We all age, but there is an idea of “sick aging,” that being that, instead of being able to remain fit, healthy, and free of disease as we grow older, we experience a host of age-related sicknesses.
Coach Kevin Don explains the best thing we can do to maintain our physical capacity as we get older. Plus: a question from a listener on bone mineral density.
Get-Fit Guy is hosted by Kevin Don. A transcript is available at Simplecast.
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Welcome back to Get-Fit Guy, I’m Kevin Don. This week I’m going to look at aging and how the best thing we can do for ourselves to maintain our physical capacity is to move. Use it or lose it.
I’ve talked before about the idea of fitness or physical training as a form of medical intervention to hedge against the relentless march towards entropy. So, perhaps I might repeat myself here, but since we all need to hear something a few times before it sinks in, that’s fine. This might also be the first time some people are listening in and that’s great, welcome to the Get-Fit Guy family.
We all age, but there is an idea of “sick aging,” that being that, instead of being able to remain fit, healthy, and free of disease as we grow older, we experience a host of age-related sicknesses. These include but are not limited to: decreased muscle mass, exercise or anabolic resistance, insulin resistance, hyperglycemia, hypertension, increased serum lipids, and increased visceral fat.
These metabolic syndromes combine to manifest as early frailty, type two diabetes, and then the resulting polypharmacy (reliance on multiple medications) and the unwanted side effects of those which could include more muscle mass loss, fatigue, brain fog and so on. Over time, these processes of aging and polypharmacy become more and more interconnected. One way out of the repeating loop is exercise as an intervention. We can increase muscle mass, decrease insulin resistance, blood pressure, and body fat all with a smart, recoverable training protocol.
So where to start? Well, I’ve been saying for at least 12 years that you have to start with strength training. That’s the fundamental prescription for an aging adult. This is because the first things we lose, muscle mass and bone mineral density, are addressed most effectively by strength training. You may not “enjoy” lifting weights, but don't tell me you “enjoy” taking pills and getting injections! Only one of these interventions can effectively address the situation without hugely unwanted side effects. Unless you consider bigger muscles to be an unwanted side effect, in which case I don't know what to tell you.
Muscles and other soft tissues in the body respond to tension. That is the force of gravity pulling us downwards, like when you hang from a tree branch or a pull-up bar. If I were to grab your feet and try to pull you off the bar, you’d tense up and the muscles would contract, allowing you to resist. So, it's not really possible to build muscular strength without this. Last week, I was at the gym and I saw the “golden oldies” class or whatever arbitrarily insulting thing they have decided to call the over 60s class. It was in the swimming pool and performed with foam weights in the water.
Now I’m looking at this and I’m wondering what thought process has gone on to lead the gym to the conclusion that this is useful for the over 60s. Firstly, if you are free-floating in the water, you don't have tension because the effects of gravity are radically diminished. Secondly, the foam dumbbells are being supported more by the water than by the participants. Thirdly, because, again, it’s removing the stronger effects of gravity we would have out of the water, we have also eliminated compression or top-down loading on the bones, which is how bones remodel themselves to become stronger.
So I decided to ask the gym manager about this and when I explained exactly the above, she told me: “Well, sounds like you don't think older people should be moving. Don't you agree them being here and doing this is better than being at home watching TV?” Erm yeah, nice straw man argument.
Damn this guy is asking questions I can't answer, I better spin this around and introduce a new argument he can't win or disagree with. The point here was actually that the person in control of the programs in the gym couldn’t explain the reason for having that program. Is it better than being at home watching TV? 1000% yes. But does it make any sense or address the needs of the demographic it claims to serve? NOPE.
This idea of compression and bone density was actually fresh in my mind, because this week I received what might be the Guinness World Record for longest email from a listener. It asks me about bone mineral density, so it’s quite relevant and useful to share.
Hi Kevin!
First, please forgive the length of this missive. It really is a two-parter, with the first part asking for some exercise recommendations after providing you background. Part two is asking for your b.s. detector to evaluate some related programs.
Part 1:
Recently, my husband broke his ankle. Because there was no trauma associated with the break, the doctor ordered a DEXA, since there is history of osteoporosis and osteopenia in his family. Sure enough, the scan came back showing moderate osteopenia. He is 68, so is in that small subset of males with bone mineral loss prior to 70.
For many years (decades), he has followed a healthy lifestyle that normally would build strong bones:
• resistance exercises (jogging and running on a treadmill);
• some barbell, weight machine, and pushup exercises for the upper body (but no real/formal free weight training);
• only moderate caffeine intake (3 cups of 1/2 decaf 1/2 caff coffee in the morning);
• moderate alcohol intake (1 or 2 glasses of wine/day);
• lots of dark green veggies like broccoli, as well as nuts, grains, etc.;
• consumption of dairy products; and
• a calcium supplement with D3;
• oh, and no smoking or tobacco products whatsoever.
For the time being, he and the doctor have agreed that he should not go on any of the osteoporosis drugs. Instead, he will continue with lifestyle changes to try to improve his bone mineral density.
Additionally, my next DEXA is coming up in another month, so I, too, am interested in also improving my bone health, no matter what my score. I am also 68.
At the start of the pandemic, we canceled our gym membership and purchased a treadmill. We have a few barbells, an ab roller, and some pushup bars. We have limited space, though, so adding any more machines/equipment is not feasible.
Our questions:
--Without going to the gym, what kinds of weight-bearing and resistance exercises can we add to our regimens, to increase bone density? Are there any?
--If not and we have to rejoin a gym, we would like to minimize the time we spend in the gym. What weight-loading exercises would give us the best bang for our time? I suspect you will say free weights, but could we also get some benefit by using weight machines?
Part 2:
Some of our friends have recommended a couple of bone-building "programs" whose efficacy seems questionable. I pretty much think these programs are a waste of money, but would appreciate your take on these, as you might have some additional information that I am missing.
• The first recommendation that friends have given us is a program that claims that just 10 minutes a week on their "osteogenic loading" machines (which look like machines to help you do isometrics) will radically improve your bone density. If they had said 10 minutes per day ... maybe. But 10 minutes a week? Paint me seriously skeptical.
• The second program a friend recommended was a "natural solution" through an alkaline diet, plus a dietary supplement (which you can buy on the website), and using a weighted vest to exercise in. Many of the other things listed on the website are standard, so some of this sounds reasonable.
Have you heard of this? Would it behoove us to use a weighted vest while exercising? Is my skepticism well-founded—or am I overly doubtful?
Thanks in advance, Kevin, for your always informative and helpful podcast! And thanks for considering my questions.
With very best regards,
-Laurie
Hi Laurie,
Thank you for the detailed email.
To answer your questions:
Are there ways to increase bone density without going to the gym? Yes, there are, BUT we are almost always talking about a bang-for-your buck-scenario. The reason for that is simple—why take a bunch of medications to cure a problem when you can take one?
The most important thing to remember is that you need to be under compression to remodel the bone. You could compress yourself with a weighted vest (as per your final question) but the issue is that at some point it won't be sufficient stress to keep driving adaptation. What are you going to get? 14-20 lbs of load on the system. A bare bar is 45lbs of load and incrementally loadable to a situation you’ll never get to: 500lbs and more. So, yes, you could wear a weight vest, carry a sandbag, or wear wrist and ankle weights, but it's almost sub-therapeutic. Get a barbell and take your medicine, Laurie.
The latter part of the question was that you want to minimize time in the gym, well yes, which is exactly why you need to go to a gym, as I mentioned above—other interventions aren't enough stress on the system and not an optimal use of time.
You want to perform the barbell back squat, the barbell deadlift, and the barbell standing press. The bench press is less impactful because the range of motion and amount of your anatomy taxed is less than in the standing press, but if you had time, I’d throw that in there also. Can you do these things on machines? Yes, but they aren't as good because the machines hold you in position or in line. You want to tax your balance and your co-ordination and core strength by having to do that yourself.
Now, on to part two.
You are correct, 10 minutes a week is a waste of money and time. I saw a study released by the company you referred to in your original email to me. It was performed on one participant. If someone's selling point is how little time and effort you have to spend doing something, ignore and move on. Real change at ANYTHING takes both effort and time.
The alkaline diet is total nonsense and the guy who wrote the book and created this diet, Robert Young, was convicted of practicing medicine without a license and went to jail. Your body works incredibly hard to maintain homeostasis and some parts of your body are highly acidic and others are highly alkaline and others more neutral. You cannot possibly make your body alkaline—your body won't allow it because you’d die if you altered your pH that much. This diet was a short-lived fad and I’m amazed to hear anyone still recommend it. As with everything else, it's good to do due diligence. Usually, people won’t like the answer, especially if they have their own anecdotal evidence about how great they feel. But when we have people reporting amazing health results from a carnivore diet and another group reporting the same from a vegan diet, we can then be objective about things and say that bias, placebo, and anecdote are afoot!
If you have a training question, are looking for individual training program design, or just want to say hi, head over to the Get-Fit Guy Facebook page or send me an email at getfitguy@quickanddirtytips.com.