Never Too Old?
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Age Limits On Exercise?
In Tuesday’s newsletter, we asked you your opinion on whether we should exercise less as we get older, and got the above-depicted, below-described, set of responses:
- About 42% said “No, we must keep pushing ourselves, to keep our youth“
- About 29% said “Only to the extent necessary due to chronic conditions etc”
- About 29% said “Yes, we should keep gently moving but otherwise take it easier”
One subscriber who voted for “No, we must keep pushing ourselves, to keep our youth“ wrote to add:
❝I’m 71 and I push myself. I’m not as fast or strong as I used to be but, I feel great when I push myself instead of going through the motions. I listen to my body!❞
~ 10almonds subscriber
One subscriber who voted for “Only to the extent necessary due to chronic conditions etc” wrote to add:
❝It’s never too late to get stronger. Important to keep your strength and balance. I am a Silver Sneakers instructor and I see first hand how helpful regular exercise is for seniors.❞
~ 10almonds subscriber
One subscriber who voted to say “Yes, we should keep gently moving but otherwise take it easier” wrote to add:
❝Keep moving but be considerate and respectful of your aging body. It’s a time to find balance in life and not put yourself into a positon to damage youself by competing with decades younger folks (unless you want to) – it will take much longer to bounce back.❞
~ 10almonds subscriber
These will be important, because we’ll come back to them at the end.
So what does the science say?
Endurance exercise is for young people only: True or False?
False! With proper training, age is no barrier to serious endurance exercise.
Here’s a study that looked at marathon-runners of various ages, and found that…
- the majority of middle-aged and elderly athletes have training histories of less than seven years of running
- there are virtually no relevant running time differences (p<0.01) per age in marathon finishers from 20 to 55 years
- after 55 years, running times did increase on average, but not consistently (i.e. there were still older runners with comparable times to the younger age bracket)
The researchers took this as evidence of aging being indeed a biological process that can be sped up or slowed down by various lifestyle factors.
See also:
Age & Aging: What Can (And Can’t) We Do About It?
this covers the many aspects of biological aging (it’s not one number, but many!) and how our various different biological ages are often not in sync with each other, and how we can optimize each of them that can be optimized
Resistance training is for young people only: True or False?
False! In fact, it’s not only possible for older people, but is also associated with a reduction in all-cause mortality.
Specifically, those who reported strength-training at least once per week enjoyed longer lives than those who did not.
You may be thinking “is this just the horse-riding thing again, where correlation is not causation and it’s just that healthier people (for other reasons) were able to do strength-training more, rather than the other way around?“
…which is a good think to think of, so well-spotted if you were thinking that!
But in this case no; the benefits remained when other things were controlled for:
❝Adjusted for demographic variables, health behaviors and health conditions, a statistically significant effect on mortality remained.
Although the effects on cardiac and cancer mortality were no longer statistically significant, the data still pointed to a benefit.
Importantly, after the physical activity level was controlled for, people who reported strength exercises appeared to see a greater mortality benefit than those who reported physical activity alone.❞
See the study: Is strength training associated with mortality benefits? A 15 year cohort study of US older adults
And a pop-sci article about it: Strength training helps older adults live longer
Closing thoughts
As it happens… All three of the subscribers we quoted all had excellent points!
Because in this case it’s less a matter of “should”, and more a selection of options:
- We (most of us, at least) can gain/regain/maintain the kind of strength and fitness associated with much younger people, and we need not be afraid of exercising accordingly (assuming having worked up to such, not just going straight from couch to marathon, say).
- We must nevertheless be mindful of chronic conditions or even passing illnesses/injuries, but that goes for people of any age
- We also can’t argue against a “safety first” cautious approach to exercise. After all, sure, maybe we can run marathons at any age, but that doesn’t mean we have to. And sure, maybe we can train to lift heavy weights, but if we’re content to be able to carry the groceries or perhaps take our partner’s weight in the dance hall (or the bedroom!), then (if we’re also at least maintaining our bones and muscles at a healthy level) that’s good enough already.
Which prompts the question, what do you want to be able to do, now and years from now? What’s important to you?
For inspiration, check out: Train For The Event Of Your Life!
Take care!
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Millet vs Couscous – Which is Healthier?
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Our Verdict
When comparing millet to couscous, we picked the millet.
Why?
In terms of macros, they’re pretty much equal, and are both moderately high glycemic index foods so to abate that, it’s good to have them with some fibrous foods (e.g. some vegetables) and fats (e.g. perhaps sauté the vegetables with a little olive oil), to slow down the carbs a little. But, as there’s nothing meaningful between them in this regard, we declare this category a tie.
In the category of vitamins, millet has more of vitamins B1, B2, B3, B6, B7, B9, K, and choline, while millet has more of vitmains B5 and E. An easy win for millet here.
When it comes to minerals, it’s a similar story: millet has more copper, iron, magnesium, manganese, phosphorus, potassium, and zinc, while couscous has more calcium and selenium. Another clear win for millet.
For those avoiding gluten, you want to be aware that millet is naturally gluten-free, while couscous is usually made of durum wheat and thus contains gluten.
For those avoiding oxalates (shouldn’t make any difference for most people, but if you have certain kidney problems, then it can matter), millet is low in oxalates and couscous is high in oxalates.
All in all, it’s a clear overall win for millet!
Want to learn more?
You might like to read:
Grains: Bread Of Life, Or Cereal Killer?
Enjoy!
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Low-Dose Aspirin & Anemia
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We recently wrote about…
How To Survive A Heart Attack When You’re Alone
…and one of the items was “if you have aspirin readily available, then after calling an ambulance is the time to take it—but don’t exert yourself trying to find some”.
But what of aspirin as a preventative?
Many people take low-dose aspirin daily as a way to reduce the risk of atherothrombosis specifically (and thus, indirectly, they hope to reduce the risk of heart attacks).
The science of how helpful this is both clear and complicated—that is to say, the stats are not ambiguous*, but there are complicating factors of which many people are unaware.
*it will reduce the overall risk of cardiovascular events, but will not affect CVD mortality; in other words, it may improve your recovery from minor cardiac events, but is not likely to save you from major ones.
And also, it has unwanted side effects that can constitute a more relevant threat for many people. We’ll share more on that at the end of today’s article, but first…
A newly identified threat from daily aspirin use
A large (n=313,508) study of older adults (median age 73) were sorted into those who used low-dose aspirin as a preventative, and those who did not.
The primary outcome was incidence of anemia sufficient to require treatment, and the secondary outcome was major bleeding. And, at least 1 in 5 of those who experienced anemia also experienced bleeding.
The bleeding issue was not “newly identified” and will not surprise many people; after all, the very reason that aspirin is taken as a CVD preventative is for its anti-clotting property of allowing blood to flow more freely.
The anemia, however, has been getting increasing scientific scrutiny lately, after long going unnoticed in the wild. Given that anemia also gives the symptom “dizziness”, this is also a significant threat for increasing the incidence of falls in the older population, too, which can of course lead to serious complications and ultimately death.
Here’s the paper itself:
Want to know more?
As promised, here’s what we wrote previously about some of aspirin’s other risks:
Aspirin, CVD Risk, & Potential Counter-Risks
Take care!
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Why are my muscles sore after exercise? Hint: it’s nothing to do with lactic acid
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As many of us hit the gym or go for a run to recover from the silly season, you might notice a bit of extra muscle soreness.
This is especially true if it has been a while between workouts.
A common misunderstanding is that such soreness is due to lactic acid build-up in the muscles.
Research, however, shows lactic acid has nothing to do with it. The truth is far more interesting, but also a bit more complex.
It’s not lactic acid
We’ve known for decades that lactic acid has nothing to do with muscle soreness after exercise.
In fact, as one of us (Robert Andrew Robergs) has long argued, cells produce lactate, not lactic acid. This process actually opposes not causes the build-up of acid in the muscles and bloodstream.
Unfortunately, historical inertia means people still use the term “lactic acid” in relation to exercise.
Lactate doesn’t cause major problems for the muscles you use when you exercise. You’d probably be worse off without it due to other benefits to your working muscles.
Lactate isn’t the reason you’re sore a few days after upping your weights or exercising after a long break.
So, if it’s not lactic acid and it’s not lactate, what is causing all that muscle soreness?
Muscle pain during and after exercise
When you exercise, a lot of chemical reactions occur in your muscle cells. All these chemical reactions accumulate products and by-products which cause water to enter into the cells.
That causes the pressure inside and between muscle cells to increase.
This pressure, combined with the movement of molecules from the muscle cells can stimulate nerve endings and cause discomfort during exercise.
The pain and discomfort you sometimes feel hours to days after an unfamiliar type or amount of exercise has a different list of causes.
If you exercise beyond your usual level or routine, you can cause microscopic damage to your muscles and their connections to tendons.
Such damage causes the release of ions and other molecules from the muscles, causing localised swelling and stimulation of nerve endings.
This is sometimes known as “delayed onset muscle soreness” or DOMS.
While the damage occurs during the exercise, the resulting response to the injury builds over the next one to two days (longer if the damage is severe). This can sometimes cause pain and difficulty with normal movement.
The upshot
Research is clear; the discomfort from delayed onset muscle soreness has nothing to do with lactate or lactic acid.
The good news, though, is that your muscles adapt rapidly to the activity that would initially cause delayed onset muscle soreness.
So, assuming you don’t wait too long (more than roughly two weeks) before being active again, the next time you do the same activity there will be much less damage and discomfort.
If you have an exercise goal (such as doing a particular hike or completing a half-marathon), ensure it is realistic and that you can work up to it by training over several months.
Such training will gradually build the muscle adaptations necessary to prevent delayed onset muscle soreness. And being less wrecked by exercise makes it more enjoyable and more easy to stick to a routine or habit.
Finally, remove “lactic acid” from your exercise vocabulary. Its supposed role in muscle soreness is a myth that’s hung around far too long already.
Robert Andrew Robergs, Associate Professor – Exercise Physiology, Queensland University of Technology and Samuel L. Torrens, PhD Candidate, Queensland University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Which gut drugs might end up in a lawsuit? Are there really links with cancer and kidney disease? Should I stop taking them?
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Common medicines used to treat conditions including heartburn, reflux, indigestion and stomach ulcers may be the subject of a class action lawsuit in Australia.
Lawyers are exploring whether long-term use of these over-the-counter and prescription drugs are linked to stomach cancer or kidney disease.
The potential class action follows the settlement of a related multi-million dollar lawsuit in the United States. Last year, international pharmaceutical company AstraZeneca settled for US$425 million (A$637 million) after patients made the case that two of its drugs caused significant and potentially life-threatening side effects.
Specifically, patients claimed the company’s drugs Nexium (esomeprazole) and Prilosec (omeprazole) increased the risk of kidney damage.
Doucefleur/Shutterstock Which drugs are involved in Australia?
The class of drugs we’re talking about are “proton pump inhibitors” (sometimes called PPIs). In the case of the Australian potential class action, lawyers are investigating:
- Nexium (esomeprazole)
- Losec, Asimax (omeprazole)
- Somac (pantoprazole)
- Pariet (rabeprazole)
- Zoton (lansoprazole).
Depending on their strength and quantity, these medicines are available over-the-counter in pharmacies or by prescription.
They have been available in Australia for more than 20 years and are in the top ten medicines dispensed through the Pharmaceutical Benefits Scheme.
They are used to treat conditions exacerbated by stomach acid. These include heartburn, gastric reflux and indigestion. They work by blocking the protein responsible for pumping acid into the stomach.
These drugs are also prescribed with antibiotics to treat the bacterium Helicobacter pylori, which causes stomach ulcers and stomach cancer.
This class of drugs is also used with antibiotics to treat Helicobacter pylori infections. nobeastsofierce/Shutterstock What do we know about the risks?
Appropriate use of proton pump inhibitors plays an important role in treating several serious digestive problems. Like all medicines, there are risks associated with their use depending on how much and how long they are used.
When proton pump inhibitors are used appropriately for the short-term treatment of stomach problems, they are generally well tolerated, safe and effective.
Their risks are mostly associated with long-term use (using them for more than a year) due to the negative effects from having reduced levels of stomach acid. In elderly people, these include an increased risk of gut and respiratory tract infections, nutrient deficiencies and fractures. Long-term use of these drugs in elderly people has also been associated with an increased risk of dementia.
In children, there is an increased risk of serious infection associated with using these drugs, regardless of how long they are used.
How about the cancer and kidney risk?
Currently, the Australian consumer medicine information sheets that come with the medicines, like this one for esomeprazole, do not list stomach cancer or kidney injury as a risk associated with using proton pump inhibitors.
So what does the evidence say about the risk?
Over the past few years, there have been large studies based on observing people in the general population who have used proton pump inhibitors. These studies have found people who take them are almost two times more likely to develop stomach cancer and 1.7 times more likely to develop chronic kidney disease when compared with people who are not taking them.
In particular, these studies report that users of the drugs lansoprazole and pantoprazole have about a three to four times higher risk than non-users of developing chronic kidney disease.
While these observational studies show a link between using the drugs and these outcomes, we cannot say from this evidence that one causes the other.
Researchers have not yet shown these drugs cause kidney disease. crystal light/Shutterstock What can I do if I’m worried?
Several digestive conditions, especially reflux and heartburn, may benefit from simple dietary and lifestyle changes. But the overall evidence for these is not strong and how well they work varies between individuals.
But it may help to avoid large meals within two to three hours before bed, and reduce your intake of fatty food, alcohol and coffee. Eating slowly and getting your weight down if you are overweight may also help your symptoms.
There are also medications other than proton pump inhibitors that can be used for heartburn, reflux and stomach ulcers.
These include over-the-counter antacids (such as Gaviscon and Mylanta), which work by neutralising the acidic environment of the stomach.
Alternatives for prescription drugs include nizatidine and famotidine. These work by blocking histamine receptors in the stomach, which decreases stomach acid production.
If you are concerned about your use of proton pump inhibitors it is important to speak with your doctor or pharmacist before you stop using them. That’s because when you have been using them for a while, stopping them may result in increased or “rebound” acid production.
Nial Wheate, Professor and Director – Academic Excellence, Macquarie University; Joanna Harnett, Senior Lecturer – Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, and Wai-Jo Jocelin Chan, Pharmacist and Associate Lecturer, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What is type 1.5 diabetes? It’s a bit like type 1 and a bit like type 2 – but it’s often misdiagnosed
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While you’re likely familiar with type 1 and type 2 diabetes, you’ve probably heard less about type 1.5 diabetes.
Also known as latent autoimmune diabetes in adults (LADA), type 1.5 diabetes has features of both type 1 and type 2 diabetes.
More people became aware of this condition after Lance Bass, best known for his role in the iconic American pop band NSYNC, recently revealed he has it.
So, what is type 1.5 diabetes? And how is it diagnosed and treated?
Pixel-Shot/Shutterstock There are several types of diabetes
Diabetes mellitus is a group of conditions that arise when the levels of glucose (sugar) in our blood are higher than normal. There are actually more than ten types of diabetes, but the most common are type 1 and type 2.
Type 1 diabetes is an autoimmune condition where the body’s immune system attacks and destroys the cells in the pancreas that make the hormone insulin. This leads to very little or no insulin production.
Insulin is important for moving glucose from the blood into our cells to be used for energy, which is why people with type 1 diabetes need insulin medication daily. Type 1 diabetes usually appears in children or young adults.
Type 2 diabetes is not an autoimmune condition. Rather, it happens when the body’s cells become resistant to insulin over time, and the pancreas is no longer able to make enough insulin to overcome this resistance. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin.
Type 2 is more common in adults but is increasingly seen in children and young people. Management can include behavioural changes such as nutrition and physical activity, as well as oral medications and insulin therapy.
People with diabetes may need to regularly monitor their blood sugar levels. Dragana Gordic/Shutterstock How does type 1.5 diabetes differ from types 1 and 2?
Like type 1 diabetes, type 1.5 occurs when the immune system attacks the pancreas cells that make insulin. But people with type 1.5 often don’t need insulin immediately because their condition develops more slowly. Most people with type 1.5 diabetes will need to use insulin within five years of diagnosis, while those with type 1 typically require it from diagnosis.
Type 1.5 diabetes is usually diagnosed in people over 30, likely due to the slow progressing nature of the condition. This is older than the typical age for type 1 diabetes but younger than the usual diagnosis age for type 2.
Type 1.5 diabetes shares genetic and autoimmune risk factors with type 1 diabetes such as specific gene variants. However, evidence has also shown it may be influenced by lifestyle factors such as obesity and physical inactivity which are more commonly associated with type 2 diabetes.
What are the symptoms, and how is it treated?
The symptoms of type 1.5 diabetes are highly variable between people. Some have no symptoms at all. But generally, people may experience the following symptoms:
- increased thirst
- frequent urination
- fatigue
- blurred vision
- unintentional weight loss.
Typically, type 1.5 diabetes is initially treated with oral medications to keep blood glucose levels in normal range. Depending on their glucose control and the medication they are using, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day.
When average blood glucose levels increase beyond normal range even with oral medications, treatment may progress to insulin. However, there are no universally accepted management or treatment strategies for type 1.5 diabetes.
Type 1.5 diabetes might be managed with oral medications, at least initially. Dragana Gordic/Shutterstock Type 1.5 diabetes is often misdiagnosed
Lance Bass said he was initially diagnosed with type 2 diabetes, but later learned he actually has type 1.5 diabetes. This is not entirely uncommon. Estimates suggest type 1.5 diabetes is misdiagnosed as type 2 diabetes 5–10% of the time.
There are a few possible reasons for this.
First, accurately diagnosing type 1.5 diabetes, and distinguishing it from other types of diabetes, requires special antibody tests (a type of blood test) to detect autoimmune markers. Not all health-care professionals necessarily order these tests routinely, either due to cost concerns or because they may not consider them.
Second, type 1.5 diabetes is commonly found in adults, so doctors might wrongly assume a person has developed type 2 diabetes, which is more common in this age group (whereas type 1 diabetes usually affects children and young adults).
Third, people with type 1.5 diabetes often initially make enough insulin in the body to manage their blood glucose levels without needing to start insulin medication. This can make their condition appear like type 2 diabetes, where people also produce some insulin.
Finally, because type 1.5 diabetes has symptoms that are similar to type 2 diabetes, it may initially be treated as type 2.
We’re still learning about type 1.5
Compared with type 1 and type 2 diabetes, there has been much less research on how common type 1.5 diabetes is, especially in non-European populations. In 2023, it was estimated type 1.5 diabetes represented 8.9% of all diabetes cases, which is similar to type 1. However, we need more research to get accurate numbers.
Overall, there has been a limited awareness of type 1.5 diabetes and unclear diagnostic criteria which have slowed down our understanding of this condition.
A misdiagnosis can be stressful and confusing. For people with type 1.5 diabetes, being misdiagnosed with type 2 diabetes might mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a greater likelihood of complications down the road.
Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce diabetes distress. If you’re experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you’ve already received, monitor your symptoms and chat with your doctor.
Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University and Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Beet “Kvass” With Ginger
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Kvass is a popular drink throughout Eastern Europe, with several countries claiming it, but the truth is, kvass is older than nations (as in: nations, in general, any of them; nation states are a newer concept than is often realized), and its first recorded appearance was in the city state of Kyiv.
This one is definitely not a traditional recipe, as kvass is usually made from rye, but keeping true to its Eastern European roots with (regionally popular) beetroot, it’s nevertheless a great fermented drink, full of probiotic benefits, and this time, with antioxidants too.
It’s a little saltier than most things we give recipes for here, so enjoy it on hot sunny days as a great way to replenish electrolytes!
You will need (for 1 quart / 1 liter)
- 2¾ cups filtered or spring water
- 2 beets, roughly chopped
- 1 tbsp chopped fresh ginger
- 2 tsp salt (do not omit or substitute)
Method
(we suggest you read everything at least once before doing anything)
1) Sterilize a 1-quart jar with boiling water (carefully please)
2) Put all the ingredients in the jar and stir until the salt dissolves
3) Close the lid tightly and store in a cool dark place to ferment for 2 weeks
4) Strain the beets and ginger (they are now pickled and can be enjoyed in a salad or as a kimchi-like snack), pouring the liquid into a clean jar/bottle. This can be kept in the fridge for up to a month. Next time you make it, if you use ¼ cup of this as a “starter” to replace an equal volume of water in the original recipe, the fermentation will take days instead of weeks.
5) Serve! Best served chilled, but without ice, on a hot sunny day.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Making Friends With Your Gut (You Can Thank Us Later)
- What To Eat, Take, And Do Before A Workout
- Ginger Does A Lot More Than You Think
Take care!
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