Sarcopenia and Why You Should Care

 

Sarcopenia is the age-related, progressive loss of muscle mass and strength. The main symptom of sarcopenia is muscle weakness. Sarcopenia is a type of muscle atrophy primarily caused by the natural aging process. Scientists believe being physically inactive and eating an unbalanced diet can contribute to the disease.

How bad is it? 

It is a common condition in people over 50 years old, although less active people begin to lose up to 3% muscle mass per year after the age of 30. This doesn't sound like a lot but it continues year after year. And it happens even faster after age 50, increasing to as much as 8%. This not only limits the ability to perform many routine activities but also shortens life expectancy in those it affects, compared to individuals with normal muscle strength. It also greatly increases the chance of losing your balance and taking a fall, a major health risk for the elderly.

Although aging is the most common cause of sarcopenia, other factors can also trigger increasing muscle atrophy. The most common of these are:

 

1. Inactivity

Disuse of muscle is one of the strongest triggers of sarcopenia, leading to faster muscle loss and increasing weakness, and it can happen rapidly. Bed rest or immobilization after an injury or illness leads to rapid loss of muscle and as little as two to three weeks of decreased walking and other regular activity is also enough to decrease muscle mass and strength.

Periods of decreased activity can become a vicious cycle. Muscle strength decreases, resulting in greater fatigue and making it more difficult to return to normal activity.

2. Low Protein Intake

A diet providing insufficient calories from protein results in weight loss and diminished muscle mass. Unfortunately, low-calorie and low-protein diets become more common with aging, due to changes in sense of taste, problems with the teeth, gums and swallowing, or increased difficulty shopping and cooking.

To help prevent sarcopenia, scientists recommend consuming 25–30 grams of protein at each meal.

3. Inflammation

After an injury or illness, or in the case of certain chronic conditions such as arthritis, inflammation sends signals to the body to tear down and then rebuild the damaged groups of cells. Chronic or long-term diseases can also result in inflammation that disrupts the normal balance of teardown and healing, resulting in muscle loss.

Examples of diseases that cause long-term inflammation include rheumatoid arthritis, inflammatory bowel diseases like Crohn's Diosease or ulcerative colitis, lupus, vasculitis, severe burns and chronic infections like tuberculosis.

4. Stress

Sarcopenia is also more common in a number of other health conditions that increase stress on the body. For example, people with chronic liver disease, and up to 20% of people with chronic heart failure, experience sarcopenia. In chronic kidney disease, stress on the body and decreased activity lead to muscle loss and cancer and cancer treatments also place great stress on the body, resulting in sarcopenia.

 

There is some good news though, and that is that aging, per se, does not make sarcopenia inevitable. In fact there is a great deal that we can do to prevent or even reverse it. Men and women can regain some of that lost muscle mass and, importantly, stay strong enough to enjoy youthful activities well into their winter years, experts say. You are never too old to take action. Read more about how  here.

The bad news? You actually do have to take action.

2024 Wellness Resoutions You Can Keep

 

The Holidays are behind us and now we face the reality that those well intentioned resolutions we made in the excitement of a new unspoiled year ahead of us are going to take some real effort and require us to make some actual changes in how we operate. Its only 15% of the way through January and already we are having second thoughts. 

By far, the most common resolution people carry with them into January is to be healthier, typically by "exercising more" and "losing weight". By the end of February about 80% of people will have abandoned the effort. By the end of the year only 8% of them will have succeeded.

As we discussed in a previous post, this is partly due to setting "results goals" rather than "activity goals". A results goal might be "I will lose 30 pounds by the end of March". You actually have no direct control over how many pounds you lose by the end of March. What you do have control over are the actions you take (or don't take) to lose weight. Your chances of losing 30 pounds are much better if the resolutions you make are to do things that will cause you to lose weight. "I will take the dog for two thirty minute walks every day." Or, "I will make dinner from fresh ingredients two nights a week."

Another reason for such high failure rates is unrealistic expectations. If it took you 10 years to gain 30 pounds, why would you expect to lose it all in three months? If you really love pizza, do you really thing giving it up entirely is going to work for you for very long?

And finally, we all know that people love change - as long as nothing is any different. If you simply set a results goal and then fail to make any changes to your habits and routines than it isn't likely that you will be successful. 

If you are among the "be healthier" crowd, here are nine ways to get healthier without trying very hard from NPR. You don't have to do them all. In fact, don't even try. Choose three that seem especially appealing to you and do them, starting right now. You most likely won't lose 30 pounds by March. But you will see some results. Small ones maybe but real ones. 

That really is the secret. Make some small changes for the better in the way you are living your life. Enjoy the feeling of succeeding. Celebrate it. Then make some more. You will astonish yourself with the progress you will have made by the time your 2025 resolutions are due.

Do You Need Cleanses and Body Detox Regimens?

 

“Detoxes” or “cleanses” refer to various diets, programs, regimens, or therapies that claim to remove toxins from the body, aid in weight loss, or promote health. Globally, the market for detoxing products was estimated to be $48.22 billion in 2020. It is is projected to grow at a compound annual growth rate of 7.65% reaching $75.06 billion by 2026. That's a lot of green smoothies and a lot of unproven marketing claims.

Just by living their lives people are exposed to chemicals, pollutants, heavy metals in food, and other environmental toxins every day. So a concern with getting these things out of our bodies is certainly reasonable. However, there's little actual research that proves prepackaged detox regimes, products, and programs are effective or even necessary. 

Detox and cleansing regimens fall into four broad categories:

• Fasting, such as calorie restriction or intermittent fasting.
  
• Restrictive diets that include only eating certain foods or eliminating certain foods or drinks.
• Liquid-only diets involve drinking only juices or similar beverages.
• Dietary supplements like additional minerals, vitamins, diuretics, laxatives, herbs, or other products are sometimes used to detox the body.

There is very little long-term research on the safety of cleanse diets and kits. Some studies suggest possible adverse effects of cleanses or detox diets. In addition, there are several factors that the National Institute of Health suggests you take into account before you begin a detox program, including:

• Some juices may not be pasteurized to kill harmful bacteria and other pathogens. This can cause serious illness, especially in children, older adults, or those with a weakened immune system.
• Some juices contain foods naturally high in oxalate, a naturally occurring substance. Drinking large amounts of high-oxalate juice can increase the risk of kidney problems.
• Very low-calorie or restrictive diets may result in short-term weight loss but do not provide all the nutrition you need and are usually not sustainable.
  
• Colon cleansing products may have side effects that are potentially serious and dangerous for people with a history of gastrointestinal diseases, colon surgery, hemorrhoids, kidney disease, or heart disease.
• Some detox programs, including laxatives, can cause severe diarrhea, leading to dehydration and electrolyte imbalance.

No regulatory body reviews the efficacy and safety of detox and cleansing products. Some have even been found to contain illegal and potentially harmful ingredients. As can be problematic with the dietary supplement and weight loss industries more broadly, detox programs or supplements can be unsafe and promote false claims.

None of this is to suggest that removing toxic substances from the body is a bad, or unnecessary, idea. Of course it is. In fact, you body has evolved ways of doing so that naturally flush toxins from the body. Various organs and organ systems help the body eliminate toxins from chemicals you may be exposed to at work, at home, through personal care products, or your food. These include your liver, kidneys, digestive system, lungs and even your skin. These serve as your body's natural detoxification systems and help expel or convert toxins into harmless compounds.

You can support your body's detoxification process and limit exposure to potentially harmful toxins in your everyday life. Eating a diet rich in fruits and vegetables, antioxidants, and fiber and limiting or eliminating smoking, vaping, alcohol, or drug use will help a lot. So will washing your fresh produce thoroughly and using green cleaning products like vinegar in your home.

It is understandable to want quick results when it comes to our health but not usually very realistic. If you really want to use a detox program it is unlikely to do you any harm. Just don't expect it to really do much good either. As is so often the case in matters of our long-term health and wellness, diet an lifestyle choices are more likely to produce the results you want.

Why Does Everything Taste Meh?

 

By now we are all familiar with the way inflation makes us poorer day by day. Anyone who has been to the grocery store lately is familiar with how much everything costs now compared to a year or two ago.

You may already have become wise to "shrinkflation" too. That is the sneaky way companies raise prices on you by holding the cost the same but putting less and less product in the package. Everything from breakfast cereal to toilet paper has gotten smaller while prices have stayed the same or even gone up. Or how my chocolate chip cookies suddenly went from 16 per box to 12.

But have you heard of the latest trick that companies, especially food producers, have been playing to get more of your money for less of what you buy with it?

It is called "skimpflation" and it is the substitution of cheaper of fewer ingredients for more expensive ones. An example is Conagra reducing the fat content in its Wish-Bone House Italian Dressing by 10%, replacing it with additional salt and... water. Yes, water. The most egregious example seen recently was in October 2022, when Conagra reduced the amount of fat in its dairy-free Smart Balance spread from 64% to 39%, which meant water became the most plentiful ingredient in the product.

One reason that companies are turning to skimpflation to deceive you is that they aren’t under any obligation to announce when they make changes to their recipes (as long as all the ingredients are accurately reflected on the label). 

And skimpflation in not new.  In 2013, Breyers was forced to legally change the labeling of its products from ice cream to “frozen dairy dessert.” Why? Because the company had reduced the amount of dairy fat in its product to the point that it didn’t legally qualify as ice cream anymore.

Don't think that skimpflation is limited to things you find at the grocery store, it is everywhere. Any time that a company lowers the quality of its product or service to same money (aka, make a greater profit) that is skimpflation. Some other examples include:

• Airlines reducing the number of air stewards and therefore giving consumers less service during a long haul flight.
• Phone companies reducing the number of workers in call centers so that when you try to call with a technical problem, it  takes longer to get through - if you get through at all. (Your call is important to us! Please hit one if you would rather have a callback from us that you will never receive or just stay on the line for 45 minutes till we get to you. After all, your call is important to us!)
  
• Hotels not providing waiter service, but relying on customers to do self-checkouts for breakfast and meals. Or asking you to help "save the planet" by not having your sheets changed.
  
• Disney World and Disneyland have eliminated their tram services to and from parking lots, forcing visitors to walk nearly a mile to enter and exit the parks.

We should note that not all companies are motivated by greed or disingenuousness. Many businesses, especially small businesses, are struggling to cope with the surging costs of regular, old fashioned inflation. They're having a hard time finding workers at the wages they used to pay. And some businesses may be unable to afford paying what it takes to recruit workers in the current environment. Nonetheless, whether it's because they can't afford to, they don't want to or they're being greedy, instead of enticing workers with higher wages, many businesses are cutting back on the quality of their services in order to stay profitable.

The bottom line is that real inflation, the kind you see on your credit card statements, is much higher than the figure reported by the government suggests.

FDA/FTC Crack Down on "Zombie Science"

 

When you walk down the supplement aisle in your supermarket or pharmacy, past the sea of bottles competing for your attention, how can you find one that works better than a sugar pill? You might assume it's reasonable to start with products labeled with words like "clinically proven" or "scientifically shown." But before handing over your money you need to look a little deeper.

According to Dr. Jeff Chen, MD, co-founder and CEO of Radicle Science, which runs some of history's largest crowdsourced clinical trials on supplements, "A majority of so-called 'clinical trials' on supplements are not rigorous and can't determine if the product is better than placebo." In other words, the claims are marketing, not science. But now, these supplement and vitamin companies will have to come up with more proof if they want to make claims on their packaging.

Misleading and unsupported claims had gotten so bad that the Federal Trade Commission, in an effort to protect consumers, released new guidance in December 2022 on the ways health claims by supplement manufacturers are regulated. All manufacturers of "health-related products" must now support their efficacy claims with gold-standard double-blind, randomized, placebo-controlled clinical trials. In April 2022, the FTC sent an unprecedented 760 notices to companies (mostly supplement companies), warning them to "avoid deceiving consumers with advertisements that make product claims that cannot be backed up."

Personally, as someone who does sell nutrition, wellness and healthy aging products, I welcome this new aggressiveness from the regulatory agencies, which is long overdue. In the meanwhile, until companies adjust to the new, more stringent reality (or the bribe congress to overturn the FTC) here are some things you can do right now to avoid being a victim of misinformation or outright fraud.

Action vs Outcomes

 

If you Google this topic you will get a long list of hits, and just about all of them will insist that you should set "results-based" goals for yourself rather than goals based on your activity. Activity, they will say, does not equal results. It seems to me that what they are suggesting is that simply being "busy" will not achieve the results you want. This is hard to argue with, since doing the wrong things will rarely produce the right results.

But I want to suggest that they are 100% incorrect in suggesting that activity does not equal results. In fact, other than pure, dumb luck, nothing else does. Whatever it is you want to accomplish, being it to lose some weight and keep it off, to start a new relationship, to add new customers to your business or anything else, those outcomes are not under your control. What you DO control are whether or not you actually perform the activities that will (eventually) lead you to the result you want.

Suppose, for example, you want to lose 20 pounds by St Patrick's day and then keep it off. Setting THAT as your goal is not going to get you there. What actions will you take that will inevitably produce the desired result if you keep doing them? Will you find and use an App to track your calorie deficit? Will you go for a 30 minute walk every day? Will you start making your own meals 4 days a week instead of eating out? If you really do those things, you will likely achieve your goal. Maybe not by March 17th, but eventually you will. Simply saying you will lose weight based on good intentions most likely won't make you successful.

Of course there are a couple of caveats here.

You have to set the right activity goals based on what you want to achieve, and then you have to actually accomplish them. Either way the activities needed to reach your goal are under your control. They produce the desired result.

I'm not saying that activity goals are easy. Around 75% of Americans make New Year's Resolutions every year, usually results that they want to achieve. By far most of these relate in some way to health and fitness. Despite the fact that over half of those who did set goals claimed to be "very confident" that they would have success, less than 10% of them actually succeed. 

Clearly there is more to it than simply renewing your annual pledge to "go to the gym more often".

Tony Robbins preaches that to have real success you must alter your habits and routines to include the activities that you want to carry out, otherwise your existing routines will simply prevent you from doing so. This can be hard work.

But difficult or not, setting realistic activity goals that will, if carried on long enough, make your desired results inevitable is the way to go. Despite what you may hear from Mr Google.

What is your BMI? Should you even care?

 

Although it was not called Body Mass Index (BMI) at the time, the concept has been in use since about 1850. The name BMI was coined in 1970 and is a number derived from an individuals height and weight. A convenient and simple way of classifying a person from underweight to obese, it has come under fire recently for its shortcomings as a predictor of a person's present and future health. BMI provides a simple (many now say simplistic) numeric measure of a person's thickness or thinness, allowing health professionals to discuss weight problems more objectively with their patients. BMI was designed to be used as a simple means of classifying average sedentary (physically inactive) populations, with an average body composition (muscle to fat ratio).

A study published by The Lancet in 2009 involving 900,000 adults showed that overweight and underweight people both had a mortality rate higher than normal weight people as defined by BMI. But in an analysis of 40 studies involving 250,000 people, patients with coronary artery disease with normal BMIs were at higher risk of death from cardiovascular disease than people whose BMIs put them in the overweight range (BMI 25–29.9). One study found that BMI had a good general correlation with body fat percentage, and noted that obesity has overtaken smoking as the world's number one cause of death. But it also notes that in the study 50% of men and 62% of women were obese according to body fat defined obesity, while only 21% of men and 31% of women were obese according to BMI, meaning that BMI was found to underestimate the number of obese subjects. A 2010 study that followed 11,000 subjects for up to eight years concluded that BMI is not a good measure for the risk of heart attack, stroke or death. A better measure was found to be the waist-to-height ratio. A 2011 study that followed 60,000 participants for up to 13 years found that waist-to-hip ratio was a better predictor of heart disease mortality.

Recently both the medical establishment and statistical community have highlighted the limitations of BMI. The BMI was always designed as a metric for European men. For women, and people of non-European origin, the scale is often biased. As noted by sociologist Sabrina Strings, the BMI is largely inaccurate for black people especially, disproportionately labeling them as overweight even for healthy individuals.

It is very simple to compute your BMI if you know your height and weight. There are easy to use BMI Calculators. But should you bother?

It is worth knowing your BMI as it gives you a quick "drive by" snapshot of your weight/health status. But you should not rely on it overmuch, or be too concerned if you are in an other than "normal" category. It is a good starting point for a conversation with your primary healthcare provider but not a very accurate forecaster of your health.

To read more about BMI, its limitations, and the alternatives you might consider, click here.