fitness

When the Waist Widens, Risk of Dementia Rises
A large belly is a bigger risk than family history in increasing the chances of cognitive disorders such as Alzheimer's, research suggests.

By Denise Gellene, Los Angeles Times Staff Writer

March 27, 2008

Having a large gut in midlife increases the chance of dementia in old age, according to new research published Wednesday that suggests that abdominal fat is a bigger risk factor than even family history.
The study of 6,583 adults found that people with the highest amount of abdominal fat between the ages of 40 and 45 were about three times more likely to develop dementia than those with the lowest amount.

By contrast, people who have parents or a sibling with Alzheimer's face twice the risk of developing the disease.
The report in the journal Neurology was the latest to show that belly fat can pose serious health risks, even for those who are not obese. Previous research has shown that people with large abdomens face a greater chance of diabetes, stroke and heart disease.
"This ought to be a wake-up call to baby boomers in terms of diet and exercise," said Dr. Sam Gandy, a spokesman for the Alzheimer's Assn. who was not involved in the study. "If they are not frightened enough about heart disease, maybe they will worry about losing their mental function."

Dementia is an age-related condition that involves the loss of memory and other cognitive functions. It affects 5.7 million Americans, or about 1 in 10 people over age 65. Alzheimer's is the most common form of dementia, accounting for 60% to 80% of cases.

Being overweight has also become a significant health problem in the U.S. About 50% of the nation's adults have an unhealthy amount of belly fat, according to the latest report.

People who tend to pack on abdominal fat are often described as apple-shaped and have a waist-to-hip ratio greater than 1 to 1 if they are male and greater than 0.8 to 1 if they are female.

The other major overweight group has a body type described as pear-shaped, characterized by fat around the thighs and lower body.

Participants in the study were members of Kaiser Permanente of Northern California who had their belly fat measured between 1964 and 1973.

Clinicians measured belly fat by placing one end of a tong-like instrument on the back of each subject and the other end of the tong on the subject's abdomen. A person had high belly fat if the distance between the two ends -- the subject's diameter -- was more than 25 centimeters, or 9.8 inches.

An average of 36 years later, 16% of the participants had been diagnosed with dementia.
Those who were overweight and had a large belly when measurements were taken were 2.3 times more likely to develop dementia in old age than those who had a healthy weight and belly size when they were younger.
The researchers categorized subjects as overweight if they had a body mass index of 25 to 29.9. The index, also known as BMI, is a ratio of height and weight. For example, a man who is 6 feet tall and weighs 184 pounds is overweight.
People who were obese -- with a BMI greater than 30 -- and had a large belly in middle age were 3.6 times more likely to develop dementia later in life than those whose weight and belly size had been in the healthy range.
Increases in thigh fat did not add to the risk of dementia, according to the report.

Lead author Rachel A. Whitmer, a Kaiser Permanente researcher, said the study underscored the need for doctors "to check not just weight but how much fat patients are carrying around their middles."

Whitmer said scientists did not know how abdominal fat might contribute to the risk of dementia.
One theory is that hormones and proteins released by abdominal fat spur the buildup of amyloid plaques in the brain, which are associated with Alzheimer's. Abdominal fat is more biologically active than fat located in other areas of the body, she said.
Another possibility, Whitmer said, is that dementia is not directly related to abdominal fat but is linked to obesity-related diseases such as stroke, diabetes or cardiovascular disease.

Although losing weight can be a challenge, she said, abdominal fat is easier to lose than other kinds of fat.
"The good news is it goes away with diet and exercise," Whitmer said.

Whole grains may curb belly fat, inflammation
NEW YORK (Reuters Health) - Cutting calories helps people lose weight, but doing so by filling up on whole grains may be particularly heart-healthy, new research suggests.
In a study of obese adults at risk of heart disease, researchers found that those who trimmed calories and increased their whole-grain intake shed more belly fat and lowered their blood levels of C- reactive protein or CRP.
CRP is a marker of chronic, low-level inflammation in the blood vessels, and both abdominal fat and CRP, in excess, are linked to heart attack and stroke.
In contrast, dieters in the study who mainly ate refined grains, like white bread, were able to lose weight, but they trimmed less fat from the middle and showed no change in CRP.
The findings offer yet more incentive for Americans to opt for whole grains over highly processed versions, according to the researchers.
"This is the first clinical study to prove that a diet rich in whole grains can lead to weight loss and reduce the risk of several chronic diseases," Dr. Penny Kris-Etherton, the senior researcher on the study, said in a statement.
She and her colleagues at Pennsylvania State University report the findings in the American Journal of Clinical Nutrition.
In general, experts recommend eating whole grains -- such as oatmeal, brown rice and barley -- rather than refined grains, like white bread and other products made from white flour. Whole-grain foods retain more of the nutrients and fiber components of the grain.
This fact might explain why dieters in the current study showed added benefits when they ate whole grains, according to the researchers. For example, fiber-rich foods may have kept participants' blood sugar levels more stable throughout the day, and this, in turn, may have lowered their CRP levels.
Alternatively, CRP might have dropped because of the antioxidant nutrients that are present in whole grains but depleted in refined ones.
The study included 50 obese men and women who had metabolic syndrome, a collection of several risk factors for diabetes, heart disease and stroke -- such as abdominal obesity, high blood pressure and high blood sugar.
All of the study participants cut calories for 12 weeks, but half were instructed to strive for whole grains, while the rest were told to choose refined grains. The whole-grain group was told to look for products with "whole grain" listed as the first ingredient on the label.
In the end, the average weight loss was about 8 to 11 pounds in both groups. However, the average CRP level dropped by 38 percent in the whole-grain group, while remaining unchanged in the refined-grain group. In addition, while both groups showed a similar change in waistline size, the whole-grain dieters showed a greater reduction in the percentage of fat around the middle.
The researchers recommend that consumers look at labels and be careful to choose products that are good sources of whole grain.
"There are a lot of foods around that claim they contain whole grain but are not really major sources of whole grain," Kris-Etherton said. She suggested looking for foods like oatmeal, breakfast cereals made from whole grains, whole-wheat pastas, granola and popcorn.
As a general rule, she said, consumers should buy grain products that are at least 51 percent whole grain. Products that put health claims about whole grains on their labels are required to contain at least that much whole grain.
SOURCE: American Journal of Clinical Nutrition, January 2008.

What Are the Benefits of Resistance Training?

1. Increase Bone Mineral Density: Bones are constantly remodeling, meaning the tissues break down at the same time they build up. The peak of remodeling takes place during puberty. However, as a person ages, our bone mineral density decreases as the remodeling is not as active anymore. This is especially a problem to post-menopausal women and the elderly, but does begin to happen in the early thirties. Bone mineral density is usually supported by the hormones and stress placed on the bones. To address the problem of not having the hormones and less stress, and to maintain the bone mineral density, physical activity is the next best option. Resistance training is one physical activity that can put enough stress on the bones to stimulate remodeling and increase bone density.
2. Increase Strength: In addition to increase in bone density and strength, muscles will grow stronger and become more developed as you progress.
3. Increase the Range of Activities: When your body is strong enough to carry some considerable weight, then you will also be capable of doing more strenuous activities. An increase in exercise lifts the mood and you will be more interested in life and a more active lifestyle. This will really create a snowball effect on your life and activities.
4. Reduce the Body Fat: Using and increasing the muscle mass (even a little bit) will increase the energy that is required by your body, even at rest. This also increases the energy needed by your body at during activities. The more muscle, the more energy is needed to be broken down to supply you body to function properly. This translates to more fat calories and fat being burned each minute. Thus with the decrease in body fat, you can expect the tone of the body to improve and you will become leaner....and did I mention sexy??
5. Improve State of the Elders: For the elderly undergoing a resistance training program will help improve their health and decrease the risks brought about by the age. They can be more independent, without needing to rely on other people for doing simple things. Being able to do so will also decrease the risk of injuries in the elders
6. Improve Heart Condition: Regular resistance training can result in a lowered heart rate and lowered blood pressure, especially after exercise. Thus, the risk of heart diseases is reduced.
This kind of training however must be properly done. It requires commitment and consistency. It will have to be done in a regular basis.

Fit, Not Frail: Exercise as a Tonic for Aging

By JANE E. BRODY

Published: June 24, 2008
Fact: Every hour of every day, 330 Americans turn 60.
Fact: By 2030, one in five Americans will be older than 65.
Fact: The number of people over 100 doubles every decade.
Fact: As they age, people lose muscle mass and strength, flexibility and bone.
Fact: The resulting frailty leads to a loss of mobility and independence.

The last two facts may sound discouraging. But they can be countered by another. Regular participation in aerobics, strength training and balance and flexibility exercises can delay and may even prevent a life-limiting loss of physical abilities into ones 90s and beyond.

This last fact has given rise to a new group of professionals who specialize in what they call active aging and an updated series of physical activity recommendations for older adults from the American Heart Association and the American College of Sports Medicine. These recommendations are expected to match new federal activity guidelines due in October from the United States Health and Human Services Department.

But you need not - indeed should not - wait for the government. Even if you have a chronic health problem or physical limitation, there are safe ways to improve fitness and well-being. Any delay can increase the risk of injury and make it harder to recoup your losses.

Miriam E. Nelson, director of the John Hancock Center for Physical Activity and Nutrition at Tufts in Boston and lead author of the new recommendations, observed last fall in The Journal on Active Aging that with every increasing decade of age, people become less and less active.e

But, Dr. Nelson said, the evidence shows that with every increasing decade, exercise becomes more important in terms of quality of life, independence and having a full life. So as of now, Americans are not on the right path.

Jim Concotelli of the Horizon Bay Senior Communities in Tampa, who oversees fitness and wellness program development for communities for the elderly in several states, noted this year in The Journal on Active Aging that many older Americans were unfamiliar with exercise activities and feared that they would cause injury and pain, especially if they have arthritis or other chronic problems. Yet by strengthening muscles, he said, they can improve joints and bones and function with less pain and less risk of injury.

The key is start slowly and build gradually as ability and strength improve. Most important is simply to start - now- perhaps under the guidance of a fitness professional or by creating a program based on the guidelines outlined here.

Although medical clearance may not be necessary for everyone for the moderate level of activity suggested, those with a known or possible problem would be wise to consult a doctor. And a few sessions with a trainer can help assure that the exercises are being done correctly and not likely to cause injury.

Until recently, physical activity recommendations for all ages have emphasized aerobics, or cardiovascular conditioning, through moderate to vigorous activities like brisk walking, cycling, lap swimming or jogging for half an hour a day five or more days a week. For those unable to do 30 minutes at a time, the activities can be broken up into three 10-minute intervals a day. If you have long been sedentary, start with even shorter intervals.

For people who prefer indoor workouts, a treadmill, cross-trainer, step machine or exercise bike can provide excellent aerobic training for the heart, lungs and circulation. Those unable to do weight-bearing exercise might try swimming or water aerobics. Keep in mind that 30 minutes a day of aerobic activity five days a week is the minimum recommendation. More is better and can reduce the risk of chronic disease related to inactivity.

Contrary to what many active adults seem to believe, physical fitness does not end with aerobics. Strength training has long been advocated by the National Institute on Aging, and the heart association has finally recognized the added value of muscle strength to reduce stress on joints, bones and soft tissues; enhance stability and reduce the risk of falls; and increase the ability to meet the demands of daily life, like rising from a chair, climbing stairs and opening jars.

Strength training can be done in a gym on a series of machines, each working a different set of major muscle groups: hips, legs, chest, back, shoulders, arms and abdomen. Or it can be done at home with resistance bands or tubes, hand-held barbells or dumbbells or even body weight. One program, the Key 3 program diagrammed here, was devised by Michael J. Hewitt, research director for exercise science at the Canyon Ranch Health Resort in Tucson. It can be completed in 10 minutes with practice.

As Dr. Hewitt explained in the International Longevity Center-USA newsletter, skeletal muscles can only contract and thus are always arranged in pairs. One muscle of the pair pulls to bend the joint (flexion), and its antagonist pulls to straighten the joint (extension). Thus, a strengthening program must be balanced, he said, pairing every pulling lift with an opposite pushing action.e

Dr. Hewitt emphasized that to reduce the risk of injury and premature muscle fatigue, the large muscles should be exercised first, followed by the smaller muscles, with the postural muscles exercised last. For example, one would start with chest and upper back muscles, then the arms and shoulders and finally the lower back and abdomen.

Muscles have to be overworked to grow stronger. The goal for each exercise is three sets of 8 to 12 repetitions to muscle fatigue. Muscles also need time to recover. So strength training should be done two or three times a week on nonconsecutive days.

The new recommendations add flexibility and balance to the mix. Improving balance and reducing the risk of falls is critical as you age - if you fall, break your hip and die of pneumonia, aerobic capacity will not save you. Ten minutes a day stretching legs, arms, shoulders, hips and trunk can help assure continued mobility, and daily exercises like standing on one foot and then the other, walking heel to toe or practicing tai chi can improve balance.

The recommendations, issued last August, are geared to healthy adults 18 to 64, with a companion set for those 65 and older or those 50 to 64 who have chronic health problems or physical limitations. Details can be found at ascm.org. Under Influence, click on Physical Activity Guidelines From ACSM and AHA.

The experts who made these recommendations urge all adults to adopt them now. As C. Jessie Jones, co-director of the Center for Successful Aging at California State University , Fullerton, said, People cant wait until they are in residential or long-term care to get started.