Total Fitness After 40 – by Nick Swettenham

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Time may march relentlessly on, but can we retain our youthful good health?

The answer is that we can… to a degree. And where we can’t, we can and should adapt what we do as we age.

The key, as Swettenham illustrates, is that there are lifestyle factors that will help us to age more slowly, thus retaining our youthful good health for longer. At the same time, there are factors of which we must simply be mindful, and take care of ourselves a little differently now than perhaps we did when we were younger. Here, Swettenham acts guide and instructor.

A limitation of the book is that it was written with the assumption that the reader is a man. This does mean that anything relating to hormones is assuming that we have less testosterone as we’re getting older and would like to have more, which is obviously not the case for everyone. However, happily, the actual advice remains applicable regardless.

Swettenham covers the full spread of what he believes everyone should take into account as we age:

  • Mindset changes (accepting that physical changes are happening, without throwing our hands in the air and giving up)
  • Focus on important aspects such as:
    • strength
    • flexibility
    • mobility
    • agility
    • endurance
  • Some attention is also given to diet—nothing you won’t have read elsewhere, but it’s a worthy mention.

All in all, this is a fine book if you’re thinking of taking up or maintaining an exercise routine that doesn’t stick its head in the sand about your aging body, but doesn’t just roll over and give up either. A worthy addition to anyone’s bookshelf!

Check Out Fitness After 40 On Amazon Today!

Looking for a more women-centric equivalent book? Vonda Wright M.D. has you covered (and her bio is very impressive)!

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Recommended

  • Come As You Are – by Dr. Emily Nagoski
  • Too Much Or Too Little Testosterone?
    One Man’s Saw Palmetto Is Another Woman’s Serenoa Repens… Learn about the benefits of saw palmetto, a herbal supplement that can increase testosterone levels in men and limit hair loss in both men and women.

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  • How Beneficial Is MCT Oil, Really?

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    Often derived from coconuts (though it doesn’t have to be), medium-chain triglycerides (MCTs) are trendy… But does the science back the hype?

    First, the principle

    MCTs are commonly enjoyed because unlike short- or long-chain fatty acids, they can be quickly broken down and either immediately converted quickly and easily into energy, or turned into ketones in the case of a surplus (in the case of true excess, however, it’ll simply be stored as fat).

    Most of that involves the liver, so for anyone who wants a refresher on liver health:

    How To Unfatty A Fatty Liver ← notwithstanding the title, this is also important knowledge even if your liver is healthy now—if you’d like it to stay healthy, anyway!

    You can also read about the ins and outs of glycogen metabolism and the body’s energy-based metabolic processes in general (including the body’s energy processes that go on in the liver), here:

    From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?

    If the liver turns the MCTs into ketones, those ketones will then be used for energy if there is insufficient glucose available (as the body will always use glucose from the blood first, if available, before moving to alternative energy sources such as ketones and/or fat reserves.)

    Thus, many people look to ketones as a solution for having enough energy to function while on a very low-carb diet such as the ketogenic diet:

    Ketogenic Diet: Burning Fat Or Burning Out?

    …which as you’ll recall, does work for short-term weight loss, but brings long-term health risks, so should not be undertaken for long periods of time.

    So, does MCT Oil help?

    With regard to weight loss, the research is weak and mixed:

    • Weak, because often the methodology was shoddy, often there are many factors not controlled-for, and often the sample sizes were small (and also, RCTs by their very nature tend to be quite short-term (often 6, 8, or 12 weeks), whereas heavy reliance on ketones from MCTs may fall into the same long-term problems as the ketogenic diet in general).
    • Mixed, because the results varied widely (probably because of the aforementioned problems).

    Rather than pick at individual studies, let’s look at this review and meta-analysis of 13 studies, with a combined sample size of 749 people (so you can imagine how small the individual RCTs were):

    ❝Compared with LCTs, MCTs decreased body weight (-0.51 kg [95% CI-0.80 to -0.23 kg]; P<0.001; I(2)=35%); waist circumference (-1.46 cm [95% CI -2.04 to -0.87 cm]; P<0.001; I(2)=0%), hip circumference (-0.79 cm [95% CI -1.27 to -0.30 cm]; P=0.002; I(2)=0%), total body fat (standard mean difference -0.39 [95% CI -0.57 to -0.22]; P<0.001; I(2)=0%), total subcutaneous fat (standard mean difference -0.46 [95% CI -0.64 to -0.27]; P<0.001; I(2)=20%), and visceral fat (standard mean difference -0.55 [95% CI -0.75 to -0.34]; P<0.001; I(2)=0%).

    No differences were seen in blood lipid levels.

    Many trials lacked sufficient information for a complete quality assessment, and commercial bias was detected.❞

    So, if we’re going to take those numbers at face value, that means a net weight loss, over the course of the trial period, was…

    *drumroll*

    0.51kg (that’s about 1 lb).

    To put that into perspective, if you did nothing else but pee 1 cup of urine before getting weighed, you’d register as having lost 0.25kg (or about ½ lb) by virtue of the bathroom trip alone.

    Here’s the paper:

    Effects of medium-chain triglycerides on weight loss and body composition: a meta-analysis of randomized controlled trials

    What about cholesterol and heart health?

    With regard to cholesterol, MCT oil is touted as improving blood lipids, which means lowering LDL and increasing HDL (within a safe range, anyway).

    You’ll remember that the above review concluded “No differences were seen in blood lipid levels”.

    It may again be a case of individual studies cancelling each other out. For example…

    This study found that it improved lipids in 40 young women as part of a calorie-controlled interventional diet:

    Effects of dietary coconut oil on the biochemical and anthropometric profiles of women presenting abdominal obesity

    This study found that it worsened lipids in 17 young men, worse even than taking an equivalent amount of sunflower oil:

    Effects of medium-chain fatty acids and oleic acid on blood lipids, lipoproteins, glucose, insulin, and lipid transfer protein activities

    In short, it’s a gamble.

    It may be good for insulin sensitivity, though

    This one seems to be specific to people with type 2 diabetes. The paper heading says it all, but we include the link in case you want to know the details (the short version is, it improved insulin sensitivity in diabetic subjects only (not others), and didn’t affect anything else that was measured:

    Dietary substitution of medium-chain triglycerides improves insulin-mediated glucose metabolism in NIDDM subjects

    The sample size was small (20 people total, of whom 10 had diabetes), and the next study was with 40 people, this time moderately overweight and all with type 2 diabetes:

    Effects of dietary medium-chain triglyceride on weight loss and insulin sensitivity in a group of moderately overweight free-living type 2 diabetic Chinese subjects

    Want to try some?

    We don’t sell it, but here for your convenience is an example product on Amazon 😎

    Enjoy!

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  • Pear vs Peach – Which is Healthier?

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    Our Verdict

    When comparing pears to peaches, we picked the peaches.

    Why?

    Both are great! But peaches are exceptional in some ways that pears just can’t match up to:

    In terms of macros, pears have more carbs and fiber, the ratio of which results in an approximately equal glycemic index. Thus, we’ll say that pears win this round by virtue of being the nutritionally denser option.

    Looking at the vitamins, pears have (slightly) more of vitamins B6, B9, and K, while peaches have (much) more of vitamins A, B1, B2, B3, B5, B7, C, E, and choline—thus sweeping this category easily for peaches.

    In the category of minerals, pears have more calcium and copper, while peaches have more iron, magnesium, manganese, phosphorus, potassium, and zinc. This time, the margins of difference for each mineral are comparably low (i.e. pears are close behind peaches on all those minerals), but still, by strength of numbers, it’s a clear win for peaches.

    When it comes to polyphenols, not only do peaches have more, but also, they have anticancer properties that pears don’t—see our link below for more about that!

    Meanwhile, adding up the sections makes for an overall win for peaches, but as ever when it comes to fruits, by all means enjoy either or both; diversity is good!

    Want to learn more?

    You might like to read:

    Top 8 Fruits That Prevent & Kill Cancer ← peaches in the #2 spot! They induce cell death in cancer cells while sparing healthy ones

    Enjoy!

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  • Why STIs Are On The Rise In Older Adults

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Three Little Words

    Sexually Transmitted Infections (STIs) are often thought of as something that predominantly plagues younger people… The truth, however, is different:

    ❝Rising divorce rates, forgoing condoms as there is no risk of pregnancy, the availability of drugs for sexual dysfunction, the large number of older adults living together in retirement communities, and the increased use of dating apps are likely to have contributed to the growing incidence of STIs in the over-50s.

    These data likely underestimate the true extent of the problem as limited access to sexual health services for the over 50s, and trying to avoid the stigma and embarrassment both on the part of older people and healthcare professionals, is leading to this age group not seeking help for STIs.❞

    ~ Dr. Justyna Kowalska

    Read more: Managing The Rise In STIs Among Older Adults

    That said, there is a gender gap when it comes to the increased risk, for example:

    ❝A retrospective study from the USA involving 420,790 couples aged 67 to 99 years, found that widowhood was associated with an increased risk of STIs in older men, but not women❞

    ~ US Dept of Health & Human Services

    Source: CDC: | Sexually Transmitted Disease Surveillance

    Is abstinence the best preventative, then?

    It is inarguably the most effective, but not necessarily the best for everyone.

    This is because for most adults, a healthy sex life is an important part of overall wellbeing.

    See also: Mythbusting The Big O

    Even in this case there is a gender gap in:

    • the level of importance placed on frequency of sexual interactions
    • what act(s) of sexuality are held to be most important:

    ❝Among sexually active men, frequent (≥2 times a month) sexual intercourse (P < .001) and frequent kissing, petting, or fondling (P < .001) were associated with greater enjoyment of life.

    Among sexually active women, frequent kissing, petting, or fondling was also associated with greater enjoyment of life (P < .001), but there was no significant association with frequent intercourse (P = .101).

    Concerns about one’s sex life and problems with sexual function were strongly associated with lower levels of enjoyment of life in men and to a lesser extent in women.❞

    ~ Dr. Lee Smith et al.

    Source: Sexual Activity is Associated with Greater Enjoyment of Life in Older Adults

    If you have the time to go into it much more deeply, this paper from the Journal of Gerontology is much more comprehensive, looking also at related lifestyle factors, religious/political backgrounds, views on monogamy or non-monogamy (of various kinds), hormonal considerations, the impact of dementia or other long-term disabilities that may affect things, widowhood, and many other elements:

    The National Social Life, Health, and Aging Project: An Introduction

    What’s the best preventative, then?

    Regular health screening for yourself and your partner(s) is an important key to preventative health when it comes to STIs.

    You can Google search for a local STI clinic, and worry not, they are invariably discreet and are well-used to everybody coming in. They’re just glad you’re being responsible about things. It’s also not their job to judge your sexual activities, even if it’s something you might have reason to wish to be secretive about, try to be honest there.

    Secondly, most of the usual advice about safe sex still goes, even when there’s no risk of pregnancy. For example, if there’s at least one penis involved, then condoms remain the #1 barrier to all manner of potential infections (we know, almost nobody likes condoms, but sometimes the truth isn’t what we want to hear).

    Lastly, if there’s at least one vagina involved, then please for the love of all that is holey, do not put anything there that could cause a yeast infection.

    What can cause a yeast infection? Pretty much anything with sugar, which includes but is not limited to:

    • Most kinds of food that Cosmo-style “liven things up in the bedroom” advice columns might suggest using (including fruit, honey, chocolate sauce, whipped cream, etc)
    • Hands that are not clean (watch out for bacteria too)
    • A mouth that has recently been eating or drinking anything with sugar in it, and that includes many kinds of alcohol, as well as milk or hot drinks that had milk in

    Yeast infections are not nearly so serious as the STIs the other measures are there to avoid, but they’re not fun either, so some sensible policies in that regard are always good!

    On a related note, see also: How To Avoid UTIs

    Recap on the single most important part of this article:

    At all ages, it remains a good health practice—unless one is absolutely celibate—to regularly get oneself and one’s partner(s) checked for STIs.

    Take care!

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Related Posts

  • Come As You Are – by Dr. Emily Nagoski
  • Vitamin D2 vs Vitamin D3: What You Would Benefit From Knowing

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small 😎

    ❝Hi, is there any important difference between vitamin d2 and vitamin d3? Is one better than the other?❞

    There is indeed! And one is better than the other!

    Where they come from

    You’ll find a lot of sources that will tell you “Vitamin D2 is from plants, D3 is from animals”, and in fact only the second half of that is true.

    In nature, there are no plants that are known to produce vitamin D.

    Vitamin D2, however, is produced by many fungi, as well as algae, neither of which are part of the Kingdom Plantae.

    Vitamin D3, meanwhile, is produced by many animals (including humans).

    When “the sun” is sometimes considered a source of vitamin D, that’s true only insofar as the sun is also a source of tomatoes, for example, which required the sun to grow. While we humans (and other animals) cannot photosynthesize in general, producing vitamin D is something we can do if exposed to UV light (such as from the sun).

    However, of course exposure to UV light (such as from the sun) comes with other problems, so… Should we get sun exposure or not?

    We weighed up the balance of evidence, here: The Sun Exposure Dilemma

    If, like this writer, you are a mostly crepuscular being who avoids the sun, we have good news: mushrooms can do the sunbathing for us!

    ❝Exposing mushrooms to UV (from sunlight or in a laboratory) increases the amount of vitamin D in mushrooms by nearly eightfold. Putting five store-bought button mushrooms in the sun, or just one portobello mushroom, produces 24 µg of vitamin D, which translates to nearly 1000 international units, providing the amount of vitamin D one needs in an entire day, and the equivalent found in most vitamin D supplements.

    If you’re wondering if the vitamin D from mushrooms actually makes it into your bloodstream, it does. A recent meta-analysis of randomized controlled trials showed that tanned (UV-exposed) mushrooms may be effective in increasing active vitamin D levels in adults with low levels of vitamin D, and studies (randomised controlled trials) have shown that it may be just as effective as supplements at increasing vitamin D levels in the blood (here, and here).

    Some research is very positive, saying that putting your mushrooms in direct sunlight for 10–15 minutes may provide you with 100% of your daily vitamin D needs, and the vitamin D content in sunlight-exposed mushrooms may be retained with refrigeration for up to 8 days.

    The production of vitamin D may be increased by a further 30% by placing them in the sun with the underside, or gills, facing up, or by 60% if you slice them.❞

    Read all about it: Tan your mushrooms, not your skin

    Which is better?

    In few words: D3 is better.

    They both do the exact same job, but with D3, you simply get more bang-for-buck:

    ❝The WMD in change in total 25(OH)D based on 12 daily dosed vitamin D2-vitamin D3 comparisons, analyzed using liquid chromatography-tandem mass spectrometry, was 10.39 nmol/L (40%) lower for the vitamin D2 group compared with the vitamin D3 group.

    Vitamin D3 leads to a greater increase of 25(OH)D than vitamin D2, even if limited to daily dose studies, but vitamin D2 and vitamin D3 had similar positive impacts on their corresponding 25(OH)D hydroxylated forms.❞

    Note: “WMD” here means “weighted mean difference”, not “weapons of mass destruction”

    Read in full: Comparison of the Effect of Daily Vitamin D2 and Vitamin D3 Supplementation on Serum 25-Hydroxyvitamin D Concentration (Total 25(OH)D, 25(OH)D2, and 25(OH)D3) and Importance of Body Mass Index: A Systematic Review and Meta-Analysis

    About that “and importance of BMI”, by the way: in persons with a BMI >25, there was no longer a difference between the two forms. Literally, no difference at all; the difference was reduced to 0%.

    Another study found similarly, but with different numbers (finding a greater difference), and without recording BMI as a factor:

    ❝D3 is approximately 87% more potent in raising and maintaining serum 25(OH)D concentrations and produces 2- to 3-fold greater storage of vitamin D than does equimolar D2.❞

    See the paper: Vitamin D3 Is More Potent Than Vitamin D2 in Humans

    “Well that sucks, because I’m vegan”

    Fear not, you can get vegan D3 too.

    Much like “you can’t get vegan B12” (but you can; it’s made by yeast), there are vegan D3 supplements, made by lichen.

    The trouble with lichen, when it comes to classifying it, it that it’s actually a hybrid colony of many small, strange things (beyond the scope of this article, but they are fascinating, so this writer is holding herself back by the scruff of the neck from explaining in detail), some of which are technically part of Kingdom Animalia, but it is hard to find even the most ardent vegan who will object to consuming bacteria, for example.

    Want to try some?

    We don’t sell it, but here for your convenience is an example product on Amazon 😎

    But watch out with the doses, if supplementing vitamin D in either form, because…

    Vit D + Calcium: Too Much Of A Good Thing? ← this also talks about safe and effective doses, and what goes wrong if you take too much

    Take care!

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  • Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to updated treatment guidelines from the Australian Commission on Safety and Quality in Health Care.

    So what is knee osteoarthritis and what are the best ways to manage it?

    Pexels/Kindelmedia

    More than 2 million Australians have osteoarthritis

    Osteoarthritis is the most common joint disease, affecting 2.1 million Australians. It costs the economy A$4.3 billion each year.

    Osteoarthritis commonly affects the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles.

    Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs.

    Is it caused by ‘wear and tear’?

    Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is not caused by “wear and tear”.

    Research shows the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are not required to diagnose knee osteoarthritis or guide treatment decisions.

    Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have shown this in people with osteoarthritis, and other common pain conditions such as back and shoulder pain.

    This has led to a global call for a change in the way we think and communicate about osteoarthritis.

    What’s the best way to manage osteoarthritis?

    Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These include education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines.

    Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms.

    Health professionals who use positive and reassuring language can improve people’s knowledge and beliefs about osteoarthritis and its management.

    Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as paracetamol and anti-inflammatories and can prevent or delay the need for joint replacement surgery in the future.

    Many types of exercise are effective for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you.

    Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time.

    Weight management is important for those who are overweight or obese. Weight loss can reduce knee pain and disability, particularly when combined with exercise. Losing as little as 5–10% of your body weight can be beneficial.

    Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. Recommended medicines include paracetamol and non-steroidal anti-inflammatory drugs.

    Opioids are not recommended. The risk of harm outweighs any potential benefits.

    What about surgery?

    People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement.

    Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain.

    However, high-quality research has shown arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis.

    Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, 53,500 Australians had a knee replacement for their osteoarthritis.

    Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management.

    The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments.

    I have knee osteoarthritis. What should I do?

    The care standard links to free evidence-based resources to support people with osteoarthritis. These include:

    If you have osteoarthritis, you can use the care standard to inform discussions with your health-care provider, and to make informed decisions about your care.

    Belinda Lawford, Postdoctoral research fellow in physiotherapy, The University of Melbourne; Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney, and Rana Hinman, Professor in Physiotherapy, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Salmon vs Tuna – Which is Healthier?

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    Our Verdict

    When comparing salmon to tuna, we picked the tuna.

    Why?

    It’s close, and there are merits and drawbacks to both!

    In terms of macros, tuna is higher in protein, while salmon is higher in fats. How healthy are the fats, you ask? Well, it’s a mix, because while there are plenty of “good” fats in salmon, salmon is also 10x higher in saturated fat and 150% higher in cholesterol.

    So when it comes to fats, if you want to eat fish and have the healthiest fats, one option is to skip the salmon, and instead serve tuna with some extra virgin olive oil.

    We’ll call this section a clear win for tuna.

    On the vitamin front, they are close to equal. Salmon has more of some vitamins, tuna has more of others; all in all we’d say the balance is in salmon’s favor, but by the time a portion of salmon is giving you 350% of your daily requirement, does it really matter that the same portion of tuna is “only” giving you 294% of the daily requirement? It goes like that for a lot of the vitamins they both contain.

    Still, we’ll call this section a nominal win for salmon.

    In the category of minerals, tuna is much higher in iron while salmon is higher in calcium. The rest of the minerals they both have, tuna is comfortably higher—and since the “% of RDA in a portion” figures are double-digit here rather than triple, those margins are relevant this time.

    We’ll call this section a moderate win for tuna.

    Both fish carry a risk of mercury poisoning, but this varies more by location than by fish, so it hasn’t been a consideration in this head-to-head.

    Totting up the sections, this a modest but clear win for tuna.

    Want to learn more?

    You might like to read:

    Farmed Fish vs Wild-Caught: Important Differences!

    Take care!

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