Antidote to Frailty: Diet and Exercise

AgingpinkclusterrosesIf we’re looking for a blueprint for healthy aging, take a closer look at diet and exercise. The combination is unbeatable to enjoy the last third of life. And it’s never too late to renew a vow to get in better shape.

Linda P. Fried’s focus called the Cycle of Frailty bears close scrutiny. Dr. Fried (geriatrics), at the Mailman School of Public Health, Columbia University, is part of the MacArthur Foundation Research Network. She has studied frailty in the elderly and discovered something quite important. Her conclusions now are called the Frailty Syndrome. This is similar to the Metabolic Syndrome of obesity, hypertension, high cholesterol and high glucose that, when present in middle age, accelerate a downslide in health because the symptoms interact.

The Frailty Syndrome is weight loss, declining strength and fitness, weakness, loss of muscle mass. It’s a slowing of walking, a low activity level, low energy, falling. In a downward spiral, it ends in metabolic changes of immune suppression, glucose intolerance and other serious factors. For years doctors watched this collection of problems and assumed an underlying illness such as cancer. Many assumed such a condition was endemic with the aging process. Usually chronic infections set in further weakening the individual. They may be respiratory or bladder—generally infections that once were occasional–and now are nearly constant and difficult to clear up.

Dr. Fried’s research conclusively proved that the Frailty Syndrome is caused by chronic malnutrition. This is not calorie restriction. It’s a lack of sufficient nutrients to maintain health over time. The first sign usually is weight loss. Once the syndrome takes hold it can be difficult to turn it back. This may not only be in the very aged but in periods throughout life: the malnourished teenager or the new mom with low nutrients. The difference is that the elderly have less resilience when it comes to turning around the cascade of decline. This is why an excellent diet/exercise is so important throughout life.

If we imagined we could age well without exercise, all indicators point otherwise. To reach a healthy old age, both aerobics and weights offset muscle decline and circulatory sluggishness. We should be running, walking, swimming, bicycling and hiking. We should be stretching and exerting resistance on weight machines. Twenty minutes with each several times a week is essential. This is the core message of Walter M. Bortz II, the former president of The American Geriatric Society, and a runner into his 80s.

He teamed up with Randall Stickrod, a science publisher and writer, to pen The Roadmap to 100. And while they describe good diet habits, a healthy social engagement and harmonious personal relations as essential elements to aging well, there’s no disguising that exercise is the balm to our late years that bring zip and zing to everyday life. Exercise will loosen our joints, rejuvenate our arteries and keep down blood pressure. Regular and vigorous exercise lifts our moods and creates a sense of well-being that counteracts many of the everyday anxieties that afflict all of us.

So here’s how to begin. Find a place that can accommodate your exercise needs. Perhaps it’s a park for brisk walking, a gym close by, a swimming pool, a bicycle path. Try for at least 20 minutes a day if possible. Look for ways to strengthen your muscles: small weights, a gym membership where you can rely on finely tuned machines, a couple of simple resistance stretch bands or other gadgets. Get in the habit of weight lifting if possible. These simple exercises may be essential to maintain strength as we age.

Bortz and Stickrod list key measures of good health as we age: lean muscle mass, the ability to take in and use oxygen, social engagement, someone to love, a healthy brain and altruism contribute to well being. But exercise makes this possible.

If you join a gym, what’s a typical workout? Here is a list from the book: two sets of chest presses, one set of bicep curls, one set of lateral raiser, two sets of seated rows, two sets of pull-downs, two sets of abdominal crunches, one set of back extensions, one set of leg presses. The authors tell us this can take 30 minutes. Ideally, start with weights that allow you eight easy pulls with the ninth requiring real effort. Once you can pull or push 10 times easily, consider a heavier weight. However you approach maintaining strength, follow your own instincts. Do enough regularly to keep fit but don’t push your body beyond its capacity. Start slowly and tiptoe into a regimen.

Add this to flexibility stretching and aerobics. Find a routine. Try for three or more times a week. Start slowly and progress. You may not reach 100 but you’ll be the best you can be at any age.

Book: The Roadmap to 100, Walter M. Bortz II, M.D. and Randall Stickrod, 2010, Palgrave Macmillan

Linda P. Fried’s lecture: