By Dr. Sarah Alvord
As one of the few internists in the area, I see a lot of patients aged 65 and older. On the whole, their questions revolve around how to continue to do the things they enjoy for as long as possible. As their strength and mobility decline, they are tempted by the quick fixes offered by supplement companies. The hard truth is that there’s no miracle drug or supplement to prevent, slow, or treat aging. There are, however, tried and true methods to build strength, endurance, and balance to keep us fit and able-bodied as we age.
Maintain Bone Mass
To counteract the loss of bone mass, weight-bearing exercise is essential. Weight-bearing exercises are those that force your body to work against gravity–to bear your weight–such as brisk walking, hiking, climbing stairs, playing tennis, and dancing. Health guidelines for older adults suggest 15-30 minutes of weight-bearing exercise, 5 days a week.
Maintain Balance
To counteract the loss of balance as the nervous system deteriorates, core strength and stability training are essential. Preventing falls can have a huge influence on our quality of life. When we were young, we could bounce back from a fall, but with brittle bones and less muscle, falls can lead to broken bones and tears in our muscles, ligaments, and tendons, all of which are much slower to heal. Core strengthening refers to building the muscles in your abdomen and back. Stability training means building strength, flexibility, and body awareness. Great options for stability training include tai chi, yoga, and Feldenkrais.
Maintain Strength
To counteract the loss of muscle mass, some sort of strength training (weight or resistance) is essential. If you haven’t done any exercise to speak of recently, start slowly. Weight training should start with light weights or light resistance training with elastic bands. Health guidelines recommend weight training a couple of days a week.
Cardiovascular Health
The leading causes of death in the US for persons over 65 are heart attack, cancer, and stroke. To lessen your risk of these diseases, take three steps: 1. Exercise regularly, 2. Eat a healthy diet 3. Treat any chronic conditions that lead to cardiovascular disease.
Conditions like high blood pressure, high cholesterol, and diabetes can all increase your risk of heart attack and stroke. If you have any of these conditions, you may feel just fine initially and wonder why your medical provider is urging you to make lifestyle modifications and take medications. Your provider knows that these conditions all drastically raise your risk of cardiovascular disease. It is very important for every older adult to work closely with their medical provider to effectively manage these silent killers.
For cardiovascular health, older adults need at least 150 minutes of moderate-intensity aerobic exercise per week, ideally, 30 minutes a day, 5 days a week. Pay close attention to your heart rate. Moderate-intensity exercise should put your heart rate at 50-70 percent of your maximum heart rate. Vigorous exercise should put your heart rate at 70-85 percent of your maximum heart rate. People’s maximum heart rates vary, of course, but according to the American Heart Association, the maximum heart rate of a 60-year-old is about 160 beats per minute. For a 65-year-old, the maximum is about 155 beats per minute. For a 70-year-old, it’s about 150 beats per minute. If you’re gardening or working on a ranch and your heart rate is over 100 beats per minute, that counts as exercise!
Nutrition
Once again, there’s no miracle food that provides all the nutrients you need in a single smoothie. The vitamins and minerals in processed foods, including meal replacements, are not typically absorbed into the body as well as vitamins and minerals from whole foods. Food doesn’t need to be organic; it just needs to be unprocessed (or minimally processed). Frozen fruits and vegetables are a great economical option.
Like many areas of life, nutritional needs change as we age. We don’t need as many calories overall, but we do need a little more protein to prevent the loss of lean muscle mass. Many of my patients are on a limited budget, so I always say the best food is the food you can afford.
If possible, eat the biggest variety of vegetables you can. “Eat the rainbow,” as they say. Onions, carrots, broccoli, kale, corn, turnips, and spinach all offer something beneficial. Five servings of veggies are ideal (a serving is about 1 cup of raw veggies or a ½ cup of cooked veggies) and two servings of fruit (½ cup per serving). Eat at least 25g of fiber a day; most vegetables, beans, legumes, and lentils are excellent sources of fiber. If you’re looking for a good source of protein, try seafood, as it is lower in fat and more nutrient-dense, either fresh or frozen. Seeds and nuts are also a good source of protein. Avoid saturated and trans fats and get a small amount of healthy fat (from fish, vegetables, nuts, and seeds).
Multivitamins are not needed if you are eating a balanced diet, and there has never been a study that shows they benefit anyone. Sometimes, certain vitamins and minerals like vitamin D and calcium are difficult to get solely through your diet. Talk to your provider about what your needs are.
Health & Wellbeing
The recommendations above will help maintain your body, which is an important element of health and vitality, but it’s not the whole story. Loneliness is a risk factor for poor health, increasing your risk of conditions like dementia. It’s also important to maintain supportive relationships, get enough sleep, and spend time doing activities you enjoy. I recommend meeting with your medical provider at least once a year. Medicare Wellness Visits are an opportunity for your medical provider to do a functional assessment, schedule annual screenings, and check in on your mental health.
Dr. Sarah Alvord is an internist at MCHC Health Centers, a local, non-profit, federally qualified health center offering medical, dental, and behavioral health care to people of all ages in Lake and Mendocino Counties.
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