Senior Health Management

How To Enjoy Life as we Mature and Retire

READ MORE

Welcome To Healthysport!

Sarcopenia: Loss of Muscle Endurance and Strength

Details
Hits: 1231

Sarcopenia is the loss of skeletal muscles as we age and this affects our overall strength and performance. This is translated into the inability to perform regular tasks which are necessary for daily living. A person suffering from sarcopenia may need walking aids, would suffer from poor strength of muscles, and start fearing mobility challenges like stairs or stepping on a bathtub; some would be very unsteady on uneven terrains such as rocky backyard to grass lawn to sandy beach because of the risk of imbalance and falls. They resort to the safety of  a stable structure like a rail, a tree trunk or someone to hold on. You see them in the airports looking healthy but could hardly walk a certain amount of distance. 

Sarcopenia occurs much later in life, most likely after the age of 70. There is a difference between sarcopenia and disability and those who fake weakness LOL. I am often amused by those who can run and jump in real life but suddenly require a scooter in Publix or a wheelchair in airports. If you ask me, I will rather walk as much as I can, even parking far from the entrance of malls, or Walmart or Publix. There is nothing more beautiful than rising up from sitting and taking steps no matter how slow. The ability to move is a gift from God and I don’t know why some would like to immobilize themselves. Some healthy people or those with very minor limitations try desperately to obtain a disabled parking permit. What is the idea? I mean, I can walk 5 miles in one sitting and why would I all of a sudden be so desperate to make a quick zip line to the grocery store? I am not generalizing. I just know some people who are like that. Obviously, there are exemptions. Buying bulky items and furniture would make sense to park closest to the entrances of stores. But ordinary shopping should encourage a healthy lifestyle among people by walking longer in good weather.

Especially when retired with extra time.  Why not take the scenic route? I park a safe distance from any store so I can take extra steps.

I live downtown and when the traffic is slow, I walk from my house to the beach. Some people walk their dogs. Some walk back and forth in their gardens. Some walk in parks and chat with friends and strangers and neighbors increasing their networks and sociability. That improves mental health (if that is your thing). Some retirees volunteer in local facilities like hospitals and churches to allow them to frequently sit and stand. There is nothing wrong with greeting and directing people especially if it lifts the spirit and burns calories.

There is a catch though. Mobility like walking is healthy cardiovascular but Sarcopenia weakens muscles also. Conventional wisdom states that as we get older, we need to combine cardiovascular and muscular strength. The strength of the muscles is reduced at a rate of 3% per year after middle age. That is a reduction in volume and mass. It is atrophy but it isn’t demonstrated because what makes up for the lost mass volume is fats. That fat within the muscles reduces metabolism and affects things like speed, endurance and balance.

So it is imperative that a good workout would include cardiovascular training for endurance and muscle training for strength. Both needed to reduce the functional and safety decline in aging. 

Then the question is when do you do cardio and when do you do strength? Do you do them separately or at the same time (meaning in the same session). There are studies done on this and they all agree that doing them together in a single session is counterproductive, it seems one cancels the other. In other worlds the buildup of endurance may reduce the buildup of strength. The evidence suggests that endurance one day and strengthening on another day may be the best exercise program to achieve both. 

What is endurance? It is the ability to perform light tasks, like walking, cooking, gardening, showering, and light household cleaning for a long time before experiencing tiredness. Strength on the other hand is the amount of effort exerted by the muscles to perform a usually short duration task. Such as lifting an object, standing from sitting, getting out of bed, picking up an object from the ground, countering an abrupt loss of balance, maintaining balance (balance is an interplay of many muscles in the body). 

Lean forward (with extra care of course) and you will observe and feel different groups of muscles acting together to correct your lean. Standing on one leg, such as putting on your pants, would suddenly recruit a lot of muscles in the body to maintain your balance. Sit on a therapeutic ball and you would feel the tension in your core as your trunk muscles simultaneously contract to maintain a midline posture. This is a factor one should consider as one ages. If one focuses exclusively on cardiovascular endurance without strengthening, there is a high risk of falling and injury. If one focuses exclusively on strengthening, medical problems such as high blood pressure, high cholesterol, blood sugar etc. may not be addressed.

It goes without saying there are many arguments over this. The strengthening proponents claim that strengthening can be altered to impact the cardiovascular while the cardiovascular proponents claim the same with endurance exercises.

Circuit training is an example of both cardio and strengthening programs. If you advance your endurance exercise up to speed, such as a quick turnover of your legs, carrying weights in both arms, or both legs, running on ramps or elevations, speeding your bicycle up a hill or mountain, stairs are considered both endurance and strengthening exercises. High-Intensity Interval Training that are short spurt but high-impact routine for HIIT such as:

  • Burpees
  • Mountain Climbers
  • Sprints
  • Tuck Jumps
  • High Knees
  • Lateral Lunges with Hops
  • Box Jumps

Can be structured to increase strength and endurance if done correctly. But I am getting outside of the Sarcopenia topic here. HIIT may be good, how but I am not sure how many ordinary senior citizens can work this out. It would probably require lots of modifications. A debilitated person might invite more injuries if these HIIT programs are attempted. There are always exceptions, but it might be more prudent to have a professional exercise coach who is familiar with the limitations of old age get you started first.

There are evidence-based studies which also show that combining endurance and strengthening in the same session is counter-productive. Since sarcopenia and old age lessen the mass and strength of muscles, it is important to separate the two goals on separate days. In my case, I do a minimum of three days cardio and two days strengthening per week. I incorporate rest and relaxation on non-workout days. 

Resources:

TWENTY-FOUR MONTHS’ RESISTANCE AND ENDURANCE TRAINING IMPROVES MUSCLE SIZE AND PHYSICAL FUNCTIONS BUT NOT MUSCLE QUALITY IN OLDER ADULTS REQUIRING LONG-TERM CARE, A. YOSHIKO, T. KAJI, H. SUGIYAMA, T. KOIKE, Y. OSHIDA , H. AKIMA (authors), Journal of Nutrition, Health and Aging 2019

PHYSICAL ACTIVITY - DECISIVE FACTOR FOR FULL LIFE OF PEOPLE IN AGE, Valentina Vassileva (author), Activities in Physical Education and Sport 2015, Vol. 5, No. 2, pp. 214-217

THE EFFECTS OF UPPER BODY STRENGTH TRAINING VERSUS CONCURRENT STRENGTH + ENDURANCE TRAINING ON INDICES OF STRENGTH, AEROBIC POWER, AND MUSCLE CROSS SECTIONAL AREA, Jose Antonio (author), Nova Southeastern University, Fight Science Lab, Exercise and Sport Science, Davie Florida USA 33328, Journal of Exercise Physiologyonline August 2023 Volume 26 Number 4

On Bad Blood

Details
Hits: 1041

I have heard about the rise and fall of Elizabeth Holmes in the past but I did not pay much attention to her story. I was already in my 50s then and startups to me were mostly in the domain of Gen Z and millennials. I just surmised her as another Madoff or Bankman-Fried and  hundreds of startups that came to the limelight being valued for billions only to end in the dustbin of failures, broken, and imploded. I witnessed this all the way from the dot-com boom, the apps boom, and now, it is the era of  the social media boom that  promises to make millionaires and billionaires if they get enough likes and followers based on the algorithms of the platforms hosting them. I remember everyone, including myself, dreaming of creating an app or a game or anything that will earn millions from subscribers alone. That was confined to dreams, the reality was, during my university days for my IT degree, I was more attracted to creating online stores to  sell something. I honed in on websites that could satisfy my creativity, showcase whatever  gifts I possess and  be happy to see a beautiful product staring back at me on my monitor. None of my dreams materialized due to real-life responsibilities. I went straight back to my old profession  after IT, dashing my hopes, promising that one day, yup, one day, I will return to my programming and take another long shot at creating an app, or a good online store, or of a data processor, or a search engine or a dating site, or a copycat facebook or job search engine or…. Well, you get the picture. It won’t probably happen but as I said, there is nothing wrong with dreaming no matter how improbable it is. Maturity makes us wiser. But it requires patience and learning from little trials and errors before reaching the big kahuna.

Reading Bad Blood, I was immediately struck by the anecdote that triggered all of Holme’s reasons to start her ‘tech’ project. She was in her teens or maybe at 20 when she declared to her family that she’d quit Standord to become a woman billionaire in the tech field. Whoa! That was a red flag to me because in my book, you don’t set out to do something because you want to be a billionaire. To me, venturing into some enterprise  should be driven by love. It means you wake up feeling excited  about your would-be project. The very people that Holmes emulated, especially Steve Jobs, did not set out in their fields to be  famous and rich, with a goal of making billions. Mark Zuckerberg just wanted to have fun with the soon-to-be Facebook and he was programming codes as early as 10 years old using his father’s computer. Bill Gates was obsessed with programming at a time computer use was so valuable that he could only ‘steal’ a couple of hours to fill the need to program. Jeff Bezos  wanted to develop his online store primarily. And not sure of this, Elon Musk co-developed PayPal before it was sold for millions. 

One thing is pretty much common among these ‘billionaires’. They did not set out to be billionaires. They set out to enjoy what they were doing and advance their projects until they stumbled into their billions. What I am trying to say is monetary gain is the worst goal you can have in pursuing a business, be it a tech or an app or a simple coffee and donut shop. 

Holmes’ trajectory was suspect. There was a goal, maybe a business plan. The business plan was very fuzzy if there was any at all. It was like saying to myself that I want to be an Olympic champion with no idea how to become one. She dropped out of Stanford in sophomore year. The reason is to start a very complex medical tech device named Theranos that could read hundreds of blood tests using a minute amount of blood from a finger prick. It is designed to compete with companies like Quest Diagnostics and LabCorp - the established labs used by clinics nationwide.

The concept was very tantalizing, Holmes stuck to the  narrative that Theranos would do countless blood tests, to the tune of 120  and on and on and on. This is quite impossible (maybe someday it will be possible) given that blood from finger prick can have insufficient concentrations and could produce false results. Some blood tests require venous blood sources to produce reliable numbers. To me, a young woman without a background in blood science, chemistry and biomedical engineering would require many decades to even come close to her nearly-impossible quest. Even if her IQ was high.

Yet people invested in her idea. Or her dream. And this is where her skills became useful. She had a good salesman’s pitch. She sold, if not oversold,  her startup and people snatched it and took out their checks and wallets based on a dream. You might wonder how investors could be this gullible. 

Know that Theranos was not the only game in town in those days. The early 2000s were the days of  startups like google, facebook, uber, airbnb which produced results and money. On the flipside were the failures that lost money : Fitness Tracker Jawbone, Pets.com, electric car BetterPlace, solar panel Solyndra. All these collected millions of investments through sales pitch and were all as tantalizing as Theranos. Angel investors were  on the lookout for the next ‘ big thing’. They did everything by the book, looking at the business concepts of some of these successes and failures, you’d not hesitate to invest. In fact, some of them were pretty much successful at the onset until the overhead and logistics and lack of control to expansion struck them hard and they fell and never had the chance to rise. 

These startups emulated the old hands that proved successful before them. Starting with Bill Gates with his Windows OS, Steve Jobs with his highly coveted designs of Apple gadgets, Google’s Brin and Page, Dell founder Michael Dell, online bookstore founder Jeff Bezos now Amazon. More recent at that time were the successful Facebook(Zuckerberg), Twitter (Jack Dempsey) PayPal (Elon Musk).

Every Gen X thought they’d become overnight millionaires with a simple code and good marketing strategy based on the success of previous ones. Unfortunately,  a lot failed, very few succeeded, while the rest  like me  watched from the sidelines. I am close to the ages of Gates, Bezos , Dell and Jobs and if I would have had the same luck as they did, I would be up there already. But I did not. I studied the field of IT for its availability at nights after work, it gave me electives that included programming languages, and languages were my main targets because I wanted to learn the art of web designing, I dabbled in apps, but my overall goal was to showcase my creative outputs in letters and literature through beautiful websites. Later I learned databases and interactive websites using MVC modeling. I did not even think of shifting my career because I was compensated well for my healthcare job. And I needed a more secure job because like any other Filipino who worked abroad, supporting family back home financially was paramount. 

And there was one more computer-related hobby that triggered a lot of passion in me. The assembly of the computer from scratch. In my old days, there was a new kernel that supported the creation of different free operating systems. Linux. There was nothing more euphoric than attempting to buy an entire operating system via floppy disks, assemble and boot the system and hear for the first time the static that tells you that you are connected to the Internet. So I was outside the game of the coders, programmers and startups although I had an idea how to play the game. 

Theranos was conceived during this exciting time. Elizabeth Holmes’ joined the crowd. She conceived a tech project (albeit no relation to a standard software development) at a time everyone was looking for the first female Steve Jobs tech mogul. She footed the bill. Smart, beautiful, young at around 20,  Stanford dropout(intentionally), highly confident, verbally convincing, some claimed her to be a genius. And the future Steve Jobs. Or Vill Gates. And female too. 

The first red flag in her startup (in my personal view) was the utilization of  software development management tools on a business that is primarily non-software related. It was a device that would read blood. I cannot understand how she ended up with herself (without any medical/engineering background) and her boyfriend Balwani (with a background in Information Systems, a little Computer science courses, whose only source of achievement  was cashing out on a B2B Internet commerce company sold at the time right time so he earned something like 40 million) to create a blood reader device they had no mastery over.

By studying Holmes' approach, it was like an agile software development technique. You compartmentalize the job, integrate, ok the initial product and offer it as the 1.0 version. Along the way you anticipate bugs from the run so you get feedback and re-analyze the project, fix the bugs and resend it out again, and these beta versions 1.1 will advance to beta 1.2, beta 1.3 until there is no more bug  to fix. Then you upgrade the software to version 2.0 and repeat the whole process. 

The trouble is, this agile technique is useful mainly to software development. You cannot apply this versioning and beta modifications on a device that involves life and death. You cannot send out a trial machine that helps to diagnose a patient and give out wrong numbers. Especially with numbers that determine the type of treatment that will be administered to a potentially  sick patient.

  1. Take Care of Your Heart: A friendly Reminder from the American Physical Therapy Association
  2. Morning Has Broken
  3. Reaction to Quiet by Susan Cain
  4. Stroke Part 5 : The Bleeding Pipe
  5. Reaction to the book 'The Beginning of Infinity (part 2)
  6. Book Reaction: The Beginning of Infinity(part1)
  7. Stroke Part 4: The good, the bad, and the bad (Cholesterol)
  8. Let's Take a Walk on the Wild Side
  9. Stroke Part 3: Burst vs Clogged Pipe
  10. Stroke Part 2: The Plumbing System

Page 5 of 69

Joomla templates by a4joomla