen your core and keep your core stable when you're on a one-legged thing and we should clarify with the one-legged thing, you don't have to have your foot up in triangle, you don't have to keep your foot, like you know, totally lifted or whatever, you just have to have it off the ground.
Speaker 2:Yeah, it can be in any position you want. Really, it just has to be off the ground. So this is an easy test you can do at home, but I recommend doing with your eyes open. Yeah definitely do with your eyes open, because it apparently tests different things.
Speaker 1:Yeah, most people under the age of six, you're going to be able to do this for 10 seconds, but if you're not, maybe it's a wake up call. Hey, I got, I got to say I, and he said, well, how do you know that? Like, there's not really a way to measure if you're better than most people. And I was like, yeah, that's actually totally right.
Speaker 2:Well, I'm not saying it's impossible for you to know, you just didn't look it up.
Speaker 1:No, no, you're totally correct, he called me out In private, but now she's making it very public. But I mean, but that's just. You know the way your brain thinks, it's very logical and analytical and you actually look at studies and stuff, and so what I modified my statement to say was I know that I am much better than where I used to be one to two years ago, when I really really struggled to just stay balanced on one leg, and now I'm able to do these various movements in my yoga classes and have it sustained for very long periods of time. Then I can feel the difference in the strength of my legs and my body and I have much more confidence. And I'm not concerned that I'm going to fall over, because that's really what you're concerned about here, right, from an orthopedic perspective, is that a patient who's not able to remain balanced or able to get themselves to the floor, get themselves back up again, is what they're going to fall and break a hip or something.
Speaker 2:That's correct and that's why I tell most of my patients they really need to focus on gluteal strengthening and I must say that you have really a sublime buttocks, like it's just. Your gluteus has really been very well developed.
Speaker 1:Well, thank you yeah.
Speaker 2:And I say that purely in a clinical complimentary doctor sense of the word.
Speaker 1:Yeah, this is a very professional show. Yeah, that's right. Normally I'm the one who's complimenting you. Well, it's very technical.
Speaker 2:I don't see why it's inappropriate. I'm saying that you've really been working your butt off. So we are building a theme here.
Speaker 1:Caleb's very attracted to my gluteus muscles.
Speaker 2:Yes, it's very calipygian, what Look it up? So we're building a theme here I've been building it from the beginning of the episode, whether you know it or not that the strong core and also what we call posterior chain muscles, meaning your hamstrings, your glute muscles, the straightening muscles of the back, called the erectors of the back, are all really critical and linked to longevity. You know it's funny. There's trends on exercise for men and women and by far, what do all women want in the gym? Like, what's the trend?
Speaker 1:I mean at least in the last 10 years. I think it's to have a big butt.
Speaker 2:It's to have a big butt.
Speaker 1:But that wasn't the way when I was a youngin.
Speaker 2:No, no, things have changed.
Speaker 1:Yeah, in the last, like 10 years with the Kardashians, the rise of the Kardashians.
Speaker 2:Yeah, but it's just funny that there's all this emphasis on having these big glutes, which it's not a bad thing. That's not to say that everyone needs to go out and just blast their glutes every single day. There's obviously balance and you need to have good, strong quads, hamstrings. Good structural leg muscles and core muscles is probably the most important thing, and there's a lot more things than just glute bridges out there. There's a lot of resources out there to develop strong glutes and core and I would definitely encourage it. The deadlift would be one of the big ones. There's also been studies that show that if you can deadlift one and a half to two times your body weight, you're going to be in really good shape and have reduced metabolic health problems.
Speaker 2:One and a half to two times your body weight, correct I don't even know that I could deadlift my body weight Even when I was deadlifting a lot.
Speaker 1:I don't think I ever got up to my body weight.
Speaker 2:Well, I would make the argument that doing your body weight would be a good goal. I think that's a pretty reasonable goal to just your body weight. For example, I weigh roughly 240 pounds, so double my body weight is a pretty substantial deadlift.
Speaker 1:Hence the Dr Big Guy nickname.
Speaker 2:Although much lighter than I used to be True. So trying to get up to two times body weight would be. It's pretty difficult, but something that I've achieved before. But I think being able to deadlift your body weight is a pretty reasonable goal for men and women, since it's proportional to body weight.
Speaker 1:I just got to worry about bursitis. Ain't got time for that. Just got to worry about bursitis, ain't got time for that.
Speaker 2:I don't know about you, but I am tired of talking about sitting up and standing, so let's take a break for Fractured Facts. You love Fractured Facts, right?
Speaker 1:I do love Fractured Facts.
Speaker 2:All right For today's Fractured Facts. Nicole, I'm going to ask you what is the strongest muscle in the human body?
Speaker 1:Strongest huh. Well, considering our emphasis on butts this evening, I'm going to have to go with the gluteus maximus. Well done, she got it.
Speaker 2:Yeah, you know, I guess I kind of gave it away, since we've been talking about glutes today. But yes, glute, the gluteus maximus, the big butt muscle. There are three glutes I think I talked about this in the last episode, so there's a set of three, but the glute maximus is the big one. It's a very large muscle. It makes up the bulk of your bottom and it is able to produce the most force out of any muscle in the body. Now, as a bonus, since that muscle, the glute, can produce the most force of any muscle, let's go down to a smaller muscle. Now we're going to talk of muscle strength relative to size. So this is going to be a much smaller muscle that's able to produce the most per square inch relative to its size.
Speaker 1:I think I might know this one. I feel like this was a trivial question way back in the day. Is it the tongue?
Speaker 2:That's not a bad guess but no, it's not Do you want another guess? It is related to the mouth, just your lips, I don't know.
Speaker 1:All right, you're getting fuller. No, no.
Speaker 2:I was a good guess, though. It's a muscle called the masseter, and that is a muscle that's attached to your jaw that allows you to bite down on things.
Speaker 1:Is that where people get TMJ?
Speaker 2:Well, TMJ is an actual joint, temporal mandibular joint. That's what TMJ stands for. So it's the inflammation of that joint, but the muscle's near that area. So the interesting thing about this is the average masseter muscle can create about 200 pounds of pressure while chewing. And if you look at the Guinness Book of World Records, I believe the Guinness Book of World Records, I believe the Guinness Book of World Records of force produced is actually up to 975 pounds of force produced by the masseter muscle.
Speaker 1:So basically, these people have evolved from saber-toothed tigers.
Speaker 2:Something like that. But people are able to produce massive amounts of force. There's one piece I read that if you're able to produce a masseter the size of a gluteus, you could bite through like a log.
Speaker 1:Then you'd be a Tyrannosaurus rex.
Speaker 2:Or a beaver.
Speaker 1:A beaver? Well, that's less majestic.
Speaker 2:Yeah, less majestic than a T-Rex.
Speaker 1:But I do kind of feel like the name masseter that's sort of kind of cool, Kind of like that gives me serial killer slash assassin vibes.
Speaker 2:Masseter, to me sounds like Excalibur, like some mythical sword.
Speaker 1:Yeah, Masseter.
Speaker 2:In terms of the gluteus, we talked about how essential it is to keep you upright, standing with a good posture, and keeping you balanced when you're walking, For whatever reason. The glute becomes really atrophied and weakened when you age, and that's why people a lot of times are so prone to falling and losing their balance and then having hip fractures, which I'm dealing with a lot of lately.
Speaker 1:Yeah, well, I guess, if all you do is sit all day at a computer desk or on a couch or whatever, then you're not really using it, are you?
Speaker 2:Yeah, if you're not standing much or waffling much, it starts to atrophy, that's correct. Much it starts to atrophy, that's correct. The Gluteus Maximus is more developed in humans than any other mammals because we are one of the few ones that walk almost continuously upright compared to other mammals. So our Gluteus Maximus tends to be more developed.
Speaker 1:But if you've got one of those dogs that I've seen on Instagram reels that will walk upright, then maybe your dog has a very strong Gluteus Maximus as well.
Speaker 2:That dog got a big butt.
Speaker 1:Dr Big Dog.
Speaker 2:So if you're done talking about chewing and big butts, we can go ahead and get back to the main part of the episode.
Speaker 1:I do kind of wonder, though, if cats have a very strong massager compared to the rest of their body, because they've got little jaws of death, don't they?
Speaker 2:It always comes back to cats for you, doesn't it?
Speaker 1:It does.
Speaker 2:Yeah, yeah, yeah, I don't have an answer for that because I'm not a veterinarian. You know, I had a friend once who asked me questions about animals whenever she had a chance and I never knew the answer.
Speaker 1:Oh well, what a disappointment.
Speaker 2:Yeah, yeah, I'm constantly disappointing women all over the place.
Speaker 2:Not this one. So there's another aspect of aging that's pretty constantly on my mind, because I have to see the effects of it all the time, and that's cognitive function. And I think, out of all the things, when I talk to other family members, I mean family members of patients at least these family members who have been around patients who have dementia or Alzheimer's disease they seem to fixate on wow, I do not want that to happen to me. I really want to hold onto my mind. I want to be sharp. I think even in the news and in the media people talk about being sharp and cognitively aware at an old age. It's praised as being something admirable, and something we should all shoot for is to be mentally sharp in our old age. What do you think?
Speaker 1:I would say so. I think that's an important goal, but I also think that our culture is set up so that when somebody retires, we don't really expect them to do anything except maybe watch TV, go on fishing trips, travel around, play with the grandkids, but they're not necessarily keeping their wits sharp because they don't have a reason to. I don't think that's the same in different cultures around the world, but I think we've seen that has pretty detrimental effects on people if they're not keeping their mind sharp either by continuing to work or continuing to play brain games. I have this one brain game app I really love called Peak, and I also happen to be a New York Times subscriber, so I can play their games like Wordle.
Speaker 2:So you're a New York Times subscriber. That means you're better than everybody else, right?
Speaker 1:I mean obviously.
Speaker 2:Yeah, I knew it, you also have a nice butt.
Speaker 1:Thank you. I got two things going for me.
Speaker 2:Well, no three really, if you consider my world score. So, all that being said, I think, out of all the things we talk about, people are like okay, you get older and you're not as strong and your balance isn't as good. Okay, who cares? I'd rather go lie on a beach on vacation in retirement anyway. But I think what scares people to death is losing their wits, having dementia, having cognitive decline. I think people look at that in their older family members. That is what strikes people and stays with them the longest.
Speaker 1:I just have this inevitability in the back of my head you get old, you get weak and you die. And it wasn't until you came along and challenged that notion that I really started to believe. Oh, I don't have to just inevitably get weak after the age of 60 and then fall apart slowly and get my HAL score. What's that stand for again?
Speaker 2:Health Adjusted Life Expectancy so we're talking about health span. How long will we have a good, healthy, happy, functional life?
Speaker 1:You were the one who first challenged that and then, thankfully, over the last several years, I've seen a lot of people who produce content on social media and they are also challenging this status quo of if you're older, you're just going to disappear into nothingness. And these people are saying, no, you can live healthy lives in your later years, your golden years, and here's how to continue to do it. So I definitely appreciate those accounts and seeing those people who are really promoting that, because I don't think that's the status quo.
Speaker 2:I think there's a big cultural shift. If we're talking back in the 40s and 50s, bodybuilding wasn't popular, yet Powerlifting wasn't popular. Crossfit didn't exist. Going to the gym and doing strength training was not a normal everyday type of thing, where it's becoming much, much more common, especially in our generation and the generation below us, to exercise. So I'm hoping that things will carry over into older age, that these younger generation will exercise as they're older, because the older generation just wasn't something they did when they were young either. You know, if you didn't exercise at all in your 20s and 30s and 40s, why would you suddenly start doing it when you're 60 and 70? It's just not normal. We have a little bit of an advantage that exercise and lifting weights and strength training became more popular and there are gyms everywhere and there's equipment everywhere and there's YouTube videos to teach us how to exercise and there's personal coaches and trainers. That didn't exist 70 years ago.
Speaker 1:I think it might have also become a classist thing. Just because people who did get a lot of manual, physical labor in, they're traditionally seen as less highbrow than folks who are wealthy enough that they could just hire other people to do it for them. The wealthy, the elite, have always traditionally been seen as sitting on their butts and not actually using their muscles because they have other people grunt workers to do it for them. But these days it's almost kind of a status symbol to be able to afford things like the Peloton bike or a CrossFit membership.
Speaker 2:A professional trainer and a dietitian, someone who makes your meals for you yeah, absolutely so.
Speaker 1:I think why we've seen it is because it's become trendy and it's something that people aspire to and keeping up with the sexy Joneses in the same way that they used to keep up with the Joneses for buying their expensive cars, but now it's just health and fitness and longevity.
Speaker 2:And there's something to that. The more money you have and the more access to resources you have, you're a little bit set up for success, but I think it's become more ubiquitous and the more resources are out there for free now too.
Speaker 1:Yeah and that's something that I think we should emphasize is that these things that we're talking about can be done with minimal resources outside of what is already provided to you from your body.
Speaker 2:But let's move a little bit into the cognitive functions, since we talked about that. The good news is we're going to continue the theme of aerobic and strength training exercises because it has a profound effect on cognition. There's a study in the Lancet Neurology in 2005 that looked at aerobic exercising increasing hippocampus volume hippocampus being a part of the brain and it can actually increase volume by 2% in older adults, basically reversing what we consider age-related volume loss, and it actually improved memory. In the study where people were doing regular aerobic exercise Regular physical activities also around midlife reduced the risk of dementia by 50% and Alzheimer's by 60% in this particular study. If you look up these numbers in other studies you'll get varying results, but now this was around 30 minutes of moderate exercise daily, however, so that's not a small amount of time.
Speaker 1:I mean, but it is a small amount of time, considering we have 24 hours, but it takes an incredible amount of discipline, as I know it, because I lack it If you even just dedicate yourself to 30 minutes a day.
Speaker 2:It can seem daunting, but 30 minutes a day if you think about the average person sitting on their phone, looking at their phone or watching a TV show, you could exercise instead and keep your mind sharp. Definitely worth it to me. Have you ever heard of brain food before?
Speaker 1:I'm guessing it's some sort of supplement that helps keep your brain happy.
Speaker 2:Well, not even that specific. Some people refer to fish as brain food, or nuts and seeds and berries as brain food.
Speaker 1:So like the Mediterranean diet.
Speaker 2:Yeah, mediterranean diet. I'm going to talk about something called the MIND study or the MIND diet, and this is a diet that's supposed to be high in foods that are helpful for brain function and that's often linked to omega-3 fatty acids and antioxidants found in berries and nuts, and seeds and leafy green vegetables.
Speaker 1:I've got to say, the worst thing about my taking my daily vitamins is the omega-3 fish oil one.
Speaker 2:Do you burp? Do you have fish burps?
Speaker 1:Well, it's not just that, it's like even just getting that thing down man Big gel pill. My friend Sterling gave me some droppers. I added it to my smoothie. That was the worst smoothie I've ever had in my life.
Speaker 2:The taste of what Tastes like sardines. It was horrible.
Speaker 1:So what's a good way to get those omega-3s in there, man?
Speaker 2:Well, you can just eat fish whole.
Speaker 1:Oh yeah.
Speaker 2:So you could eat fish, but most people just supplement it. Look up foods that are rich in omega-3 and you can find them, but a lot of people will just supplement it.
Speaker 1:You know how they have those like pill encasements for dogs and cats. Can you find that for a human too?
Speaker 2:If you're snoring, I could just drop a pill in your mouth one night. If you'd like, we can try that.
Speaker 1:That's well. I guess that's one way to do it.
Speaker 2:We'll see how it goes. If you're joking, I know the Heimlich maneuver and mouth to mouth Well, there you go.
Speaker 2:So there are some studies that looked at the mind diet. Essentially, what you looked at was leafy green vegetables, root vegetables, berries, nuts, whole grains, fish, lean meats, beans and olive oil. But this diet also looked at reducing refined sugars, carbohydrates, pastries, pastas, breads and fried food. This study showed that a reduction of Alzheimer's risk up to 53% in participants who had a high adherence and 35% of participants who had a moderate adherence to the diet. Now, what does high and moderate adherence really measure up to?
Speaker 2:Studies looking at people eating diets are really hard to do. Well, because you're dealing with normal people, reporting what they eat, because you're not keeping an eye on them forever, right, you're not watching, literally watching all of these people, what they eat all the time. So you have to take these studies with a grain of salt. I think the point that the study is showing is, if you have this diet where you eat high in antioxidants, high in omega-3s, and you reduce these inflammatory foods that are in have excessive calories, excessive sugar and are not highly processed, you have a better chance of having preserved cognizant and having a lower risk of developing dementia and Alzheimer's disease.
Speaker 1:That's cool and also those foods sound delicious to me.
Speaker 2:I know people are probably getting tired of me saying this on the podcast, but a lot of diets will work for you and I think really what it comes down to is, if you're mindful about what you eat and you're not eating a bunch of fried food and sugar-added food and highly processed food, you're going to be okay.
Speaker 1:I think it requires cooking a lot of your own food, though.
Speaker 2:Well, so much food has a lot of these added things that you're not thinking about to make it palatable and make you want to eat more, so you kind of do have to make your own food. That's the ideal thing. So one of my other favorite topics to talk about is sleep, which I need to get some. Sleep supposedly helps reduce plaque buildup in your brain Plaque in your brain.
Speaker 1:I'm thinking plaque in my teeth.
Speaker 2:Well, it's a different kind of plaque.
Speaker 1:I'm thinking plaque in my heart valves.
Speaker 2:Different kind of plaque. Have you ever heard of beta amyloid?
Speaker 1:No, of course not.
Speaker 2:It's a type of protein and it's linked to Alzheimer's disease. Sleep is supposedly supposed to lower depositions of this type of plaque in your brain that are linked to Alzheimer's disease. So getting proper sleep with the correct duration and quality of sleep, going through all your sleep cycles, is also associated with decreased Alzheimer's disease if you're getting regular, good quality sleep. So yet another reason to get on a normal sleep schedule. Wear your blue light blocking glasses and get to bed at roughly the same time throughout the week whenever you can, to be able to reduce your risk of Alzheimer's disease. I think that's a pretty big reward for not that much effort.
Speaker 1:Yeah, plus sleep is great.
Speaker 2:If you just think about it, would I rather stay up and watch the Netflix show an episode or two, or would I rather not have Alzheimer's disease, maybe a little bit dramatic, but if it helps you, it helps you. There's also this idea that you mentioned before in constantly learning new things and using your peak app to like try to challenge your brain, and there are studies that demonstrate that if you are trying to engage your brain to learn new concept and be constantly learning, that this can also have a mental protective effect, meaning it can help you retain some of your cognitive function into older age as well.
Speaker 1:I have to say that the older I've gotten, the more resistant I am to wanting to learn new things. It's anything from as simple as oh yeah, the young kids these days are on TikTok or whatever else, and I'm just like I don't really feel like learning yet another app.
Speaker 2:Yeah, I don't know what that is, but I think it happens to every generation, and that's when you realize that you're old. Yeah, but we're there, we're there.
Speaker 1:Yeah.
Speaker 2:Another one. Again, something we've talked about in our mental health episode is social engagement. Social isolation is not good for your mental health and it's not good for your cognitive function. This could be for a number of reasons. It could be that just having other people around is good for your mental health, which is therefore good for your brain, but I think a lot of it is language learning, talking with other people, engaging with other people and using your brain. If you're not engaging with other humans, then your brain begins to atrophy. It could be as simple as that, but there are studies that show that people who have better emotional and cognitive networks of people that they interact with regularly show enhanced neuroplasticity or ability to learn and adapt with their brain. So let's run it back. We've talked about not using your brain and what are the detriments of that. We also had discussions about what we can do to keep our brains active and limber.
Speaker 1:Are our brains technically muscles?
Speaker 2:No.
Speaker 1:Okay.
Speaker 2:No, our brains are not really muscles per se.
Speaker 1:I don't know why I always thought of it that way.
Speaker 2:Well, I think people refer to the brain as a muscle. Okay, it's really not. When we talk about muscle tissue, it's not. It has a different structure To me. I know I'm biased because I love exercise, but I think most of this boils down to exercise. Obviously, you can employ a lot of the strategies that we discussed in this podcast today to be neuroprotective, but a lot of it comes down to being strong, having good balance and having a strong butt, also core, also legs. Those are very important things.
Speaker 2:There's another study I didn't mention that obesity also is associated with higher risk of dementia. Obesity midlife in one study in BMJ and demonstrated a higher risk of dementia up to 74% at the age of 40. They recommended maintaining a BMI between 18.5 and 24.9. Now I think everyone knows that BMI is sort of a non-perfect way of measuring your body weight, but in this article in 2005, it's a little bit old now I think a lot of people know that if you are obese, you are going to likely have health problems down the road. But something else if you are not obese but have very low muscle mass, very low strength, you're also going to have some significant health problems. Some people may have heard the term skinny fat. Are you familiar with that?
Speaker 1:I've heard that.
Speaker 2:It's not a great term. I think it's a little pejorative, maybe hurts people's feelings and maybe we could come up with a better term. So everyone's got in their head obesity bad. What I would love for people to get into their head is low muscle mass bad, and it has a host of different effects and most of it is linked to having a shorter, less healthy, less functional life. So if I had to have one takeaway today is that I would love for people to get out and exercise, have a strong core, strong back, strong glute muscles, strong hamstrings, strong quads just a good foundation for you to walk, so you can walk fast, you can climb stairs, you can sit and stand and you have good balance. I think that will lead to a much more functional, healthy life and lead to a longer and happier life.
Speaker 2:The diagnosis of sarcopenia is not inevitable. Yes, as we age, we're going to not be as fast and sharp as we were when we were 20, but we can prevent sarcopenia. We can manage it by doing lifestyle interventions like exercise, proper nutrition, regular monitoring of our muscular health, testing our grip strength, testing whether or not we're able to do simple functional tasks and then talking to our doctor about whether or not we're at higher risk for it and what we can do to mitigate it and talk about personalized strategies for you. Since we've talked so much about what are these feats, these measurable functional tests that we can do, let's break some of them down. We talked about grip strength already.
Speaker 2:I think we've talked about that ad nauseum. You don't necessarily have to go get a grip strength tester. You can just pick up something heavy that you know the weight and get a decent idea for what you're able to grip. I think that's probably an easy way to do it, but you can also get one on Amazon for like 25 bucks and test your strength if you're really curious. Now that everybody knows about health-adjusted life expectancy and sarcopenia and the key to reducing the risks of sarcopenia is strength training and protein intake I'm hoping everybody can take this information and start eating more meat or eggs or fish or supplementing their protein if they have to. I also hope you might consider more physical activities and exercises and going out and testing and seeing if you may be at high risk or you've lost a step in your functional capabilities of activities of daily living.
Speaker 1:Yeah, it sounds like I should keep doing some yoga.
Speaker 2:Yoga is a great place to be, but I would love it if you could do a little weight training too.
Speaker 1:Okay, I'm going to have to work on my deadlifting, my body weight.
Speaker 2:Yeah, let's try to deadlift your body weight. Plus, if there's a fire and I pass out, I'd love it if you could carry me out.
Speaker 1:There will never be a fire in our house because I have so many fire extinguishers.
Speaker 2:It's true, nicole has a passion for fire safety. We have a fire extinguisher in every room, so be on the lookout for some videos of some of these tests that we talked about today. If you follow us on Wellness Blueprint Podcast on Instagram and TikTok and YouTube, we will be posting some of the videos of some of the tests that we talked about today, whether or not it's helpful. Maybe you'll just get a good laugh out of us seeing a struggle.
Speaker 1:Check it out.
Speaker 2:Then give us a follow. Nicole, do you have any words of wisdom to give to wrap up the show?
Speaker 1:I would definitely encourage you to test yourself against some of these things. It's not only fun, but it'll be a good challenge for you. You can do it with your family and friends. I definitely need to have a rematch with Ryan on who can stand on one leg.
Speaker 2:Yeah, that's a fun one to watch, especially as a bystander. If you don't have access to a gym, you can do things like push-ups, pull-ups, bodyweight squats as a good way to start. I'd encourage everybody to get out there, walk some stairs, do some strength training, get a good, strong butt, and even just something as simple as that would be a great place to start, and it's better than doing nothing. So remember, be humble, be happy and be healthy and go do some squats. We'll see you next week.
