Let’s Talk About Aging

Written by: Dr. Kenneth Cheng

It’s true, we are all getting older.  Most of us know that eating right and keeping moving is critical to living a long and healthy life, but let’s dig a little deeper  on the subject of aging and what it truly means for each of us.  We spend a tremendous amount of time in our daily lives working, worrying about finances, family, friends, but how much time to we devote to planning our future health?  What do you want your body to feel like in ten years?  How active do you want to be?  What about in twenty years?

Critical to aging gracefully is being aware of the many factors you should manage on a daily basis.  Physical health, mental health, and emotional well-being can help all of us look forward to personal fulfillment and a long life.  Understanding that there is a large amount of information floating around on the subject, we thought it might be useful to break it down to a simple list that you can use when thinking about your health today and what you want it to be in the future.  Below you will find the top six things we recommend you do to help you live a long and energetic life.

 #1  Eat Well – Yes, we know, we say it over and over again.  What you eat probably affects your health more than anything else you do.  Eating a poor diet of fatty, processed, fried food and simple sugars greatly burdens your body and will lead to breakdown.  Educate yourself on what healthy eating really means and practice it every day.  A great book we like to recommend to get you started is Toxic Fat by Barry Sears, Ph.D.

 #2 Get Moving – Another given.  Healthy people, centenarians included, have one thing in common,  they lead an active life.  Exercise is essential for a healthy metabolism, proper circulation, and the disposal of wastes.  Being overweight and inactive will lead to rapid aging and disease.

 #3 Be Happy – Did you know that unhappy people are twice as likely to develop heart disease?    Unhappiness and depression negatively affects your physical health in many ways.  If you are feeling this way, find the source of your depression; find someone to talk to as soon as possible.  Joyful, happy people live longer and healthier lives. Happiness is a choice and for many takes practice and work to achieve.  Laughter increases the release of endorphins which give us a sense of well-being.  It’s time to laugh more!

 #4 Relieve Stress – Stress is a natural part of our very busy lives, but it can take a tremendous toll on your health.  Our “survival mode” gets turned on all too often these days.  Stress continually depletes your body of energy resources and can lead to exhaustion, broken-down immune system, weight gain, and disease.  Give yourself a break!  Take a deep breath, try to put things in perspective, and find ways to divert or relieve what is stressing you out. 

 #5 Get Some Sleep – The average adult needs seven to eight hours of quality sleep to maintain health, there is no way around it.  Your immune system drops by an average of 60% after just three nights of poor sleep.  Without sufficient time for your body to recover and heal every night, you are paving the way to disease.  

 #6 Get a Yearly Comprehensive Physical – Yearly screening is critical to early detection and helping you to live the life you deserve.  Visit your doctor at least once a year for a comprehensive physical, including blood screening.   Make sure to get the necessary tests required for your age and commit to following up with all issues. 

We hope you find these six tips useful and that you find the time to pay attention to your body and live a long, strong, and happy life.

Aging & Brain Health

Written by: Dr. Marcia Whalen

Our partners from the Neuroscience Institute of Hoag Hospital  recently shared a fascinating article with us on some of the latest advancements in brain health.  We hope you find it interesting.  For our clients, we will be offering the MCI Screen discussed below in the near future.

Brain Health: A Vital Component of Overall Wellness

Most of us have grown accustomed to our doctor’s admonishments to eat balanced meals, exercise regularly, manage our cholesterol and hypertension, and keep our weight under control.  While this excellent advice is tied to broad health benefits, it is driven in large part by a focus on a healthy heart and vascular system. 

The Heart-Brain Connection

The focus on the heart will likely persist, but don’t be surprised if your physician has some new advice during your next visit.  An avalanche of evidence over the past 18 months has hammered home the importance of maintaining brain health as a vital component of overall wellness.  This makes sense given that the brain is the heart’s most important customer, demanding a major share of the oxygen rich blood that the heart distributes.

 As you would guess, a healthy brain and high cognitive function are critical components of performing good self-care.  One must remember well, and use sound judgment, in adhering to therapy for chronic conditions such as diabetes, asthma, and hypertension.  If cognition is impaired and therapy becomes poorly administered, these conditions can spiral out of control and further impair self-care in an ever-worsening chain reaction.

 How to Care for Your Brain

So how should you go about taking good care of your brain?  As noted, taking good care of your heart is a good start, but that is not enough.  You and your physician must also be vigilant in detecting and intervening against any medical condition known to impair brain function.  The list of such conditions is long and includes thyroid disorders, depression, sleep disorders, vitamin deficiencies, small silent strokes, medications, poorly controlled diabetes and hypertension, and many others.

 To regularly test and monitor, for all of the conditions mentioned above, would require an intensive effort by your physician.  However, thanks to new advances in the field of cognitive assessment, your physician can evaluate your cognitive function with a short test that will accurately detect any underlying problem. Performing well on the test eliminates the need for many other diagnostic efforts.  However, a poor performance triggers an evaluation by your physician to detect the underlying problem and treat it in a timely and effective manner.

The short test described is called the MCI Screen.  It is administered in the physician’s office and consists of a series of short memory and judgment tasks, which are scored by a computer.  The test takes ten minutes and should be part of any routine physical, or part of any evaluation of a memory or cognitive concern.

Trends in Maintaining Brain Health

Two important trends, one national and one local, underscore the emerging importance of routine cognitive assessment.

On the national level, a key component of healthcare reform is the inclusion of an annual wellness visit for Medicare recipients.  During such visits, physicians are required to assess cognition, even if the patient has no cognitive complaint. This is consistent with the evidence that early detection of cognitive decline and timely intervention to treat the underlying cause, lead to the best outcomes, the best self-care, and the best overall health.

Locally, you may be aware of the Orange County Vital Aging Program*, sponsored by the Unihealth Foundation, and driven by the Neuroscience Institute at Hoag Hospital.  The program is promoting optimal cognitive health for the aging population in the Orange County.  A key element of the program is education for physicians about the importance of monitoring cognitive health with tools like the MCI Screen.  The Personal Care Physicians group is among the early participants who have taken a leading role in providing such high standards of care to their patients.

 So keep taking good care of your heart, but also remember the importance of maintaining a healthy brain.  It’s as easy as monitoring your cognition when you visit the doctor to make sure your brain is functioning at a high level.  If it is not, the assessment will allow your physician to intervene and treat the underlying problem in a timely manner.

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*The Orange County Vital Aging Program provides education and resources to Orange County residents and physicians, to facilitate an informed and proactive approach to managing cognitive vitality.  Additional details about the program are available at www.OCVitalAging.org.

Aging For Men: How Your Body Changes

Written by: Dr. Jeffrey Barke

Did you know that after age 25-30 the average man’s maximum heart rate declines by one beat per minute, per year and that your aerobic capacity to pump blood drops by 5%-10% every 10 years? A healthy 25 year old heart can pump 2 ½ quarts of oxygen a minute, but a typical 65 year old heart can’t get above 1 ½ quarts. At 80 the average male is down to less than a quart. This diminished aerobic capacity is exactly what makes us fatigued and breathless as seniors.

Most men begin to gain weight in midlife, usually 3-4 pounds a year without significant lifestyle change. Since men start to lose muscle in their early 40s, that extra weight is all fat. This extra fat contributes to a rise in your LDL (bad cholesterol), a fall in your HDL (good cholesterol) and increases in silent inflammation within the body. It also explains why blood sugar levels rise by about 6 points per decade, making type 2 diabetes increasingly common as we become senior citizens.

Eventually, a typical man can lose up to 50% of their muscle mass which will significantly contribute to weakness and disability in your later years. One reason for this drop is the drop in the male hormone testosterone, which declines about 1% per year after the age of 40. Most men will continue to have normal testosterone levels and reproductive capacity throughout life, but many will also experience a gradual decline in libido and sexual vigor.

Yes, it all sounds grim, and these changes happen to healthy men, but you can slow the pace of or stop many of these changes. As many of my patients know, my favorite quote is:

“Those who think they have not time for bodily exercise will sooner or later have to find time for illness”  by Earl Edward Stanley (1799 – 1869)

Exercise is not the fountain of youth, but is one of the biggest steps you can take to slowing or even reversing every one of the physical issues described above. The other critical step is proper nutrition. Wondering what it takes to make this happen? Keep reading.

Yes, it’s true, even just 30 minutes a day of brisk walking will go a long way toward enhancing your health. Furthermore, men at 50 respond to exercise training just about as well as a 20 year old. Men will benefit from exercise at any age, just make sure you talk to your doctor first if you haven’t been active for some time.

Thinking about doing a little more? Wondering what the best exercise is to ward off all of these looming realities? If you are ready to commit to a lifelong fitness program that will positively change your physical health in your later years, you will need to design a program that includes the following to be most effective:

• Endurance training – this is the best way to improve cardiovascular function. This keeps your heart muscle strong and supple, your arteries flexible, and boosts the heart’s ability to deliver oxygen rich blood to the body’s tissues. Your cholesterol and blood pressure will lower as well. Endurance training is any activity that gets your heart rate up, and keeps it up for sustained or interval periods. Biking, running, swimming, fitness classes, commit to getting that heart pumping!
• Resistance training – Otherwise known as weight training. Weights or exercise machines will enhance muscle mass and strength and preserve bone calcium. You will need to learn what to do and instructors can help. There are many options here, including home programs with easy to use equipment.
• Flexibility training – This will keep you mobile as you age. Stretching is an ideal way to warm up and cool down after endurance exercise. 20 minutes of dedicated stretching two or three times a week is ideal. Make sure to include in this poses that work on balance as well, utilizing balance balls, Bosu devices, and Yoga can be great tools for this as well.

Using your body will keep it young. Following a life-long program of exercise will make a difference in how you age. Reflecting back on the initial data shared earlier in this article; if you exercise you will experience the following benefits.

We are all aging, but we do have the ability to control what our later years will be (or are). Regular exercise, a good diet, good medical care and commitment to health will help you to live the life you deserve for a very long time.

Aging for Women: Menopause and Exercise

Written by: Dr. Marcia Whalen

For women, menopause is inevitable, but understanding what to expect and having a plan to help with the symptoms can be the key to getting through it a bit more easily. Menopause is a series of natural biological changes that occur when your ovaries stop producing the hormone estrogen, and fertility ends.

Beginning around the mid-thirties, the ovaries decline in hormone production. This accelerates in the 40′s, hormones fluctuate more dramatically and by the 50′s, women’s menstrual cycles usually end completely.

This process can cause several symptoms that can be tough to manage including:

• Hot flashes
• Depression, stress and anxiety
• Sleep disorders
• Irritability
• Osteoporosis
• Cardiovascular disease

In addition to this many women may experience weight gain, especially around the midsection. Part of this has to do with those declining hormones, a decrease in your metabolism and a possible increase in appetite. Combine this with the fact that many women exercise less as they get older, weight gain becomes inevitable.

Keeping your metabolism going (the amount of energy your body burns in calories to energize itself) is critical to preventing that unwanted weight gain. One reason metabolism declines with age is the loss of muscle mass. Muscle burns more calories than fat, so when you lose that muscle (about ½ pound a year if you don’t preserve it with weight training/exercise), you don’t burn as many calories.

What is the answer?

There are a number of ways to manage menopause symptoms, from alternative therapies (such as acupuncture) to eating a healthy diet. However, one simple thing you can do that will make a significant difference is exercise. A regular exercise program that balances cardiovascular training (get that heart rate up), strength training, and stretching / flexibility work will provide you the following benefits:

• Weight loss – Exercise will help you burn calories. Creating a deficit in calories (burning more than your body needs for energy) is what will lead to weight loss. For every 3500 calories you burn, you can lose 1 pound in fat.
• Reduction of hot flashes – Exercise can help increase estrogen levels, which can decrease the severity of hot flashes.
• Increased bone mass - Strength training can help strength the bones and prevent osteoporosis.
• Cardiovascular benefits – Exercise can help lower high blood pressure and greatly reduce your risk for heart attack and stroke.
• Stress reduction – Menopause can often lead to depression, anxiety and stress. Exercise is proven to help reduce stress and improve your mood.

Exercise may cause the same magnitude of change as that induced by estrogen therapy.

Ready to get started?

The key to committing to a life-long exercise program is that you must find activities that you enjoy. A brisk walk is a great way to get started. Get yourself moving and as you get stronger over time you can start to challenge yourself more. Walking, running, cycling, swimming, group fitness classes, and cardio machines are all great ways to get your cardiovascular system in shape.

Strength training is equally important, especially if you want to increase your metabolism and lose body fat. You don’t have to train like a bodybuilder to get the benefits, but you do need to use resistance (such as dumbbells, machines or resistance bands) and you do need to challenge your muscles and body. You might want to work with a personal trainer to get started to ensure you are using proper form and don’t hurt yourself.

Additionally, schedule your time to exercise just like any other appointment or meeting, make it a priority in your daily life. Get your friends and family involved, exercise is a great way to spend quality time together. Taking control of your physical health will get you through menopause and provide you with life changing benefits.

Exercise Is Worth It! A Client’s Story

Written by: Krista Reader

Six months ago I was a different person. Run down, dealing with significant knee and joint pain, I felt physically defeated and had become a woman I did not recognize. Having tried every “weight loss” product and method in the past, I decided to take the advice of my doctor, Dr. Kenneth Cheng and join Personalcare Physician’s Healthfit 4 Life Fitness Program. Feeling at the end of my rope, I gave in to his suggestion.

With the help and expertise of Krista Reader, my Healthfit 4 Life Fitness Coach,  my customized exercise program, her motivation, inspiration, and nutritional guidance, I have lost one-third of my body weight! In the past, the thought of being able to ski, horseback ride, or run again was a dream. Now, these activities are my reality. Krista has helped me achieve a body that is strong enough to handle all of these exercises and surpass my dreams. I will be completing a half marathon on May 1st and June 5th, I hit the slopes this season; and I have been riding horses. I feel like I am 25 years young again! 

As the program is integrated with my doctor, it has been wonderful to see the medical progress as well. My cholesterol and blood pressure have decreased along with my weight. I truly feel blessed to have this team in my life, helping support me and encourage my health success. It has inspired me to now act as the same light and inspiration to my friends, family and co-workers. I am very grateful for the Healthfit 4 Life Program, and I encourage everyone to commit to their health and to then take action to make their dreams their reality.

Who knew – exercise and diet really DO produce results as long as you put in the work!

Patti