Pillar – Page 13 – Lifestyle Medicine

Gardening as a Lifestyle Medicine Practice

Healthful Nutrition, Social Engagement, Student Blogs

By Donovan Giang, Maya Shetty, and Rusly Harsono, MD

Life hastens while we focus on our goals, and this can be overwhelming and stressful. Let’s find balance and evaluate our lifestyle! Do you feel like you are eating healthy or connecting well with people around you on a consistent basis? Home and Community Gardening may help you and your family to get there. Home gardening is the practice of growing plants in a traditional outdoor garden or a kitchen garden using pots or trays inside our home. Community gardening, on the other hand, involves gardening in a space shared by the community. Studies showed that both forms of gardening have several health benefits, from improving nutrition to social connection.

Home Gardening Impact on Nutritional Health

Carney et al in 2013 reported that adults and children’s vegetable intake “several times a day” increased significantly from 18.2% to 84% (p<0.001) and from 24% to 64% (p = 0.003) respectively following a community-based participatory research project that enrolled 163 household members in a community-based gardening project to assess food security, safety and family relationships.

Researchers from the University of California, San Francisco in 2020 provided insight into how home gardening may improve nutritional health and facilitate better health behaviors. This qualitative study explored changes in health behavior following the implementation of a home gardening and nutritional education program in an urban community at high risk for cardiometabolic disease. Participants from low-income, Latino / Latina population in Santa Clara County were provided with home gardening supplies and attended 10 educational workshops to learn about nutrition, as well as gardening skills and healthy recipes. After a year of gardening, participants reported increased consumption of fresh produce, shifted toward home cooking, and decreased fast food consumption. Participants attributed these changes to the affordability, convenience, flavor, and freshness of their grown produce, as well pride in their garden.

Gardening and Social Connection

One of the most significant benefits associated with gardening is the circle of sharing that promotes connection within a local community. As individuals start their own gardens in their home or as part of a community garden, the act of sharing with those around them can build friendships, leading to continued social interaction, trust, and reciprocity. A qualitative research study in 2004 titled “Growing urban health: Community gardening in South-east Toronto” demonstrated these benefits among community gardeners. The researchers collected data from active community gardener participants on their experiences through direct observation, focus groups discussions, and in-depth interviews. Participants reported greater attachment to their community, more positive social interactions, and stronger relationships due to their community gardening experience. A participant of the study even described the joy from being able to share home-grown produce with friends, suggesting community gardens may also help strengthen social connections beyond the boundaries of one’s neighborhood.

Through stronger social relationships and a growing sense of joy in gardening, gardeners have more opportunities to inspire those around them to start their own gardens. Carney et al (2013) reported this effect with home gardeners. In this study, the researchers provided support and resources for participant families, who were mostly of a Hispanic and farm working background, to start their own home gardens. Through pre- and post-gardening questionnaires and interviews, the researchers found that not only did a significant proportion (94.9%) of participants report an improvement to their family’s health but also many of these participants (92.3%) encouraged other families to start gardens as well. As a result, one individual’s gardening can blossom into a rewarding community effort.

Nutrition and social engagement are key to support a healthy lifestyle. Researchers reported that through gardening we can improve our lifestyle medicine practices in at least these two pillars: healthful nutrition and social engagement. Boles et al in 2021 reported that targeting mindsets about the process of health behaviors have meaningful implications for individuals’ engagement in healthy behaviors. Gardening can transform the process of eating healthy into fun through opportunity to relax, expressing creativity and connecting with others.

Let’s try gardening for yourself, try collaborating with your neighbors or larger community to create a shared garden! Home gardening in your backyard or kitchen countertop is a great way to start living healthy. Hydroponic gardens recently have become popular to allow indoor gardening without dirt all year round. No matter which form of gardening you do, take the opportunity to try something new and maintain a healthy lifestyle!

References:

Boles, Danielle Z., et al. “Can Exercising and Eating Healthy Be Fun and Indulgent Instead of Boring and Depriving? Targeting Mindsets About the Process of Engaging in Healthy Behaviors.” Frontiers in Psychology, vol. 12, Oct. 21, pp. 1-14., https://doi.org/10.3389/fpsyg.2021.745950
Carney, Patricia A., et al. “Impact of a Community Gardening Project on Vegetable Intake, Food Security and Family Relationships: A Community-Based Participatory Research Study.” Journal of Community Health: The Publication for Health Promotion and Disease Prevention, vol. 37, no. 4, Aug. 2012, pp. 874–81., https://doi.org/10.1007/s10900-011-9522-z.

Eng, S., et al. “Healthy Lifestyle Through Home Gardening: The Art of Sharing.” American Journal of Lifestyle Medicine, vol. 13, no. 4, July 2019, pp. 347-350–350., https://doi.org/10.1177/1559827619842068.
Palar, Kartika, et al. “Nutrition and Health Improvements After Participation in an Urban Home Garden Program.” Journal of Nutrition Education and Behavior, vol. 51, no. 9, Oct. 2019, pp. 1037–46., https://doi.org/10.1016/j.jneb.2019.06.028.
Sarah Wakefield, Fiona Yeudall, Carolin Taron, Jennifer Reynolds, Ana Skinner, Growing urban health: Community gardening in South-East Toronto, Health Promotion International, Volume 22, Issue 2, June 2007, Pages 92–101, https://doi.org/10.1093/heapro/dam001

June 12, 2023/by dom-wp-admin

How Does Caffeine Affect You?

Healthful Nutrition, Restorative Sleep

It is difficult to predict how and for how long caffeine affects our bodies. Research suggests that caffeine affects everyone differently and our relationship with it could change as we age. A study examining the relationship between chronotype and the effects of caffeine on sleep in Stanford students found early birds had a strong correlation between daytime caffeine use and waking during sleep. Night owls’ sleep seemed to not be affected by their daytime caffeine intake. People in between seemed to experience minor effects. However, this study was exclusive to Stanford students, who are generally a more sleep-deprived population. It is unclear the degree to which this affected the results but is likely a significant confounding variable.

One of our sleep experts, Dr. Jaime Zeitzer, PhD, says , “There is massive variability in how people metabolize caffeine and in many, even a single cup of coffee with breakfast can interfere with sleep. Being aware of how your caffeine consumption personally impacts your sleep is incredibly important.”

By: Carly Mae Smith, BS

Sources:

Modeling caffeine concentrations with the Stanford Caffeine Questionnaire: preliminary evidence for an interaction of chronotype with the effects of caffeine on sleep

May 31, 2023/by dom-wp-admin

Coffee & Longer Lives

Healthful Nutrition

A team here at Stanford studying inflammation in older adults found an interesting correlation between those that regularly drank caffeinated coffee and those with lower levels of chronic inflammation. The study suggests that regular, moderate coffee intake may protect us from age-related inflammation and diseases. The clinical trial looking at markers of inflammation and age-related diseases found that 89 older subjects who regularly consumed caffeine from coffee experienced suppressed disease-related inflammation.

Before grabbing your next cup of joe, there are a few things are team would like you to keep in mind:

1) Coffee can mask grogginess, but you still need regular, sustained sleep! Coffee at any time of the day could disrupt sleep.

2) Too much sugar in your coffee may negate Some health benefits!

3) Be careful not to drink too much! Caffeine levels vary by coffee type.

4) If you don’t like coffee, try tea! We see many nutritional benefits in black and green tea too!

There are lots of factors to consider when discussing the impact of coffee and caffeine on our lifestyles, and we hope to cover a lot of them in the near future! To learn more about how caffeine may affect people differently, check out our post on caffeine and chronotypes.

By: Carly Mae Smith, BS

Sources:

Expression of specific inflammasome gene modules stratifies older individuals into two extreme clinical and immunological states

May 31, 2023/by dom-wp-admin

What a 10-Second Balance Test Can (and Can’t) Tell Us About Longevity

Movement & Exercise

A recent study found that standing on one leg for 10 seconds was independently associated with survival and that those unable to perform this test had double the usual risk of premature death. This relationship is an association and not causal – meaning, the test cannot predict when someone will die. It does, however, highlight the importance of monitoring and maintaining balance as we age. Good balance later in life can lower fall risk and help maintain independence, mobility, functional abilities, and overall quality of life.

According to Corey Rovzar, an expert in balance a postdoctoral fellow at the Stanford Prevention Research Center in the School of Medicine, balance is often overlooked in most people’s exercise regimes and is not regularly included in routine health checks for middle-aged and older adults. This study highlights the importance of monitoring and maintaining balance as you age since balance tends to decline most rapidly beginning in your 60s – and this decline can lead to faulty biomechanics and/or falls. The good news is that you can improve your balance through training! This could be as simple as standing on one leg while you brush your teeth, performing single-leg exercises, or engaging in activities such as tai chi and yoga. Strength training is also important, especially for the lower body, because stronger muscles allow you to have greater stability as you move and to move at an ideal speed. The key to any exercise program is consistency – find something that you enjoy and stick with it!

By: Corey Rovzar, PhD & Maya Shetty, BS

Sources:

Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals

May 25, 2023/by dom-wp-admin

Beneficial Effects of Tea on Longevity

Healthful Nutrition

The study analyzed data from 6387 participants and identified three distinct tea consumption trajectories. After a median follow-up of 17.9 years, it was found that high tea consumption was associated with a lower risk of mortality, but this effect was observed only in non-alcohol drinkers. Among current alcohol drinkers, increasing tea consumption was linearly associated with increased mortality. Additionally, the study revealed that alcohol intake masked the protective effect of tea consumption against blood pressure progression.

In conclusion, individuals with a long-term high tea consumption trajectory had a lower risk of all-cause mortality and a slower rate of blood pressure increase. However, the beneficial effects of tea consumption were diminished or even harmful in the presence of alcohol intake.

By: Michael Fredericson, MD

Sources:

Alcohol intake masked the protective effects of tea consumption against all-cause mortality and blood pressure progression: Findings from CHNS cohort, 1993–2011

May 24, 2023/by dom-wp-admin

Can Lifestyle Reverse Your Biological Age?

Cognitive Enhancement, Healthful Nutrition, Movement & Exercise, Restorative Sleep, Social Engagement, Stress Management

By: Ben Maines, MD candidate

We all know that eating right, sleeping well, and minimizing stress are good for our health, but what if they could turn back the clock on biological aging? A small but groundbreaking 2020 study found that an 8-week prescription of a healthful diet, stress reduction breathing practices, and exercise decreased participants’ epigenetic age by a little over three years relative to a control group. Sounds too good to be true, doesn’t it? And what do we mean by epigenetic age? We’ll answer those questions and more, but first, a primer in epigenetics. Epigenetics describes reversible molecular modifications made to DNA. At the cutting edge of our modern understanding of medicine and cellular biology, epigenetics facilitates variation between genetically identical cells like your neurons and muscle cells. In the case of twins, for example, you can think of the DNA as the blueprint shared by twins, while epigenetics is the footnotes — instructions that dictate how the blueprint is interpreted and applied. Think of it as the mechanism that bridges nurture and nature, fine-tuning your genetics in response to your environment and lifestyle. At the molecular level, that tuning involves the addition or removal of small molecules like methyl groups to DNA and its packaging. Some molecules make the genes to which they are attached more accessible to the machinery that will translate them, essentially turning those genes on, while others do just the opposite. Evolutionarily, these changes facilitate rapid adaptation to an ever-changing environment. An individual’s experience of famine, for example, can epigenetically tune their metabolism and growth for energy conservation. These epigenetic changes may also be seen in their descendants for several generations to come. The exciting news is that tuning isn’t permanent, which is where lifestyle medicine comes in. Many of the epigenetic phenomena that we understand are related to metabolism and stress responses. Though evolutionarily conserved, these epigenetic changes can be maladaptive in the modern context. A traumatic childhood experience, for example, can trigger epigenetic modifications that not only alter an individual’s stress response to cause chronic stress, but are also heritable to their offspring. This enhanced stress response may have protected an early human in the savannah from repeating risky behaviors, but in our more predictable modern world, chronic stress more often contributes to poor mental health and diseases like cardiovascular disease and high blood pressure. Thinking back to epigenetic age, it seems rational then that if we know the patterns of epigenetic modifications associated with failing health and the diseases of aging, we can use them as a surrogate measure of healthfulness. Though we don’t yet fully understand its nuances, molecularly determined epigenetic age is a better predictor of an individual’s health and longevity than chronological age, presenting an exciting frontier for understanding and modifying health and longevity through lifestyle medicine and targeted therapeutics. For example, a team led by scientists here at Stanford and at the Buck Institute for Research on Aging used deep learning to identify key molecules of systemic inflammation such as CXCL9 that correlate closely with morbidity, cardiovascular degradation, frailty, and other signs of biological aging. As we age, this increasing chronic, systemic inflammation is likely driven by epigenetic changes, raising the tantalizing possibility that it could also be reversed.

How can we use lifestyle medicine to modify our epigenetic fate?

So far, the main clinical epigenetic therapies that have seen success are small molecules that reduce DNA methylation to treat cancer. These molecules function by pushing the reset button on many of the accumulated epigenetic changes that allow the cancer cells’ runaway growth. What if we could do the same to the changes that predict ageing, chronic inflammation, and disease? For now, it seems that our therapeutic tools are too blunt, lacking the precision to target the maladaptive and disease-associated epigenetic changes. So, for now, our best tool for harnessing our epigenetic destiny is our lifestyle. Let’s take a deeper dive into what that looks like at the cutting edge of each of our Stanford Lifestyle Medicine Pillars.

Epigenetics & Physical Activity

Daily exercise has long been associated with health benefits from reduced incidence of cardiovascular disease and improved cancer prognosis to slower cognitive decline. The CDC recommends getting at least 150 minutes of moderate-intensity aerobic activity and 2 strengthening workouts a week for optimal health benefits. There is now evidence that exercise also broadly improves the capacity of your cells to alter their methylation patterns. Exercise leads to higher levels of the protein superoxide dismutase, which works through a series of receptors and pathways in the liver to alter the methylation of key metabolism genes and enhance metabolic function. These pathways affect health in a myriad of ways including improving glucose tolerance to reduce the risk of diabetes. Though some of those epigenetic changes are maintained from parents to children, many are re-programmed during critical developmental periods in-utero, allowing maternal exercise during pregnancy to have profound impacts on offspring health later in life. Lifestyle, it seems, is preventive care that begins even before we’re born. The systemic epigenetic changes induced by physical activity were seen in a recent study by Washington State University that analyzed differences between physical activity and epigenetics in identical twins. Researchers found that twins who exercised for 150 minutes a week or more had more epigenetic markers related to lower risk of metabolic syndrome than twins who exercised less.

Epigenetics & Nutrition

According to recent research, what you eat, and perhaps more unexpectedly, what your parents ate, seems to affect our health through epigenetics in two interesting ways. First, by the availability of small molecules that participate in and modulate the biochemical reactions that add and remove epigenetic tags. For example, plant-forward diets tend to be high in epigenetic substrates like folate, a precursor of the methyl groups added to DNA; cofactors that facilitate that reaction like vitamins A and C; and polyphenolic compounds like curcumin (found in turmeric) that modulate DNA Methyltransferase, the protein that initiates the reaction. Leading theories suggest that by maintaining abundant nutrients involved in epigenetic processes, the body’s response to stress and ever-changing metabolic supply and demand can be efficiently fine-tuned. Diseases like diabetes arise in part because of maladaptive or improper metabolic tuning. A second way that nutrition impacts epigenetics seems to be mediated by metabolic stressors and nutrient sensing. Our cells work along the spectrum between two main modes; when nutrients are limited, pathways turn on that favor maintenance, and clearing and recycling debris, to enhance cellular function and efficiency. Abundant nutrients, on the other hand, downregulate the efficiency pathways and promote storage and more reckless use of resources. With time, famine or feast can become encoded as heritable epigenetic changes, contributing to the increased risk of obesity, diabetes, and several other health conditions in the offspring of parents with poor diet and nutritional profile.

Epigenetics & Sleep

Sleep, namely the lack thereof, has been associated with everything from heart disease and stroke to metabolic disruption. Its greatest impact, though, is on the brain. Interestingly, susceptibility to sleep deprivation is a highly genetic phenomenon. Some people can barely function without 8 hours of sleep, while for others, 6 is more than enough. This suggests a significant role for epigenetics. Cognitive functions like learning and memory rely on neural plasticity, which requires fine-tuned epigenetic adjustments to the gene expression patterns of individual neurons. This process requires sleep, and even single sleep disruption events can impair them, especially in the hippocampus, one of our primary memory and learning centers. More chronic sleep deprivation can alter mood, exacerbate psychiatric disorders, and increase the risk of neurodegeneration as in Alzheimer’s. Most of the epigenetic changes seen with sleep deprivation modify genes involved in metabolism, circadian rhythm, and synaptic plasticity and signaling. For example, night shift workers have altered expression of the genes CLOCK and Dlg4, a master regulator of our body’s internal clock, and a protein implicated in autism that scaffolds synaptic signaling respectively.

Epigenetics & Stress

Technically, stress is any stimulus that disrupts our body’s homeostasis, whether running from a predator in our evolutionary past, experiencing a traumatic life event, or persistent psychological distress. The hypothalamus-pituitary-adrenal (HPA) axis, then, is the stress response control center, a system that connects our brain to our hormone-secreting glands that release systemic stress signals like cortisol, adrenaline, and pro-inflammatory molecules. These signals go on to modulate all our body’s systems, from metabolism and neuronal activity to immune function, and are themselves epigenetically tuned. Typically, our bodies overcome the stressor and return to homeostasis, but traumatic and chronic stress can lead to compounding epigenetic changes that dysregulate our immune, metabolic, neuronal, cardiovascular, and other systems. For example, traumatic childhood experiences trigger epigenetic changes in immune cells like macrophage, increasing pro-inflammatory reactivity and hormonal dysregulation, which may underlie the plethora of adverse health outcomes associated with childhood trauma. Much like the epigenetics of nutrition and exercise, parental stress can be passed on to children both through inherited epigenetic patterns, and through stress hormones circulated from the mother to the developing fetus. On the bright side, positive life experiences, social relationships, and mindfulness practices like meditation and breathing exercises all work to short-circuit these maladaptive stress responses and associated epigenetic changes. For example, one mindfulness-based intervention in breast cancer patients resulted in a reduction of greater than 50% in the epigenetically controlled levels of 91 pro-inflammatory hormones and molecules compared to control patients, an effect that persisted 12 months later.

Epigenetics & Social Engagement

Our capacity to form complex social bonds is evolutionarily foundational to survival, so it’s no wonder that relationships, too, are intimately tied to epigenetics. On one hand, the epigenetic changes associated with chronic and traumatic stress are implicated in impaired capacity for developing and maintaining social bonds. On the other hand, Strong social relationships are important for mitigating stress and its deleterious epigenetic effects, and are one of the strongest predictors of health, happiness, and longevity. Though this is one of the more complex and least understood areas of epigenetics, it’s hard to overstate its role. For instance, mutations in MeCP2, a gene that helps interpret epigenetic methylation patterns, results in the profound cognitive and social dysfunction known as Rhett syndrome.

Epigenetics & Cognitive Enhancement

As it turns out, synaptic plasticity, the phenomenon underlying higher cognitive functions like memory and learning, is largely governed by epigenetic mechanisms. In a highly simplified sense, the strength of patterns and combinations of synaptic firing are enhanced by repeated stimulation, and conversely tuned down in the absence of activity. This is accomplished by epigenetic changes that modulate the sensitivity of neurons to subsequent stimulation. Carrying that principle one step farther, research indicates that enhanced synaptic activity is also essential in synaptic and axonal regeneration after damage such as in the brain of a stroke patient. In animal models, for example, exposure to stimulatory physical and social environments after a brain injury or in disease states such as Parkinson’s leads to increased synaptic activity, which triggers epigenetic changes that promote regenerative healing. Given this observation, it is speculated that similar mechanisms underlie the positive effects of exposure to nature and socially stimulating environments on cognitive and neurological recovery after a brain injury or in diseases like Alzheimer’s. Further, it is plausible that the epigenetic benefits of physical fitness, a varied, plant-based diet, sleep, and relationships translate to beneficial effects on cognitive performance in both health and recovery. For example, the Mediterranean Diet is associated with slowed brain aging and improved cognitive functioning, whereas the Western Diet has been implicated in accelerating natural brain aging processes.

April 26, 2023/by dom-wp-admin

Importance of Proper Magnesium Intake For Exercise Performance and Healthy Functioning

Healthful Nutrition

Whether you’re a regular at the gym or interested in supplement talk, you may have been recommended to increase your magnesium intake. Are you getting enough? Why does is matter? There are many benefits of having a healthy amount of magnesium in our diets since it is believed to be involved in muscle relaxation, regular neural firing, energy production, and other systems throughout the body that keep you performing and feeling well. One specific phenomenon popular in research right now is the potential ability of enhanced magnesium intake to reduce the occurrence of muscle cramps. This is of interest to both the exercise science and sleep communities since cramping can disrupt either activity significantly. So, how much magnesium should you be getting regularly anyways? National intake recommendations vary by age, sex, and events of pregnancy, but tend to range between 310 and 420 mg daily for most adult individuals. For the most efficient absorption and usage by the body, it is also recommended that magnesium intake be balanced with Vitamin D and calcium. We have put together a quick reference for different foods that are pretty rich in magnesium content to make reaching this goal easier, but visit the National Institute of Health’s page for more.

By: Marily Oppezzo, PhD & Carly Smith, BS

Sources:

https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/

April 21, 2023/by dom-wp-admin

Stop The Clock: The Shocking Truth About Age-Related Muscle Loss and Steps to Fight Back

Healthful Nutrition, Movement & Exercise

By: Sarita Khemani, MD

As a physician specializing in peri-operative medicine, I have witnessed firsthand the detrimental impact of muscle loss on patients. Whether it is individuals presenting with hip or spine fractures, or those who have suffered from bleeding in their brain following a fall, many of these acute conditions have a hidden underlying cause: the loss of muscle mass.

Although losing muscle may not seem like a significant concern, it can be a silent yet deadly issue that progressively drains our vitality and strength, leading us to become frail and dependent.

In this blog, we will explore the latest scientific research on the trajectory of muscle loss as we age and discuss practical steps that we can take to prevent or alleviate its effects.

Understanding Skeletal Muscle: Composition and Function

Skeletal muscle is the type of muscle tissue that we can control voluntarily, such as when we intentionally flex our biceps or perform other movements. It is composed of many smaller bundles of muscle fibers, each containing hundreds to thousands of individual fibers. These fibers are primarily made up of two proteins: myosin and actin, which work together to facilitate muscle contraction.

The muscle fibers themselves are arranged in a specific pattern, extending the muscle’s length between the tendinous ends, and are bundled together and wrapped in connective tissue. This arrangement allows the muscle to generate force and produce movement when it contracts.

In terms of composition, muscle tissue is approximately 70% water and 30% protein. The body synthesizes muscle protein from the amino acids that are present in the protein we consume through our diet.

Image credit: University of Miami: https://www.bio.miami.edu/dana/360/360F18_15.html

As we age, the gradual decline in muscle mass and strength worsens with each passing decade. This decline can be attributed to several factors, including reduced dietary protein intake, decreased physical activity, a decline in hormone levels, chronic inflammation, muscle denervation, mitochondrial dysfunction, infiltration of fat into muscle, and insulin resistance.

Research suggests that the rate of loss of muscle strength is greater than the loss of muscle mass and plays a crucial role in healthy aging. When low muscle mass and function, including strength and physical performance, occur with aging, it is known as sarcopenia. The term “sarcopenia” originates from the Greek words “sarx,” meaning flesh, and “penia,” meaning loss.

Sarcopenia can be classified into two categories: primary sarcopenia, which is the cumulative result of various factors leading to muscle loss with aging, and secondary sarcopenia, which is caused by a specific insult, such as surgery, hospitalization, or injury. By understanding these categories, we can better diagnose and manage sarcopenia in older adults.

The trajectory of age-related muscle loss

The loss of muscle strength with age can be surprising to many people, as it can start as early as age 30. As numerous research studies have shown, the rate of decline for muscle mass with age worsens with each decade.

Age	Percent loss of muscle mass/decade
50s	0.5-2%
60s	4-5%
70s	7-8%

The decline in muscle strength is more dramatic and can be 2-5 times greater than decline in muscle mass.

Age	Percent loss of muscle strength/decade
50s	3-4%
60s	9-10%
70s	11-12%

A study found that there was muscle loss of between 35% and 40% occurring between the ages of 20 and 80. Additionally, studies of nursing home residents have found that sarcopenia, affects 30-40% of individuals. Mobility aids, such as canes, walkers, or wheelchairs, are commonly used by older adults, with 24% of those aged 65 years and older relying on such aids. Alarmingly, the death rate from falls is projected to rise sharply in the coming years, as shown in the graph below.

Image Credit: CDC:

Skeletal muscle mass is shown to be an independent predictor of death, highlighting its crucial effect on longevity.

These statistics don’t consider the sudden health events that can accelerate muscle loss. A rapid decline in muscle mass and health occurs with hospitalizations and illnesses. In addition to the lack of activity during hospital stays, other factors like increased levels of pro-inflammatory agents and cortisol can have a compounding effect. For older adults, this loss of muscle mass and function can lead to permanent disability or even death.

Connection between muscle health and dementia

Dementia affects more than 55 million people worldwide, and physical inactivity is one of the modifiable risk factors for the condition. There is a well-established link between low muscle mass, low physical activity, and cognitive impairment in old age.

Exercise releases myokines from the muscle, which crosses the blood-brain barrier and helps regulate BDNF, a protein that supports the survival and growth of neurons in the brain. Furthermore, the lower an individual’s muscle mass, the more significant their cognitive decline, suggesting a dose-dependent effect.

Steps to preserving muscle health and function.

Protecting your muscle mass is like increasing your savings: the greater the savings, the more comfortable you will be as you age.. While we might develop pharmacological treatments for muscle loss in the future, currently, the best way to preserve muscle function is to put in work upfront.

1. Strength training, “the medicine”

Resistance training activates our DNA to respond to stress, leading cells to produce increased muscle protein.

Initially, we may see an improvement in strength but not much muscle hypertrophy because of an increase in muscle protein breakdown. However, this slows down after about six weeks, and we start seeing an increase in muscle size.

Strength training can counteract the accumulation of fat in the muscle, improve the health of neuromuscular junctions, improve muscle quality, and reduce inflammatory markers.

People who do regular resistance training have a 20-year advantage. For example, 85-year-old weightlifters showed similar power and muscle features as 65-year-olds who did not engage in regular training in studies.

To achieve optimum improvement in muscle mass and strength, we should engage in resistance training 2-3 times per week per muscle group in addition to any aerobic exercises.

Resistance exercises that involve increasing load and speed should be done under supervision to ensure proper form and avoid injury.

2. Protein intake

Studies have shown that higher protein intake is associated with greater muscle mass and lower risk of developing frailty in older adults.

Protein intake should be individualized based on age, sex, activity level, and health status, but generally range from 1.6-2.2 grams per kilogram of body weight per day.

A systematic review and meta-analysis published in the British Journal of Nutrition in 2020 found that plant-based protein sources can be just as effective as animal-based sources for improving muscle health. It’s best to mix and match various plant-based sources of protein for optimum effect.

Consuming more than 35-50 grams of protein at one time does not provide any additional benefit for muscle growth, as excess protein is used for energy production. Therefore, it is best to spread protein intake out throughout the day rather than consuming the whole day’s amount in one sitting.

3. Supplements: Please see an excellent blog by Dr. Kaufman on this website to gain more knowledge about the safe use of supplements.

4. We all know to get good sleep and stay hydrated—more on these topics in future blog posts.

April 11, 2023/by dom-wp-admin

What Does Grip Strength Indicate About Your Health?

The Importance of Grip Strength: Exploring its Link to Longevity

Movement & Exercise

Your future lies in the palm of your hand… kind of. A popular topic in longevity and exercise science involves the association between grip strength and life span, but what exactly are people talking about? Two recent studies describing the relevance of grip strength in the field have started to analyze what information one’s grip strength actually provides. “Grip strength is inversely associates with DNA methylation age acceleration” covers cross-sectional and longitudinal associations between hand grip strength and three different clock models to describe the pace of one’s aging in American adults over the age of 50 years old. Essentially, these three different clocks take in information from a DNA methylation sample, and output a relative estimate of how quickly someone is aging based on the different health outcome risk biomarkers they are entrained on. As it pertains to grip strength, the three age-acceleration clocks looked at in the study found significant associations to suggest that greater grip strength can help one protect their body from physically aging faster. These clocks could be useful tools in future clinical applications to begin to better understand the needs of different patients later in life. However, there is still work left to be done as the sample of this study may not be representative of the diverse middle and older aged populations in the larger United States or on a global scale. When reading information from the study above, it can also be easy to believe that increasing the amount of grip-strength exercises you’re doing will help you slow down how fast you’re aging and live longer, which is not exactly the case. Another study from the Journal for Clinical Interventions in Aging, reviews the literature to suggest how grip strength’s relevance to aging science may be due to its associations with total body strength, bone density, reduced risk of falls and fractures, etc. Knowing that there is ample research on the protective effects of these measurements on later-in-life life expectancy, grip strength may be a starting place to begin to clinically understand risks the potential mobility and functionality risks for some patients.

To read the full article from the Journal of Cachexia, Sarcopenia, and Muscle, follow this link: https://doi.org/10.1002/jcsm.13110

To read the full article from the Journal for Clinical Interventions in Aging, follow this link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778477/.

By: Carly Mae Smith

April 4, 2023/by dom-wp-admin

Sauna Use As a Lifestyle Practice

Cognitive Enhancement, Stress Management

By: Vanika Chawla, MD

Emerging evidence suggests that beyond its use for pleasure, sauna bathing may be linked to several health benefits including cardiovascular, neurological and metabolic benefits. A recent review by Patrick & Johnson outlines evidence of the benefits of sauna use, potential mechanisms of action, and adverse effects and contraindications. Sauna bathing is characterized by short-term exposure to high temperatures (ranging from 113F to 212F), and there are various forms including “dry” and “wet” saunas which differ in the amount of humidity.

A large study done by Laukkanen et al., examining data from over 2000 middle-aged men in Finland showed that men who used saunas two to three times a week had a 27% reduction in mortality associated with cardiovascular disease compared to those who used saunas once a week, and men who used saunas four to five times a week had a 50% reduction rate in mortality associated with cardiovascular disease. The risk of mortality from all causes was reduced by 40% in frequent sauna users compared to infrequent users! Duration of sauna use was inversely correlated with the risk of cardiovascular disease and coronary heart disease, meaning those who used saunas for longer than 19 minutes had better outcomes than those who used saunas for less than 11 minutes. Results were adjusted for factors such as socioeconomic status.

Many of the physiological effects of sauna use are similar to those elicited during moderate to vigorous-intensity aerobic exercise. Studies show that aerobic exercise in combination with frequent sauna use has a synergetic effect in reducing cardiovascular and all-cause mortality. Exposure to high temperatures stresses the body and this heat exposure induces protective responses that promote cardiovascular health, such as increased heart rate, decreases in blood pressure, and improved blood flow. Heat stress may lead to improved physical fitness by increasing cardiorespiratory fitness, endurance and preserving muscle mass. During exercise the core body temperature rises and heat acclimation from the sauna optimizes the body for tolerating core body temperature elevations during future exercise, as well as supporting other cardiovascular and thermoregulatory functions that are important in fitness and exercise. pThese mechanisms contribute to muscle mass maintenance and prevent muscle loss that can occur with aging.

Further analysis of the data from Finland also showed that men who used saunas four to seven times a week had a 66% lower risk of developing dementia compared to those who used saunas once per week. Proposed mechanisms for improved brain health in response to sauna include heat exposure and the subsequent cardiovascular response increasing the expression of brain-derived neurotrophic factor (BDNF), which is an important factor that supports the development of new neurons in the brain, and increased blood flow to the brain. Heat shock proteins also protect against brain disease.

Findings from the study also show that regular sauna users had a lower risk of developing pneumonia and sauna use may bolster the response of the immune system and promote respiratory health.

Caution should be exercised for sauna use in special populations such as pregnant women and children. There are some reports of reduction in male sperm count following sauna use in a 10-person study, but measures returned to normal within 6 months of sauna use cessation. Some contraindications for sauna use include alcohol use, hypotension, recent heart attack, severe aortic stenosis, and altered or reduced sweat function (such as in certain autoimmune or neurological disorders). Proper hydration is recommended prior to and during sauna use.

You may want to consider using a sauna as you cultivate a positive, healthy lifestyle. It can be pleasant and soothing on a cold winter’s day, and may reduce your risk for some upper respiratory infections. There is no clear evidence indicating whether the benefits of sauna are limited to specific climates or seasons, or whether sauna bathing during hot weather confers health benefits.

References:

Patrick RP, Johnson TL. Sauna use as a lifestyle practice to extend healthspan. Exp Gerontol. 2021;154:111509. doi:10.1016/j.exger.2021.111509

Laukkanen T, Khan H, Zaccardi F, Laukkanen JA. Association between sauna bathing and fatal cardiovascular and all-cause mortality events. JAMA Intern Med. 2015;175(4):542-548. doi:10.1001/jamainternmed.2014.8187

March 27, 2023/by dom-wp-admin

By Donovan Giang, Maya Shetty, and Rusly Harsono, MD

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Epigenetics & Physical Activity

Epigenetics & Nutrition

Epigenetics & Sleep

Epigenetics & Stress

Epigenetics & Social Engagement

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