Aug 27, 2020

Interview Transcript

Your arthritic joints ache, and there's a soft chair and a great book that's calling you. Tomorrow, you'll get a little exercise. Really?

After 50, it's use it or lose it. That refers to your brain, your bones, your joints, your muscles, and your heart. And after 50, the best perspective is move it or lose it.

Although many of the studies on aging and exercise use men as research subjects, more and more are including older women, and some specifically focus on women. Women are more likely to develop fragile bones from osteoporosis and creaky joints from osteoarthritis, and both are significantly improved with exercise. Women are more likely to be diagnosed with depression and anxiety, which may be like asking for directions. They are more likely to ask for help with these conditions than men, so are given the diagnosis more often.

The most common, crippling diseases of aging that lead to loss of life and quality of life include diabetes, hypertension, heart failure, and dementia. All can be modified for the better with exercise. Now, not all exercise does the same thing, and the same kind of exercise can be boring. Some exercises are off the table because of joint pain. Running is less likely to be comfortable with knee arthritis even though there's evidence that moving those joints makes them better. Some exercises are easy on your knees, but you have to get into a swimsuit, you know, hat black piece of Lycra that's hiding somewhere that you haven't put on for some years. The good news is that Lycra in old swimsuits seems to be infinitely stretchable, and at the pool, in the water aerobics class, it's just a giggle. You're under the water. Nobody can be looking at you, and you can look at everybody walking by. What fun.

For women in midlife, the following types of exercise are important. They don't need to be done every day and they don't take a long time, but some mix needs to be getting into your exercise salad.

Cardio. Ugg, I hate it when my heart beats fast. I spent a professional life as an OB-GYN working to stay calm and keep my heart rate down. But I know that getting my heart rate up is good for my brain and my heart.

Let's start with the brain. Randomized trials have found that short bouts of high-intensity exercise, 5 to 10 minutes, increases your capacity to do cognitively challenging tasks that require what's called executive function, to hold one thing in your brain that helps you solve the next step. That's really important in living. Being cardiovascularly fit, being able to do and doing cardio decreases your risk of developing dementia. It also improves insulin function, which decreases your risk of diabetes. There are lots of videos about short, high-intensity workouts, HIIT, high-intensity interval training. You don't want to run in public? How about stairs? Six minutes of going upstairs as fast as you can. Can only do it for a minute? Can only do it for 30 seconds? Work up to it. You don't have any stairs? Get a little step, 6 to 10 inches. Up one foot, then down. Up on the other foot, then down as fast as you can for a few minutes. It's okay to hold on to a chair if you're worried about your balance. Swimming, biking, rowing, running, hiking uphill, or any exercise that get your heart rate up is the right thing. Make your heart work a little is good for your heart.

Strength training. Now, post-menopausal women can put on muscle, and muscle improves insulin function. Being strong means that you can get out of a chair. Being strong means that you can rebalance yourself if you get tippy. Weight-bearing exercise in mice builds new memory neurons. Now, remember, mice like to run. They don't like to lift weights. So maybe it was the stressful new thing that was making them build new memory neurons. This probably works for women too. Or it works to improve cognitive function because new exercises, novel physical activities build more brain connections. You can do this at home. There are videos of six-minute workouts. Developed by The New York Times is a good one, that works all your muscle groups and there are bunch of them available.

Stretching and flexibility. Of course, yoga is the poster child for stretching and flexibility, but yoga was developed in a country where people have been squatting since birth, and they're more flexible. Still there are a lot of videos about stretching and keeping a range of motion in your neck, your shoulders, your hips, your knees, and your feet.

Balance. Tai Chi is the poster child for senior citizens doing balance, but there are balance exercises that you can do at home while you're brushing your teeth or waiting for the water to boil while you're making coffee. And you can Goggle "balance exercise for seniors" on your YouTube. You aren't senior? Okay, you can check out balance for deniers. There's any age. I'm a fan of Bob and Brad, the most famous physiotherapists on the internet, in their opinion, and they have lots of balance exercises.

How much? The American Heart Association recommends 150 minutes a week of moderate exercise, a brisk walk, or 75 minutes a week of vigorous exercise. And that's only about 10 and a half minutes a day if you're doing it vigorously or a combination of both. Recommendations for midlife women for resistance training, read weights, are 20 minutes 2 to 3 times a week. The 20 minutes could be several sessions of the 6-minute workout. Put the phone down. Put the book down. Walk away from the computer. Ten minutes, three times a day, upstairs, some weights, some balance. Mix it up. Pushing and pulling and lifting in the garden counts as resistance training.

Ten minutes, only 10 minutes, your heart, your brain, your joints, your mood, your sleep will all get better. Then do it again. And thanks for joining us on The Scope.

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