Staying Strong: Tips To Prevent Muscle Loss With Age

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Dr. Andrea Furlan, specialist in physical medicine and rehabilitation with 30 years of experience, has advice:

Fighting sarcopenia

Sarcopenia is so common as to be considered “natural”, but “natural” does not mean “obligatory” and it certainly doesn’t mean “healthy”. As for how to fight it?

You may be thinking “let us guess, is it eat protein and do resistance exercises? And yes it is, but that’s only part of it…

Firstly, she recommends remembering why you are doing this, or because understanding is key to compliance (i.e. your perfect diet and exercise program will mean nothing if you don’t actually do it, and you won’t do it enough to make it a habit, let alone keep it up, if the reasons aren’t clear in your mind).

Sarcopenia comes with an increased risk of falls, reduced physical capacity in general, resultant disability, social isolation, and depression. Of course, this is not a one-to-one equation; you will not necessarily become depressed the moment your muscle mass is below a certain percentage, but statistically speaking, the road to ruin is laid out clearly.

Secondly, she recommends being on the lookout for it. If you check your body composition regularly with a gadget, that’s great and laudable; if you don’t, then a) consider getting one (here’s an example product on Amazon), and b) watch out for decreased muscle strength, fatigue, reduced stamina, noticeable body shape changes with muscle loss and (likely) fat gain.

Thirdly, she recommends more than just regular resistance training and good protein intake. Yes, she recommends those things too, but also getting enough water (can’t rebuild the body without it), avoiding a sedentary lifestyle (sitting leads to atrophy of many supporting and stabilizing muscles, you know, the kind of muscles that don’t look flashy but stop you falling down), and getting good sleep—vital for all kinds of body maintenance, and muscle maintenance is no exception (there’s a reason bodybuilders sleep 9–12 hours daily when in a gaining phase; you don’t need to do that, but don’t skimp on your 7–9 hours, yes, really, even you, yes, at any age).

Lastly, she recommends continuing to learn about the topic, as otherwise it’s easy to go off-track.

For more information on all of the above and more, enjoy:

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  • Toasted Chick’n Mango Tacos

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    Tacos aren’t generally held up as the world’s healthiest food, but they can be! There’s so much going on in this dish today, healthwise, in a good way, that it’s hard to know where to start. But suffice it to say, these tacos are great for your gut, heart, blood sugars, and more.

    You will need

    For the chickpeas:

    • 1 can chickpeas, drained
    • 1 tbsp ras el-hanout*
    • 1 tsp red pepper flakes
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Extra virgin olive oil

    *You can easily make this yourself; following our recipe (linked above in the ingredients list) will be better than buying it ready-made, and if you have strong feelings about any of the ingredients, you can adjust per your preference.

    For the tahini sauce:

    • ⅓ cup tahini
    • 2 tbsp apple cider vinegar
    • 2 tbsp finely chopped fresh dill
    • ¼ bulb garlic, minced
    • 1 tsp red pepper flakes
    • ½ tsp black pepper, coarse ground

    It may seem like salt is conspicuous by its absence, but there is already enough in the chickpeas component; you do not want to overwhelm the dish. Trust us that enjoying these things together will be well-balanced and delicious as written.

    For the mango relish:

    • ½ mango, pitted, peeled, and cubed
    • 2 tsp apple cider vinegar
    • 2 tsp cilantro, finely chopped (substitute with parsley if you have the “cilantro tastes like soap” gene)
    • 1 tsp red pepper flakes

    For building the taco:

    • Soft corn tortillas
    • Handful of arugula
    • 1 avocado, pitted, peeled, and sliced
    • ½ red onion, sliced

    Method

    (we suggest you read everything at least once before doing anything)

    1) Heat a sauté pan with a little olive oil in; add the chickpeas and then the rest of the ingredients from the chickpea section; cook for about 5 minutes, stirring frequently, and set aside.

    2) Combine the tahini sauce ingredients in a small bowl, stirring in ¼ cup water, and set aside.

    3) Combine the mango relish ingredients in a separate small bowl, and set aside. You can eat the other half of the mango if you like.

    4) Lightly toast the tortillas in a dry skillet, or using a grill.

    5) Assemble the tacos; we recommend the order: tortillas, arugula, avocado slices, chickpeas, mango relish, red onion slices, tahini sauce.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

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  • Good Energy – by Dr. Casey Means

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    For a book with a title like “Good Energy” and chapters such as “Bad Energy Is the Root of Disease”, this is actually a very science-based book (and there are a flock of well-known doctors saying so in the “praise for” section, too).

    The premise is simple: most of our health is a matter of what our metabolism is (or isn’t) doing, and it’s not just a case of “doing more” or “doing less”. Indeed, a lot of “our” energy is expended doing bad things (such as chronic inflammation, to give an obvious example).

    Dr. Means outlines about a dozen things many people do wrong, and about a dozen things we can do right, to get our body’s energy system working for us, rather than against us.

    The style here is pop-science throughout, and in the category of criticism, the bibliography is offloaded to her website (we prefer to have things in our hands). However, the information here is good, clearly-presented, and usefully actionable.

    Bottom line: if you ever find yourself feeling run-down and like your body is using your resources against you rather than for you, this is the book to get you out of that slump!

    Click here to check out Good Energy, and get your metabolism working for you!

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  • Super-Nutritious Shchi

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    Today we have a recipe we’ve mentioned before, but now we have standalone recipe pages for recipes, so here we go. The dish of the day is shchi—which is Russian cabbage soup, which sounds terrible, and looks as bad as it sounds. But it tastes delicious, is an incredible comfort food, and is famous (in Russia, at least) for being something one can eat for many days in a row without getting sick of it.

    It’s also got an amazing nutritional profile, with vitamins A, B, C, D, as well as lots of calcium, magnesium, and iron (amongst other minerals), and a healthy blend of carbohydrates, proteins, and fats, plus an array of anti-inflammatory phytochemicals, and of course, water.

    You will need

    • 1 large white cabbage, shredded
    • 1 cup red lentils
    • ½ lb tomatoes, cut into eighths (as in: halve them, halve the halves, and halve the quarters)
    • ½ lb mushrooms sliced (or halved, if they are baby button mushrooms)
    • 1 large onion, chopped finely
    • 1 tbsp rosemary, chopped finely
    • 1 tbsp thyme, chopped finely
    • 1 tbsp black pepper, coarse ground
    • 1 tsp cumin, ground
    • 1 tsp yeast extract
    • 1 tsp MSG, or 2 tsp low-sodium salt
    • A little parsley for garnishing
    • A little fat for cooking; this one’s a tricky and personal decision. Butter is traditional, but would make this recipe impossible to cook without going over the recommended limit for saturated fat. Avocado oil is healthy, relatively neutral in taste, and has a high smoke point for caramelizing the onions. Extra virgin olive oil is also a healthy choice, but not as neutral in flavor and does have a lower smoke point. Coconut oil has far too strong a taste and a low smoke point. Seed oils are very heart-unhealthy. All in all, avocado oil is a respectable choice from all angles except tradition.

    Note: with regard to the seasonings, the above is a basic starting guide; feel free to add more per your preference—however, we do not recommend adding more cumin (it’ll overpower it) or more salt (there’s enough sodium in here already).

    Method

    (we suggest you read everything at least once before doing anything)

    1) Cook the lentils until soft (a rice cooker is great for this, but a saucepan is fine); be generous with the water; we are making a soup, after all. Set them aside without draining.

    2) Sauté the cabbage, and put it in a big stock pot or similar large pan (not yet on the heat)

    3) Fry the mushrooms, and add them to the big pot (still not yet on the heat)

    4) Use a stick blender to blend the lentils in the water you cooked them in, and then add to the big pot too.

    5) Turn the heat on low, and if necessary, add more water to make it into a rich soup

    6) Add the seasonings (rosemary, thyme, cumin, black pepper, yeast extract, MSG-or-salt) and stir well. Keep the temperature on low; you can just let it simmer now because the next step is going to take a while:

    7) Caramelize the onion (keep an eye on the big pot, stirring occasionally) and set it aside

    8) Fry the tomatoes quickly (we want them cooked, but just barely) and add them to the big pot

    9) Serve! The caramelized onion is a garnish, so put a little on top of each bowl of shchi. Add a little parsley too.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

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  • Shrimp vs Caviar – Which is Healthier?

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    Our Verdict

    When comparing shrimp to caviar, we picked the caviar.

    Why?

    Both of these seafoods share a common history (also shared with lobster, by the way) of “nutrient-dense peasant-food that got gentrified and now it’s more expensive despite being easier to source”. But, cost and social quirks aside, what are their strengths and weaknesses?

    In terms of macros, both are high in protein, but caviar is much higher in fat. You may be wondering: are the fats healthy? And the answer is that it’s a fairly even mix between monounsaturated (healthy), polyunsaturated (healthy), and saturated (unhealthy). The fact that caviar is generally enjoyed in very small portions is its saving grace here, but quantity for quantity, shrimp is the natural winner on macros.

    …unless we take into account the omega-3 and omega-6 balance, in which case, it’s worthy of note that caviar has more omega-3 (which most people could do with consuming more of) while shrimp has more omega-6 (which most people could do with consuming less of).

    When it comes to vitamins, caviar has more of vitamins A, B1, B2, B5, B6, B9, B12, D, K, and choline; nor are the margins small in most cases, being multiples (or sometimes, tens of multiples) higher. Shrimp, meanwhile, boasts only more vitamin B3.

    In the category of minerals, caviar leads with more calcium, iron, magnesium, manganese, phosphorus, potassium, and selenium, while shrimp has more copper and zinc.

    All in all, while shrimp has its benefits for being lower in fat (and thus also, for those whom that may interest, lower in calories), caviar wins the day by virtue of its overwhelming nutritional density.

    Want to learn more?

    You might like to read:

    What Omega-3 Fatty Acids Really Do For Us

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  • Alzheimer’s Sex Differences May Not Be What They Appear

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    Alzheimer’s Sex Differences May Not Be What They Appear

    Women get Alzheimer’s at nearly twice the rate than men do, and deteriorate more rapidly after onset, too.

    So… Why?

    There are many potential things to look at, but four stand out for quick analysis:

    • Chromosomes: women usually have XX chromosomes, to men’s usual XY. There are outliers to both groups, people with non-standard combinations of chromosomes, but not commonly enough to throw out the stats.
    • Hormones: women usually have high estrogen and low testosterone, compared to men. Again there are outliers and this is a huge oversimplification that doesn’t even look at other sex hormones, but broadly speaking (which sounds vague, but is actually what is represented in epidemiological studies), it will be so.
    • Anatomy: humans have some obvious sexual dimorphism (again, there are outliers, but again, not enough to throw out the stats); this seems least likely to be relevant (Alzheimer’s is probably not stored in the breasts, for examples), though average body composition (per muscle:fat ratio) could admittedly be a factor.
    • Social/lifestyle: once again, #NotAllWomen etc, but broadly speaking, women and men often tend towards different social roles in some ways, and as we know, of course lifestyle can play a part in disease pathogenesis.

    As a quick aside before we continue, if you’re curious about those outliers, then a wiki-walk into the fascinating world of intersex conditions, for example, could start here. But by and large, this won’t affect most people.

    So… Which parts matter?

    Back in 2018, Dr. Maria Teresa Ferretti et al. kicked up some rocks in this regard, looking not just at genes (as much research has focussed on) or amyloid-β (again, well-studied) but also at phenotypes and metabolic and social factors—bearing in mind that all three of those are heavily influenced by hormones. Noting, for example, that (we’ll quote directly here):

    • Men and women with Alzheimer disease (AD) exhibit different cognitive and psychiatric symptoms, and women show faster cognitive decline after diagnosis of mild cognitive impairment (MCI) or AD dementia.
    • Brain atrophy rates and patterns differ along the AD continuum between the sexes; in MCI, brain atrophy is faster in women than in men.
    • The prevalence and effects of cerebrovascular, metabolic and socio-economic risk factors for AD are different between men and women.

    See: Sex differences in Alzheimer disease—the gateway to precision medicine

    So, have scientists controlled for each of those factors?

    Mostly not! But they have found clues, anyway, while noting the limitations of the previous way of conducting studies. For example:

    ❝Women are more likely to develop Alzheimer’s disease and experience faster cognitive decline compared to their male counterparts. These sex differences should be accounted for when designing medications and conducting clinical trials❞

    ~ Dr. Feixiong Cheng

    Read: Research finds sex differences in immune response and metabolism drive Alzheimer’s disease

    Did you spot the clue?

    It was “differences in immune response and metabolism”. These things are both influenced by (not outright regulated by, but strongly influenced by) sex hormones.

    ❝As [hormonal] sex influences both the immune system and metabolic process, our study aimed to identify how all of these individual factors influence one another to contribute to Alzheimer’s disease❞

    ~ Dr. Justin Lathia

    Ignoring for a moment progesterone’s role in metabolism, estrogen is an immunostimulant and testosterone is an immunosuppressant. These thus both also have an effect in inflammation, which yes, includes neuroinflammation.

    But wait a minute, shouldn’t that mean that women are more protected, not less?

    It should! Except… Alzheimer’s is an age-related disease, and in the age-bracket that generally gets Alzheimer’s (again, there are outliers), menopause has been done and dusted for quite a while.

    Which means, and this is critical: post-menopausal women not on HRT are essentially left without the immune boost usually directed by estrogen, while men of the same age will be ticking over with their physiology that (unlike that of the aforementioned women) was already adapted to function with negligible estrogen.

    Specifically:

    ❝The metabolic consequences of estrogen decline during menopause accelerate neuropathology in women❞

    ~ Dr. Rasha Saleh

    Source: Hormone replacement therapy is associated with improved cognition and larger brain volumes in at-risk APOE4 women

    Critical idea to take away from all this:

    Alzheimer’s research is going to be misleading if it doesn’t take into account sex differences, and not just that, but also specifically age-relevant sex differences—because that can flip the narrative. If we don’t take age into account, we could be left thinking estrogen is to blame, when in fact, it appears to be the opposite.

    In the meantime, if you’re a woman of a certain age, you might talk with a doctor about whether HRT could be beneficial for you, if you haven’t already:

    ❝Women at genetic risk for AD (carrying at least one APOE e4 allele) seem to be particularly benefiting from MHT❞

    (MHT = Menopausal Hormone Therapy; also commonly called HRT, which is the umbrella term for Hormone Replacement Therapies in general)

    ~ Dr. Herman Depypere

    Source study: Menopause hormone therapy significantly alters pathophysiological biomarkers of Alzheimer’s disease

    Pop-sci press release version: HRT could ward off Alzheimer’s among at-risk women

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  • The Brain’s Way of Healing – by Dr. Norman Doidge

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    First, what this book isn’t: any sort of wishy-washy “think yourself better” fluff, and nor is it a “tapping into your Universal Divine Essence” thing.

    In contrast, Dr. Norman Doidge sticks with science, and the only “vibrational frequencies” involved are the sort that come from an MRI machine or similar.

    The author makes bold claims of the potential for leveraging neuroplasticity to heal many chronic diseases. All of them are neurological in whole or in part, ranging from chronic pain to Parkinson’s.

    How well are these claims backed up, you ask?

    The book makes heavy use of case studies. In science, case studies rarely prove anything, so much as indicate a potential proof of principle. Clinical trials are what’s needed to become more certain, and for Dr. Doidge’s claims, these are so far sadly lacking, or as yet inconclusive.

    Where the book’s strengths lie is in describing exactly what is done, and how, to effect each recovery. Specific exercises to do, and explanations of the mechanism of action. To that end, it makes them very repeatable for any would-be “citizen scientist” who wishes to try (in the cases that they don’t require special equipment).

    Bottom line: this book would be more reassuring if its putative techniques had enjoyed more clinical studies… But in the meantime, it’s a fair collection of promising therapeutic approaches for a number of neurological disorders.

    Click here to check out The Brain’s Way of Healing, and learn more!

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