Healthy Aging

Aging Gracefully: How to Look and Feel Your Best at Any Age

Though something we rarely like to think about, aging is a natural (and unavoidable) part of the life cycle. Our bodies go through many changes as we age, but taking the steps to maintain your health throughout every stage of life can play a significant role in helping you to look and feel your best at any age.

Researchers at the University of Cambridge report that the combination of four behaviors – not smoking, engaging in regular exercise, drinking moderate amounts of alcohol and eating five servings of fruit and vegetables daily – can add an average of 14 years to your life!1

Lifestyle. According to the CDC, regular physical activity can improve health, help manage weight, support healthy joints and muscles, and contribute to a healthy mood.2 To maintain health, the American College of Sports Medicine and the American Heart Association recommend healthy individuals under age 65 do 30 minutes of moderate cardio exercise 5 days a week, or 20 minutes of vigorous cardio exercise 3 days a week and strength training exercises twice a week. Individuals over 65 (or adults 50-64 with significant chronic conditions) have the same recommendations with the possible addition of an extra strength training session each week. And for individuals who are at risk for falls, incorporating balance exercises can help increase stability. Be sure to work with your health care professional to develop your physical activity plan to manage any risks and to take any personal therapeutic needs into account.3

Diet. As we get older, good nutrition plays an increasingly important role in how well we age. Yet statistics show that only 17% of Americans over the age of 60 consume a good diet. Try to consume a diet that is low in cholesterol, fat (particularly saturated fats), and salt and high in fruits, vegetables and fiber. Also keep in mind that as we age, our body’s daily energy needs slowly decrease, requiring an intake of fewer calories. Women over 50 typically need between 1,600 and 2,200 calories a day, while men require between 2,000 and 2,800 a day.

Nutrients. Vitamin B12 is an important nutrient that helps convert food to energy, and maintain the health of red blood cells and the nervous system.* But as people grow older, some have difficulty absorbing vitamin B12 that is found naturally in food. Additionally, B12, along with folic acid and vitamin B6 has been shown to help support healthy brain function as we age.*4 B6 is also important for healthy immune system function in older individuals. Calcium plays an important role in maintaining the health and strength of bones, which is increasingly important as we age.* Vitamin D, which our bodies produce through exposure to the sun’s UV rays, helps to promote absorption of calcium.* However, many older adults do not get sufficient vitamin D though sun exposure, which can result in less than optimum calcium levels in the body.*

1.Khaw K, et al. PLoS Med 2008;5(1):39-47.
3.Nelson ME, et al. Circulation 2007;116:1094-1105.
4.Leblhuber F, et al. Am J Clin Nutr 2005;82(3):627-35.

Win the Fight against Fat: Nix Refined Flour, Fast Food and Sugar

By Kathy Jordan, MS, RD, LDN, CPT, CTA

I am not a big fan of diets with lists of forbidden foods. They usually instill a lot of guilt and don’t work in the long run. Instead, I promote adopting a healthy lifestyle that includes healthy food choices that maximize your nutritional intake, strength training, aerobic exercise, adequate sleep and stress/time management. HOWEVER, the research is piling up that certain types of foods contribute to obesity, type-2 diabetes, non-alcohol related fatty liver and a number of other debilitating lifestyle-related conditions.

Consuming foods that are fast, convenient, and calorically dense while low in nutrients on a regular basis is not in your best interest if you want to avoid obesity, lose weight and have a long healthy life. The biggest culprits are refined flours, FAST FOOD and sugars.

The Stats and Studies:
The USDA Dietary Guidelines for Americans describe a healthy diet as one that is low in saturated fats, trans fats, cholesterol, salt and added sugars1. This is consistent with the 2002 position paper on weight management by the American Dietetic Association that blames a sedentary life coupled with access to an abundance of energy-dense foods for the epidemic of obesity, chronic disease, and escalating national health care costs2. A 2006 study conducted by the National Weight Control Registry found that weight re-gain was associated with several factors including high calorie and high fat intake, and fast food consumption. Factors associated with long-term weight loss included limiting fast food consumption3.

Why pick on fast food? A typical fast food meal is high in calories from fat, refined starches, salt and sugar. It is energy dense, supplying an average of 150% more calories than a traditional meal. It increases the risk of obesity and related health issues by encouraging inadvertent over consumption of calories. And supersizing compounds the issue. A supersized fast food meal often exceeds 1,600 calories, more than many people should eat in an entire day. These meals are woefully low in fiber, but pack in plenty of unhealthy fat, sugar and sodium. And it’s not just the fare at fast food restaurants we should be concerned about; ready-to-eat and other convenient meal solutions offered at supermarkets and convenience stores may have similar nutrient profiles.

Not all carbs are created equal. Sugar and refined flour or other refined starches (grains such as: cereals, breads, pasta, white rice and crackers, made from grains that have been processed to remove the husk also removing most of the fiber, vitamins and minerals along with it) are more rapidly digested into glucose – causing blood sugar levels to rise. This stimulates insulin production, which signals the body to convert more of the excess energy into: body fat, fatty lipids that circulate in the blood and deposits of fat in the liver4.

In 2001, the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) called for a drastic reduction in sugar consumption, citing that poor diet contributes to 60% of the 56 million annual reported deaths worldwide. Americans consume over 100 pounds of sugar per year. High sugar foods and beverages are usually high in calories and low in or completely void of nutrients. Soda and other sweetened soft drinks, such as sports drinks, fruit drinks, sweetened ice tea and lemonade are the leading sources of sugar in the American diet. Researchers from Children’s Hospital in Boston and the Harvard School of Public Health report that sugar-sweetened beverage consumption increases the incidence of obesity5.

As our consumption of sugars, refined starches and fast food has risen, so has the incidence of overweight and obesity. The average male and female American adult weighs approximately 25 pounds more today than we did 45 years ago, and the incidence of overweight and obesity among our youth has tripled since the 1960’s and 70’s. To win the fight against fat, we will have to choose foods that contribute to health over those that contribute to health decline.

1 U.S. Department of Agriculture: Dietary Guidelines for Americans 2005, 6th ed.
2 American Dietetic Association. Position of the American Dietetic Association: weight management. J Am Diet Assoc 2002;102(8):1145-55.
3 Phelan S, et al. Are the eating and exercise habits of successful weight losers changing? Obesity 2006;14(4):710-16.
4 Ludwig DS. Dietary glycemic index and obesity. J Nutr 2000;130(2S Suppl):280S-283S.
5 Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 2001;357(9255)505-8.

Aging Skin

During our early adolescent and teenage years, most of us rarely think about our skin and the aging process that will one day affect the condition and appearance of our skin. However, after our early 20s, aging changes will begin to show up in the skin; changes which will progress as we age into our 30s, 40s, 50s and beyond.

It’s never too late to begin taking care of your skin and protecting it from future damage. Although your skin will continue to age as you get older, you can take certain precautions and use certain products to help keep your skin looking healthy, refreshed, and youthful.

How Does Skin Change With Age?

As we approach our 30s, our body’s production of collagen and elastin (two substances that give the skin firmness and elasticity) begins to slow down. The collagen and elastin also begin to loosen and unravel which results in skin that sags and has poor elasticity. A young person, with plenty of both collagen and elastin, has firm, smooth, unwrinkled skin. As that person ages, the loss of collagen and elastin causes the skin to become looser and less supple.

At the same time, fat cells beneath the skin may begin to disappear. With the loss of this supportive fat, collagen, and elastin, plus the pull of gravity, the skin begins to sag and form wrinkles. The skin also loses the ability to moisturize itself and retain moisture with age, leading to skin that is drier, possibly with itchy, irritated patches.

With age also comes the appearance of those familiar lines and wrinkles that we associate with older skin; frown lines (those between the eyebrows) and crow's feet (lines that radiate from the corners of the eyes) begin to appear as a result of permanent small muscle contractions.

Your Habits, Your Skin

In addition to the natural processes that occur in our bodies and skin as we age, other long-term habits can cause damage to our skin.

Sun exposure is the most damaging external factor that affects the condition and health of our skin and is the primary cause of prematurely aging skin (called photoaging). In fact, many of the features we associate with aged skin are actually caused by sun exposure, and not by the natural aging process. Photoaging can cause a number of skin conditions, including:

•Fine wrinkles
•Liver spots (a.k.a. age spots)
•Dilated blood vessels
•Roughened skin

Smoking cigarettes is also harmful to the skin. Smoking causes the blood vessels in the top layers of the skin to narrow (constrict), which reduces the blood supply, reduces the amount of oxygen available to the skin, and reduces the removal of waste products and dead cells. This process contributes to the reduction in collagen and elastin and prevents Vitamin A from bonding with skin cells to repair skin damage, leading skin to have a grayish or bluish cast and a leathery texture. Smoking also restricts circulation, taking away the rosy blush of young skin. The facial expressions smokers make when smoking may also cause wrinkles, with wrinkles appearing around lips pursed around a cigarette and around eyes that squint to keep out smoke.

Common Signs of Aging Skin

When skin ages and accumulates damage from sun and other habits, a number of skin conditions may result including:

Lentigines - Also known as "age" or "liver" spots, lentigines are flat, brown spots that usually show up on the face, hands, back and feet. These spots are not dangerous (and are not a sign of liver disease). If, however, you notice a dark, flat area with irregular (not rounded) borders, see a dermatologist to ensure that it is not a melanoma.
Bruises - Older skin bruises more often than younger skin and takes a much longer time to heal. Bruises that don't heal after a week or so should be seen by a dermatologist.
Wrinkles - As skin becomes less elastic, it begins to sag, particularly around the eyes, mouth, forehead, and cheeks.
Telangiectasias - Often called "broken capillaries," telangiectasias are visible, dilated blood vessels in the face, usually caused by sun damage.
Actinic keratoses – These are rough, warty, reddish or brownish growths, caused by sun damage and are often a precursor to squamous cell carcinoma (skin cancer).
Cherry angiomas- These are red, protruding growths on the body caused by dilated blood vessels. They are harmless and occur in about 85% of those over middle-age.
Seborrheic keratoses – These are brown or black raised spots, or warty growths on the skin’s surface.

Keep Your Skin Looking Younger

It's best to start protecting your skin during childhood, however, anyone at any age can begin to take the necessary precautions to help protect the skin, keep it looking young and healthy, and hopefully slow down the affects of aging. Following are some tips on how to achieve younger looking skin.

Minimize Sun Exposure – Minimizing sun exposure is the most important thing you can do to protect your skin and keep it looking young. Wear sunscreen of at least SPF 15 when outdoors, and protect the face with a brimmed hat. Try to avoid sun exposure from approximately 10:00 AM to 4:00 PM, which is the most hazardous time for UV exposure.
Protect Skin From Dryness - Aging skin can be dry, flaking and itchy. Use a moisturizer containing petrolatum or lanolin immediately after bathing. Also, use milder soaps and consider bathing less often and using less drying warm water to bathe rather than hot water.
Drink Plenty of Water- Drinking water throughout the day ensures proper hydration of the body and helps to reduce skin dryness. Doctors and nutritionists recommend drinking at least 6-8 glasses of water every day.
Eat a Healthy Diet- Eating a healthy, balanced diet will benefit your body as well as your skin. Fruits and vegetables are particularly important for preventing premature skin aging since they contain many antioxidants.
Exercise- Exercise promotes capillary functioning which can decrease premature aging. It also increases oxygen to the tissues which keeps skin looking young and healthy
Stop Smoking - Quitting smoking at any age reduces further damage to skin.

Product Helpers

Following are some common active ingredients in over-the-counter products that can help keep your skin looking young and healthy:

Alpha-hydroxy acids (AHAs) - These acids produce a mild sloughing (peeling) action, taking off the top layer of skin and exposing the fresher skin underneath. AHAs are usually derived from fruit or from dairy products, and many moisturizers now contain them. They are safe to use on the face. These are sometimes called "lactic acid" if they’re derived from dairy products.
Retinol - Related to Vitamin A, retinol is contained in many skin creams, and may temporarily cause tissues of the face to swell very slightly, reducing the appearance of fine lines and wrinkles.
Antioxidants - Topical antioxidant vitamins such as Vitamins C and E can help support against the sun's ultraviolet rays and smoking. This can help skin appear smoother and more glowing.
Ammonium lactate - The combination of lactic acid mixed with ammonium hydroxide, ammonium lactate is used to clear up dry, scaly patches on the skin.
Ceramide - This substance is beginning to play a large part in creams intended to make skin look younger. Ceramide helps the skin hang on to its natural moisturizing lipids.

Fit after Fifty

By Kathy Jordan, MS, RD, LDN, CPT

Life is a precious gift and most of us want to live each day to the fullest. Unfortunately, as we get older, suboptimal health and fitness can affect our quality of life by limiting our ability to do our favorite activities. Many of us blame this on age. But actually, much of what we consider a result of aging is actually due to a gradual decline in muscle mass. According to the American Council on exercise, we lose 3-5% of muscle mass per decade after we turn 30. The rate of muscle loss accelerates after 50, particularly for postmenopausal women. This results in a loss of stamina, strength, and balance. According to the American College of Sports Medicine (ASCM), we can slow these losses by doing things that maintain – or even improve – muscular strength and power.

You don’t have to feel old before your time. Adopting a better diet and fitness plan will help you have the energy and stamina to continue an active lifestyle as well as prevent age-related illnesses. Attaining the best possible state of fitness requires a life-long commitment to healthy lifestyle habits. If you want to transform your body into what it was 10 or 20 years ago, consume a well balanced diet that contains plenty of lean protein, fruits, vegetables and whole grains – but that’s just the first step. A balanced exercise plan, like the one detailed below, helps complete the transformation.

There are four components of an exercise program to optimize health and slow the aging process. First and foremost is strength training. Adequate strength is needed to more easily perform daily activities such as cleaning, yard work and playing with the grandchildren, as well as enjoying your favorite pasttimes (golf, skiing, etc). The others include: balance, flexibility and cardiovascular or aerobic exercise. These are not mutually exclusive; for example, you will likely have gains in cardiovascular health and improvements in balance from resistance exercises. And you can gain some strength while working on balance or from aerobic exercises that rely on the larger muscle groups.

Strength Training
Maintaining your weight over time does not mean muscle isn't vanishing, notes Steven B. Heymsfield of St. Luke's-Roosevelt Hospital Center in New York. Muscle loss usually goes unnoticed for decades. In fact, the body hides its loss by subtly padding affected areas with extra fat. This change in body composition in favor of fat can be slowed or reversed by coupling a healthy diet with exercise that incorporates resistance training.

The American Heart Association and the American College of Sports Medicine (2007) recommend doing 10-15 repetitions of 8-10 exercises using weights or other resistance equipment two or more times per week. If you have limited time, focus on the larger muscle groups or exercises that work a combination of muscle groups at one time.

Added benefits include increased bone density and a faster metabolism, which means you’ll burn more calories throughout the day.

Here are some suggestions for maximizing your time and activating the most muscles:

  1. Focus on the large muscle groups including Quadriceps and Hamstrings.
    Your quadriceps is the large group of muscles on the front of the upper leg. These muscles run along the front of the thigh, starting at the hip joint and ending at the knee joint. Hamstrings run along the back of your leg from the knee to the hip. Together, their primary function is to flex the hip and extend/bend the knee, motions needed for walking, running, jumping, climbing stairs and pedaling. Squats and lunges target these muscles. Both can be done with or without weights.
  2. Large muscles/combination: Lat pull downs. You can do these on a lat machine or using resistance bands. This exercise uses several groups of muscles in your back as well as arms and abs if you focus on your from and posture. Other suggestions include assisted pull-ups and push-ups.

For additional exercises and demos go to the website of Georgia State University, Department of Kinesiology and Health.

While this is not the exercise of choice for adding muscle, if you are now sedentary you will add a little muscle by doing aerobic activity. The real benefits of aerobic exercise include improved circulation and emotional well-being. Low impact activities such as brisk walking, bicycling, swimming and hiking are not only easy on your joints, but also have been shown to improve cardiovascular and cognitive health. If your goal is heart health, then track your steps with a pedometer and aim for 10,000 per day. If your goal is weight loss, you may have to work up to 12,000 steps or more per day. Weight loss will be of higher quality and easier to maintain if you couple your aerobic exercise with a couple bouts of strength training every week.

Balance is “the ability to maintain the body's center of mass over its base of support against the forces of gravity and acceleration” (Shumway-Cook, 2001). If you are just turning 50, you probably aren’t overly concerned with balance. However, as the years slip by this will become more and more important for maintaining quality of life. Believe it or not, strength training, particularly with free weights, is one of the best ways to maintain balance. Other exercises that focus specifically on balance, such as step ups on a Bosu Balance ball (looks like half an exercise ball with a flat bottom) or single leg squats, can be included in your strength training routine.

Have you noticed how much more difficult it is now to reach back and get that seatbelt? Our flexibility declines as we age, resulting in restricted range of motion. Stretching after you’ve warmed up your muscles, or doing yoga and Pilates, are good ways to build flexibility. Pilates and yoga can also help you develop core strength and balance.

To build muscle and maintain overall health and fitness:

  • Weight train at least 30 minutes, 2-3 times per week, making sure you have at least 48 hours rest before working out the same muscle groups.
  • Warm up for at least 5 minutes before you start your workout.
  • A rowing machine or elliptical with the handles will warm up upper and lower body simultaneously.
  • Include at least 30 minutes of aerobic exercise 3 or more times per week. Vary your workouts to prevent overuse of the same muscles and joints.
  • Take a yoga or Pilates class once a week.

If you want to do weight training and aerobics on the same day, I recommend a 5 minute warm-up followed by 30-60 minutes of strength training, finishing with a half hour of aerobic activity such as walking, cycling or swimming.

Remember to stretch at the end of your workout when your muscles are warm and more pliable.
If you get really serious about building strength and muscle, you will need to adjust your diet. I recommend whey protein drinks before your workout and again about 10 minutes after you complete your strength training. Proper supplementation can optimize performance.

If you find you enjoy aerobic activity and want to participate in events of longer duration, you may need to include some supplements to provide extra “fuel” to maintain your energy and maximize recovery.
Regular physical activity that includes these 4 basic components – strength, aerobics, balance and flexibility – not only helps you look and feel younger; it also lowers your risk for a variety of conditions.

1. Janet Raloff. “Vanishing Flesh.” Science News online, Aug 10,1996.
2. Steven B. Heymsfield, Obesity Research Center, St. Luke's-Roosevelt Hospital Center.