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Sarcopenia: Muscle Loss with Aging

Competitive masters athletes, 40 to 81 years old, who trained four to five times per week did not lose any muscle size or significant strength with aging (The Physician and Sportsmedicine, October 2011;39(3):172-8). This shows that loss of muscle size and strength in older people is caused by lack of exercise, not just with aging. The athletes did gain fat in spite of exercising. Those in their 70s had almost as much strength and thigh muscle size as those in their 40s.

MOST PEOPLE LOSE MUSCLE: Recent studies show that after age 40, men lose more than eight percent of their muscle size each decade, and this loss of muscle increases after age 70. The people who lose the most muscle are usually the ones who die earliest. They are also most at risk for falls and broken bones.

HOW EXERCISE PREVENTS MUSCLE LOSS WITH AGING: Muscles are made up of thousands of individual muscle fibers. Each muscle fiber is innervated by a single nerve. With aging, humans lose the nerves that innervate muscle fibers, and with each nerve loss, they lose the associated muscle fiber so muscles become smaller. We used to think this happens because of aging. However, this new study and others show that lifelong competitive athletes do not lose the nerves that innervate their muscles with aging. They retain the nerves and therefore retain most of the muscle fibers that they would have lost if they were inactive.

MESSAGE: If you exercise regularly, continue to do so. If you don't, check with your doctor and then get instructions on how to start an exercise program.

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Intense Exercise Gives More Health Benefits than Just Exercising

Intense exercise is even more effective than just exercising in prolonging life and preventing disease. A study from Norway shows that the more fit you are, the fewer heart attack risk factors you have and the less likely you are to develop diabetes (Medicine & Science in Sports & Exercise, August, 2011;43 (8):1465).

VO2 PEAK: The authors measured level of fitness by a test called VO2 peak: the highest amount of oxygen a person can use in an all-out exercise test. It is a direct measure of a person's fitness, and the more intensely a person exercises, the greater the increase in VO2 peak. Intensity of exercise is far more important than duration in determining peak oxygen uptake.

Women whose fitness values were low (VO2 peak < 35.1 mL kg- 1 min-1) were five times more likely to have heart attack risk factors compared to those whose fitness was high (VO2 peak (< 40.8 mL kg-1 min-1). Men with low fitness (44.2 mL kg-1 min-1) were eight times more likely to have heart attack risk factors than those with high fitness ((50.5 mL kg- 1 min-1).

Furthermore, those who changed from low to high intensity training had substantially higher VO2 peak at follow-up compared with people whose activity remained low.

HEART ATTACK RISK FACTORS: Heart attack risk factors include high blood pressure; high blood levels of total cholesterol, triglycerides, the bad LDL cholesterol, blood sugar, and the diabetes test HBA1C; low levels of the good HDL cholesterol or vitamin D3; being overweight, especially if you store fat primarily in your belly; and not exercising.

STRESS AND RECOVER: Competitive athletes know that running, cycling or skiing lots of slow miles will not help them in competition. They call these "junk miles" and exercise at a slower pace only on the day or days after a very intense workout when their muscles feel sore and they are recovering from exercising almost as intensely as they could. The same type of "stress and recover" training that makes a competitive athlete faster and stronger, can make you healthier, prevent disease and prolong your life.

Realize that every time you exercise intensely, your muscles are damaged and feel sore on the next day. If you try to exercise intensely when your muscles feel sore, you increase your risk for an injury. Plan to exercise at low intensity on the day after you exercise intensely. Most athletes set up their programs so that they go intensely three times a week (for example, Tuesdays, Thursdays, and Saturdays) and go slowly on the other four days. If they feel sore on a scheduled intense day, they usually go easy instead or take the day off. Exercisers probably should go easy on the day after an intense workout, regardless of how well they feel.

CAUTION: Every healthy person should exercise the way competitive athletes train. The greatest concern is that many North Americans have blocked arteries leading to their hearts and do not know it. These people could die of heart attacks if they exercise intensely. Intense exercise forces the heart to consume huge amounts of oxygen. If the heart cannot receive the amount of oxygen it needs, it can start to beat irregularly and the person can die. Unfortunately, the best test to check for blocked arteries is an extremely expensive Stress Thallium Test and most people will never receive that test.

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Avoid Diabetes with Lifestyle Choices

Making any one of five lifestyle changes can reduce your chances of developing diabetes by a third, and correcting all five of these factors can reduce your chances of developing diabetes by 80 percent (Annals of Internal Medicine, September 6, 2011;155(5):292-299).
• lose weight
• exercise
• eat whole grains and high-fiber foods
• do not smoke
• restrict alcohol

One of three Americans will develop the type of diabetes that is caused by personal living habits. Many of these people will die of heart attacks, and all are at increased risk to lose function of any tissue in their bodies, resulting in blindness, deafness, strokes, kidney failure, dementia, amputations and so forth.

YOU CAN BECOME DIABETIC IN JUST SEVEN DAYS: After seven days of markedly increasing their intake of food, healthy men developed laboratory signs of becoming diabetic: higher fasting blood sugar levels, much higher rises in blood sugar levels after meals, markedly elevated insulin levels, and more fat stored in muscles and fat cells. Then, after seven days of reduced caloric intake, their measures of insulin sensitivity returned to normal (International Journal of Obesity, November 2011).

HOW YOUR BODY PROCESSES SUGAR: When blood sugar levels rise, your pancreas releases insulin to drive sugar into cells. Before insulin can drive sugar into cells, it must first attach onto special hooks on the outer surface of cells called insulin receptors. If insulin receptors are blocked, insulin cannot do its job of clearing sugar from your bloodstream, so blood sugar levels rise. This causes sugar to stick to the outer surface of cell membranes, which can damage every cell in your body. Anything that blocks insulin receptors can cause diabetes, and anything that opens insulin receptors can prevent, treat and cure diabetes.

HOW TO AVOID (AND TREAT) DIABETES:
1) LOSE FAT: Fat in muscle and fat cells blocks insulin receptors. All extra calories are converted to fat. The fat stored in fat cells causes fat cells to produce special cytokines that turn on your immunity to cause inflammation that damages every cell in your body. Fat in fat cells also blocks insulin receptors. Fat stored in muscles blocks insulin receptors to make muscles less able to extract sugar rapidly from your bloodstream.

2) GROW MUSCLES: Anything that enlarges muscles helps prevent diabetes. For each 10 percent increase in the ratio of muscle mass to total body weight, there is an 11 % reduction in insulin resistance, a precursor to diabetes, and a 12 % reduction in higher-than-normal blood sugar levels (Journal of Clinical Endocrinology and Metabolism, September, 2011).

3) GET BLOOD LEVELS OF VITAMIN D3 ABOVE 75 nmol/L. Vitamin D is necessary for insulin receptors to respond to insulin, so lack of vitamin D can cause diabetes.

4) AVOID FOODS THAT CAUSE A HIGH RISE IN BLOOD SUGAR: Sugared drinks cause the highest rises in blood sugar levels. Refined carbohydrates, such as those made from flour also cause high rises in blood sugar.

Only liquid soups can pass from your stomach into your intestines. So foods that take a long time to be converted to soup take a very long time to pass into your intestines and then your bloodstream. For example, an orange can stay in your stomach for up to 5 hours. However fruit juice can pass immediately into stomach. Therefore you should restrict all sugared drinks. Fruit juice can cause as high a rise in blood sugar as sugared soft drinks.

Whole grains have a thick capsule that markedly delays absorption. However when you grind a whole grain into flour, you lose the capsule and markedly increase the rate of absorption and the rise in blood sugar.

5) EAT LOTS OF FRUITS, VEGETABLES, WHOLE GRAINS, BEANS, NUTS AND OTHER SEEDS. Foods high in fiber slow the absorption of sugars. Plants also contain plant cholesterol that blocks the absorption of cholesterol from meat, fish and chicken. Soluble fiber in plants passes to the colon where they are fermented by bacteria to form short chain fatty acids that are absorbed through the colon to pass through the bloodstream to the liver where they block the synthesis of cholesterol.

6) AVOID RED MEAT. The saturated fat in red meat blocks insulin receptors.

7) DON'T SMOKE.

8) DO NOT TAKE IN OR THAN TWO ALCOHOLIC DRINKS A DAY. A drink is 5 ounces of wine, 12 ounces of beer or 2/3rds of a shot glass of alcohol. Even this may be too much; see my report on Alcohol and Breast Cancer Risk.

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Recipe of the Week:

Three Sisters Soup

You'll find lots of recipes and helpful tips in The Good Food Book - it's FREE ***********************************************

November 13th, 2011
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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