Exercise Health Benefits

Exercise Health Benefits

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Exercise – how it benefits your health

balance strong man balancing on rock.
balance exercise — strong man

Exercising.   Is there anything new we can say about the benefits of exercising?   You have seemingly heard it all from the exhortations to buy the latest exercise tape to the knowledge that this is a nation of larger and larger people – fat. There was a tiny note in the news many years ago that the seats at Wimbledon were being increased by 2” – too many “strawberries and cream.”

So tell me something new.

It seems that too many of us are not exercising at all. We know that. But the flipside is that too many of us may actually be over-exercising. The most illustrative example is extreme sports. There is a terrific toll being taken on those pursing the really extreme sports – Iron Man competition and similar events.

As we age, we know that our physiology and “internal furnace” or thermostat changes. What we could eat indiscriminately as a teenager is no longer tolerated. We could eat all the root beer floats, cheese burgers, and fries and never gain significant amounts of weight. But advancing age and various internal hormonal and biochemical shifts no longer afford us this indiscreet behavior.

ErgospirometryMy good friend, Dr. Frank Shallenberger in Reno, Nevada has developed a  highly unique and innovative system of measuring the quality and efficiency of your exercise routines. It is a variation of VO2Max determination (maximal oxygen uptake efficiency).  He has determined that as we age we shift from fat-burning, a more powerful source of energy at 9 kcal/gram, to carbohydrate-burning, a less efficient source of energy at 4.5 kcal per gram. The quite obvious conclusion is that we lose the ability to burn extra fat as a source. It accumulates in all those unsightly areas. Meanwhile, we pursue a less efficient source of energy which leads to glucose and insulin intolerance and ultimately … diabetes.

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Menopause-andropause

Menopause-andropause

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Menopause and Andropause: The Next Passage

Menopause / Andropause is the result of age related waning sex steroid levels.

nuage de mots bulles ZOOM : ménopause
menopause causes so many symptoms

Think steroids.   What’s the first thing that comes to mind?   What’s the first image?   Bulked up Olympic Athletes?  Baseball players testifying before congress?   Or something else? Sex hormones — it’s what keeps us youthful, vital and playful.

We live in a world loaded with images and mis-perceived words. Menopause has become so much more”acceptable” to talk about. You could go to a local bookstore and find maybe 5 or 6 books on this subject 25-30 years ago. Now you can find an entire section. But andropause was less well known or even accepted until more recently popularized by marketing mad men as the “low-T-syndrome.”

There is one recurring theme where the sexes change roles. Women take charge and solve problems when not feeling well. When “off” men just keep working harder trying to ignore the fact that something may be “not quite right.”  So men tend to become overwhelmed and find themselves about 25 years behind women in this final “passage.”

It has been said that we should stop worrying so much about Menopausal symptoms.  Just let it unfold. Live with it and it will all pass.  Surely this is the way of nature. Grow old gracefully.

But the truth is that we are living in exceptional times.

At the dawn of the 20th century, as consistently difficult as it is to believe, life expectancy was 47 years. By 1936 it had increased to 65 years. Today life expectancy is about 78 years. A dramatic increase, as illustrated by the very fact that for most of human existence, most women never lived long enough to “suffer” the pangs of menopause.

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Staying Competitive in the Workforce

Staying Competitive in the Workforce

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Staying Competitive in the Workforce

work competition
staying competitive in the workforce

It is a recurring theme, the baby boomers lead once again. Why? There are 76 million of us turning 50 at the rate of 1 every 18 seconds for the next 20 years. It remains a potent force as it has for the last 5 decades. You can’t ignore us because the population bulge in the modern world continues to favor the baby boom population. We are an aging society. The World Health Organization and large annuity companies are only too aware of this developing fact. The fastest growing segment of our population is … 85 and above.

A new field and discipline is emerging in Medicine. It has various appellations — Anti-Aging Medicine, Rejuvenation Medicine, Longevity Medicine, or Age Management. But its common theme is applying well researched phenomenon of the aging process to a focus on a new paradigm. This is the essence of functional medicine. It is the application of medicine to improve and optimize function as opposed to the late stage intervention and treating of disease states. It is forward thinking and is the solution to the dilemma facing modern medicine — treating larger numbers of people with diminishing national economic resources.

So what does this mean to you?  In the Silicon Valley, as in so many large metropolitan areas around the country and even around the world, we are faced with the business dilemma of retaining an aging workforce. Until recently the simple solution has been the hiring of younger workers at less expensive salaries or, worse, off-shoring. But we lose an entire generation of expertise, savvy and know-how. It is a temporary fix. Long term, more and more post-50 workers will stay in the work force — of necessity. How?  This is even more critical for physicians who are retiring en masse after the age of 60 because of a crush of regulations.

The most successful application of Anti-Aging Programs is a coordinated and structured approach that begins with solid and time tested principles of good nutrition, exercise and supplementation. There is a level of hormonal modulation and balance but it is followed by “cognitive enhancement.” This means staying smart and retaining memory. Brain Longevity, as it was called by Dharma Singh Khalsa in his epic volume. We all experience a loss of memory for names and small details past the age of 50 (actually past 38). So that a structured approach to reviving this memory gap remains vital. Our memory storage and recall are our little internal hard discs. We resort to the use of external devices such as PDAs and Google searches. …

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Osteoporosis detection and prevention

Osteoporosis detection and prevention

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Osteoporosis — the preventable epidemic

California Age Management Institute

Osteoporosis.  Now you thought this was a problem of 70 and 80 year olds. What was once heard described by a patient quoting her physician, “well, Mabel it seems you have moldy bones.” But some of the largest and well known HMOs won’t even begin testing for this until after 60 — until it may be quite late in the game.  So why be concerned?

aging osteoporotic bones
osteoporosis with advancing age

Osteoporosis by definition is a lack of bone strength — leading to a fragile structure usually characterized by a lack of calcium. It

is technically a decrease in bone mineral density which is best diagnosed by a DEXA (dual energy x-ray absorption) scan. But calcium (or milk and dairy products) alone, contrary to such popular belief is not enough. By way of example, a piece of chalk is loaded with calcium carbonate and we all know how strong simple chalk can be — not very. Why suggest that both men and women start checking for this in their early 40’s rather than waiting until much later? Maybe it has to do with current eating patterns. Maybe … it has to do with …prevention.

It is a painful sight to this physician and writer to see patients shuffling past an office window, stooped over a haltingly advancing walker. It is all so preventable. Hopefully, you are whispering — not for me.

At variable rates of aging or even extreme athletic competition is a subtle and then progressive outflow of calcium from bones. We are withdrawing calcium from “the bank” Our bones, seen as the skeletal support that keeps us upright, remains our main reservoir and “bank” for total body calcium. The outflow eventually moves into the blood vessels, heart valves and tissues. High performance athletes actually accelerate this shift much earlier.

What controls this process? It is a complex set of hormones, including testosterone, estrogen, progesterone and parathyroid hormone; minerals including calcium, magnesium, strontium, boron; and the vital regulatory Vitamins D3 and K. But there is a greater culprit lurking.

Carbonated Soft drinks.

These ubiquitous little companions have high concentrations of phosphoric acid which gives it the fizz. But phosphoric acid is a superb calcium chelator, meaning it sucks calcium out of the bones with vigor. So to an entire generation that is waking up to carbonated soft drinks, diet or otherwise, we are filing up the tank with powerful calcium thieves. And this is why the “epidemic” could reach such alarming levels in the next decade or two. Osteoporosis, the “disease” of the “elderly” is going to be more commonly diagnosed in mid forty year old women and, who knows, younger.

The good news — osteoporosis is preventable.

This is where Anti-Aging Medicine can begin to realize the promise of a new paradigm. If we can begin to see that some gentle shifts in eating habits, and modest exercise, and the proper consumption of true “bone builders” loaded with a healthy balance of calcium, magnesium and more, then the answer is upon us.

The iconic images of Sophia Loren, John Glenn, Jack LaLaine and Clint Eastwood give us positive pause. Vigorous, fit, mobile and youthful members entering seventh, eight and even ninth decades. We all have a choice.

There is the offer of various drugs such as Fosamax and Evista and others to reverse this process. This caters to the old model of drive-through medicine — fix me up now that the process has resulted in a fracture of the hip or the backbone (lumbar vertebrae). But those of us in the baby boom population have a different answer. Active and progressive prevention.

And you have another advantage — the sun. Recently vilified as causing wrinkly skin and skin cancers, the Sun is your most important source of Vitamin D. This is the up and coming micronutrient that is essentially free and widely available in Florida. Modest and brief “unprotected” exposure to sunlight can produce as much as 10,000 units of Vitamin D daily. This is one of the crucial regulators. Healthy vitamin D that is at low levels in more Northern climates. Vitamin K2 remains the other vital nutrient available in foliage vegetables and as a supplement from select companies.

Take these healthy precautions, and ask for DEXA scanning in your 40s and a brisk upright, confident walk and stance remain in your future.

As we say, it’s up to you and it’s about time …

Philip Lee Miller, MD
Founder, California Age Management Institute  [formerly Los Gatos Longevity Institute]
Author, the Life Extension Revolution
March 2, 2006

Originally published in the Affluent newspaper

California Age Management Institute
Monterey, CA, USA
(408) 358-8855 tel
(408) 358-8855 fax

copyright © 2006-2016 AntiAging.com ™ and California Age Management Institute (formerly Los Gatos Longevity Institute).
All rights reserved.
Most recent update: January 11, 2016

Stress or Distress

Stress or Distress

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In Times of Stress

The matador is in a very high stress job situation and says to his doctor, "I've been feeling a lot of work related stress".

“I’m so stressed I can’t even think straight.” Sound familiar? Is stress always bad? Can it even be motivating? Are we suffering too much stress today? What is the link between stress and memory and mood?

Strangely there is a link. Stress physiology has come of age. It all started in the late 1950’s with the pioneer work of Hans Selye at McGill University in Canada. He developed the general adaptation theory. The modern leading researcher in stress is Robert Sapolsky author of the delightful and whimsical book Why Zebras Don’t Get Ulcers. He is professor of biology and neurology at Stanford University and a research associate with the Institute of Primate Research, National Museum of Kenya.

But let’s start with Selye and the short unknown volume he wrote in 1975 entitled Stress with out Distress. Turns out stress is actually motivating. It gives us our edge. It is what keeps us moving. It is distress that causes dis-ease. So the notion we call stress is really distress, a pathologic condition that leads to ill-at-ease, disease and a general assault on our immune system. This has given rise to a most compelling but quite daunting term — psycho-neuro-immunology. It is the science of how our emotions and perceptions (brain) control our immune system and thereby affect our susceptibility to disease and pathology like cancer and chronic illnesses. …

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Memory decline and impairment

Memory decline and impairment

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Where Did I leave My Keys?

Schematized memory
Brain lobe sections made of cogs and gears representing intelligence and divisions of mental neurological activity.

Memory.  How is yours today?  Do you remember?

In the whimsical and delightful adaptation of the classic Peter Pan — Hook — Toodles is heard to say, “I’ve lost my marbles.” At the very end there is resolution. Memory until quite recently was thought to be irretrievable. You lose it forever. A senior moment. “Now, why did I come into this room?” “Where are my eyeglasses?” How many times have you tried to recall a familiar name, an actor or actress, an old friend, only to recall it minutes, hours or even days later? It was not gone — just temporarily beyond reach.

What is memory? An ancient question that still has no definitive answer. We do know these facts. Memory traces start fading at the age of about 38 according the most astute practitioners of psychometric testing. But these are fleeting moments. At age 50 these become a bit more disconcerting. Certainly by 60 these become more frequent lapses and beyond. But this is not inviolate.

One of the most daunting interviews this reporter remembers from the last 10 years was an interview with George Burns at the age of 92. He was witty and “on.” He had total recall of so many of the old jokes. Like a catalogue. Maybe as anyone would ride a bicycle, or golf, or bowl, you don’t forget these things. But it underscores the point that age had not diminished his most cherished bag of tricks.

Short term memory is stored in the more primitive part of the brain also reserved for emotions and sexual arousal — the limbic system. Longer term memory is stored in the left temporal lobe. We also know that as we age the fine neural network connections between neural cells — the dendritic arborizations — thin out. The network is not as rich. As if the internet highway between San Francisco and New York have less possible routings. …

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Upcoming Calendar of AntiAging and Aging Research Conferences

Upcoming Calendar of AntiAging and Aging Research Conferences

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We are indebted to our good friend, John Furber, who sends us this most highly recommended list of AntiAging and Aging Research conferences.

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Let’s Revolutionize Prostate Cancer

Let’s Revolutionize Prostate Cancer

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A New Approach to Prostate Cancer

It is time.  We need to rationally approach prostate cancer with new tools.  Imaging first — biopsy last.

In 2004 Dr. Thomas Stamey, Chief of Urology at Stanford, published a seminal article, heralding the end of the PSA era.  He was known as the “the father of the PSA.”  This was not greeted with great applause.  He concluded that PSA testing was not an accurate measure of prostate cancer.  In subsequent years, he has admitted the correlation coefficient between PSA testing and prostate cancer is approximately 20 percent.   That is less than even odds that an elevated PSA equals prostate cancer.  (Vigorous sex can raise your PSA up to 40 percent.)

Men are in constant fear of an elevated PSA and its implications.  It’s like watching the Dow.  But the approach has been too slow to evolve.

Let me give you the best example.  Women typically have an annual mammogram — often followed by an ultrasound (it should be the opposite).  If you are diagnosed with a suspicious mass, a wire-guided biopsy is performed.  This is very targeted and limited only to the specific area of interest.   A positive biopsy is now most commonly followed by a lumpectomy.  The story then becomes complicated.

For men, the approach is backwards, and medieval.   A suspicious digital rectal exam, followed by an elevated PSA (greater than 4.0) will inevitably demand a prostate biopsy.  15 years ago this would have been a “4 core” sample.  4 blind stabs.  But over the interval there has been a tendency to increase to 8 cores, then 12 cores and now 16 cores.  Blind stabs through an area that cannot be sterilized.  This can frequently cause infection, bleeding and pain.

It is time for this approach to come to an ignominious end. …

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Health Care: The Day After

Health Care: The Day After

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It was never about Health.  It was never about universal health care.   Access does not equal care and certainly not quality care.   Yes, one side “won.”   This is not a victory for you.

It is not a left-wing agenda.  It is not socialized medicine.  This is the first time the Federal Government has mandated the purchase of a private party product.  And from the very racketeering group that is the root cause of the problem in the first place.   What a travesty.   Another government subsidy.   Effectively amounts to another “government bailout.”

As Michael Moore wryly said:

The larger picture here is that the private insurance companies are still the ones in charge. They’re still going to call the shots. And if anything, they’ve just been given another big handout by the government by guaranteeing customers. I mean, this is really kind of crazy when you think about it.

This is not the same as a state mandate for auto insurance.

The State of California is unrelenting on this point.  Driving is a privilege!  It is not a right.  If you do not drive, you are not mandated to purchase auto insurance.  Furthermore, the reality is auto insurance does not cost $5000-12,000 annually.

This is the first major landmark piece of legislation in American history that was passed by such a narrow margin without a single Republican vote.   Social Security passed with bipartisan support in 1935 — 81 Republican Congressman and 16 Republican Senators.   In 1965  Medicare passed with bipartisan support —  70 House Republicans and 13 Senate Republicans.  In 2010 there was not one single Republican vote.   And the margin in the House was razor thin — 220 to 212.

It also violates a well-tested political strategy — sell it first to the American people who will then pressure Congress to pass new legislation.  The public is not aboard.   The latest Quinnipiac and Washington Post polls show the public still opposes this landmark Act.

AT&T has already made plans for a $1 billion write-off in advance of cost shifting.   And legal staff is hard at work looking for technical loopholes.  This just in from Robert Peer at the New York Times:

William G. Schiffbauer, a lawyer whose clients include employers and insurance companies, said: “The fine print differs from the larger political message.  If a company sells insurance, it will have to cover pre-existing conditions for children covered by the policy. But it does not have to sell to somebody with a pre-existing condition. And the insurer could increase premiums to cover the additional cost.”

Everyone is giddy about “the win.”   This is only the end of the beginning.

Remember the Telecommunications act of 1996?   It was enacted to guarantee local competition amongst the major carriers.  It never happened.

Now watch this interview with Michael Moore:

Health Care Reform: Myths and Misunderstandings

Health Care Reform: Myths and Misunderstandings

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Too often have I written about the endgame.  Shades of Mark Twain — reports of my death are exaggerated.  But this really is the ninth inning.  The problem is the president is looking for the long ball — the out of the park home run.  When he should have been hitting singles, or emulating the great Joe Montana — short yardage high percentage gains — not Hail Mary passes.

Ave, Imperator, morituri te salutant

The secret fate of all voting democratic House members.  The arm twisting in the house rises to epic proportions not seen since the days of the infamous Tom DeLay – the Hammer.

This will be a bad bill.  You are all unwitting pawns in this game.  It will solve nothing.  It cures nothing.  It has emboldened the insurance racketeers and Big Pharma.  It has only one potential good outcome — Rush Limbaugh has promised he will leave the country.

They have rolled Howard Dean and Dennis Kucinich.   Other voices have been marginalized – Bernadine Healy, Robert Reich, Norman Goldman of Talk Left, Marcia Angell. And who will benefit from a fatally flawed passage?   The rising unaffiliated — the independent vote.  This is a Greek tragedy.   A Pyrrhic victory.

We are all too aware of the right wing echo chamber.  A well orchestrated score promoting stereotyped rat a tat answers.   How do they do this?

The same may be true in on the left as well.  We hear platitudes and assertions over and over again without challenge.

1. United States ranks number 37 in the world in healthcare.

Why repeat this assertion over and over and over again?  Because it makes a false point.

This figure is derived from life expectancy in the OECD  (organization of economic cooperation and development) countries.  The spread is narrow – less than five years.

My friend Burton Goldberg, one of the most successful publishers of alternative medicine, constantly beseeched me on this issue — investigate life expectancy derivations.  Life expectancy is a highly complex mathematical formula that balances death with infant mortality.

A country with a high infant mortality has a lower life expectancy rate – at birth.

For the most perplexing reasons, the United States still has a relatively high infant mortality rate.  If the figures are adjusted for life expectancy after the age of 60 we rate number 5 in the world.   If life expectancy figures are adjusted after the age of 80 we rate number 3 in the world.

In other words, as we advance in age, the effect of infant mortality is factored out and the real life expectancy becomes more apparent.  We are not number 37 in the world.  We are in the top three.  Life expectancy figures beg a revised definition.

Life expectancy change with age
US Life Expectancy — 3rd place by age 80

Furthermore, life expectancy is a dreadfully  inadequate measure of the health of a nation.  It says nothing about the quality of life.  HDI, (Human Development Index) may be a better measure.]  It says nothing about vibrancy, activity, mental health, social health, sexual health, or productivity.   It simply means that you crossed the finish line at a particular age.   No matter whether you dashed across or fell across the finish line and died.

In Anti-Aging Medicine, we talk about “squaring the curve.”  Increased Health Span and not Life Span.  A healthy life until old age followed by sudden death.  Not a slow inexorable painful march to the end.

2. The medical system suffers from over utilization.

Not as I see it.   Quite the opposite.  I see scores of patients who have pleaded for years for adequate and thorough lab testing only to needlessly suffer through unnecessary dysfunctional states   This is a natural consequence of HMO and PPO medicine.   Bottom-line cost-recovery medicine is a zero sum game.

3.  If you do not pass this bill everybody will end up in the emergency room.

There is such an appalling lack of medical input in this entire debate.   Urgent care medicine had its roots in the 1980s.   Originally funded and promulgated by astute entrepreneurs and ex-emergency physicians, these facilities answered the need for acute medicine outside of an emergency facility.   There are more than 8700 Urgent centers visits vs. 4600 emergency departments.     [And by the way, Emergency care represents less than 3 percent of the nation’s $2.1 trillion in health care expenditures while covering 120 million people a year.]

This is market-oriented medicine.  A workable and elegant solution in response to a market demand for immediate care outside of exorbitant emergency rooms.   They are successful and see all comers.   In Atlanta alone, my good friend Jordan Rice, one of the leading Urgent Care entrepreneurs in the country boasts of the ability to see any and all comers — Medicaid and cash paying patients.

Even the original Medicare bill of a 1965 garnered 13 Republican votes in the Senate and 70 Republican votes in the House.  To pull every legislative trick in the book only underscores the thinness of support for this ill-conceived rewrite of our society.  To be honest, Michelle Obama’s anti-obesity campaign could have more far-reaching effects that all 2700+ pages of this legislative lunacy.