What Are You Doing to Prevent Sarcopenia? Use It or Lose It!

Have you ever had major surgery? If you have, you will know that once the anesthesia has worn off, the first thing the doctors and nurses require of you is to "get out of bed" and move! But, "wait a minute," you cry, "I just had major surgery--let me rest." Thankfully, however, for you, that request is denied. Otherwise, severe complications in all body systems can occur, as well as death.

Prolonged bedrest effects all body systems, but it especially effects the cardiorespiratory system (heart and lungs are major muscles) and the musculoskeletal system (such as decreased muscle mass and strength, and bone loss). The older an individual is, the more pronounced and serious the consequences.

• Did you know that for every two days of bedrest, the heart rate increases one beat?

• Did you know that in healthy men, the rate of bone loss increases 50 times with bed rest? (Although bone mineral is gradually restored after bed rest, the rate of restoration is 4 times slower than the rate of loss.)

• Did you know that for every week of complete bedrest, muscle strength declines by 10-15%?

• Did you know that within 8 hours of immobilization of a muscle in the shortened position, muscle fibers begin to shorten, limiting full range of motion? (Ever have a hard time getting those legs to move again, after sitting in a movie theatre for just two hours?)

So what does this have to do with "Sarcopenia," and WHAT is Sarcopenia?

What is Sarcopenia?

Sarcopenia (pronounced sarko-peen-ya) is the "age-related" loss of muscle. The word comes from the Greek, for "flesh reduction." It can have the same serious musculoskeletal consequences caused from bedrest. Just like osteoporosis and arthritis, "sarcopenia is a serious degenerative condition that increases ones risks for falls and makes one more vulnerable to injury."

Less obvious consequences are metabolic effects that result when muscle-the body's most metabolically active tissue---diminishes. Metabolism is altered when there is less muscle, and many other consequences result, such as obesity, impaired glucose tolerance, and changes in the ability to regulate body temperature. In addition, since muscular contractions help keep bones strong, muscle loss can also weaken bones.

Sarcopenia generally starts to set in around age 45, when muscle mass begins to decline at a rate of about 1 percent per year. As muscle mass begins to decline, so does muscle strength. Studies have revealed that muscle strength declines by approximately 15 percent per decade in the sixties and seventies and about 30 percent thereafter. As strength goes, so does physical functioning---the ability to do chores, take walks, climb stairs, or the accomplishment of other activities. This loss of strength can create a vicious cycle. Since it takes a great deal of physical effort and discomfort to perform daily tasks, one naturally avoids it, which creates even more weakness. Even some activity, no matter how limited, can help maintain muscle mass.

Sarcopenia occurs in people of all fitness levels, however physically inactive adults will see a faster and greater loss of muscle mass than physically active adults. Women, however, face a greater risk than men, because women have less muscle than men, and those who have less muscle to begin with, generally have a greater loss.

Nutrition can also be a factor in the development of sarcopenia if one is not consuming adequate energy intake. Many older individuals may not be consuming enough calories and/or protein, thereby depleting muscle protein to sustain energy requirement.

Can Sarcopenia Be Treated and/or Prevented?

Along with proper nutrition, a powerful intervention in the prevention and treatment of sarcopenia is resistance training (weight-lifting or strength training). Resistance training works to build muscle by forcing the body to heal the damage to muscle cells that occur with use. When the intensity is high enough, microscopic tears occur in the muscle, which then rebuild protein and make the muscle stronger.

Although it has been known for decades that resistance training increases muscle mass and strength in young adults, many thought that muscle loss in older people was inevitable. However, it is now known that past studies done on older people using weights, did not show a positive response because the studies were not using the correct exercise intensity. Instead, subjects were lifting weights that were too light.

More current studies, using higher intensity workouts have shown that "strength could be doubled in only 12 weeks of training, and that even frail nursing-home residents in their 90's could build muscle and strength."

But I Walk and Swim... Isn't that Enough to Prevent Sarcopenia?

When most people start a fitness program, they do an aerobic activity, such as walking or swimming, in order to strengthen their heart muscle. But, before one can walk, they must first be able to get out of a chair and maintain an erect posture and balance while walking, and that requires muscle power.

The American College of Sports Medicine, in its guidelines on exercise and physical activity for older adults, says that aerobic conditioning should follow strength and balance training, which is, unfortunately, the opposite of what is usually done. Aerobic exercise, while it strengthens the heart and lungs, is not sufficient by itself to prevent sarcopenia.

It's easy to understand why older adults participate in aerobic activity for exercise rather than resistance training. Walking doesn't require a lot of planning to incorporate it into the day, and swimming or biking are familiar activities. Resistance training, however, is less familiar and it requires one to set aside extra time. However, as little as 40 minutes a session, or an hour and a half a week, is enough to see significant results.

Are there other benefits of Resistance Training?

In addition to building muscle, one also builds vigor and self-esteem, which ultimately leads to one staying active and doing things they enjoy. Preserving muscle mass also impacts the ability to withstand disease. The body burns protein faster than usual, when sick, which then causes protein components to be pulled from the muscle to be delivered to the immune system, to help fight the illness. Sarcopenia reduces the amount of protein available to fight disease.

"If you don't use it, you'll lose it." That saying has never been more true than for the use of our "muscles." When we lose our ability to use our muscles, we lose independence, and quality of life diminishes. Let's choose to not take for granted our ability to move around, and incorporate resistance training, into our exercise routine. Length of life is insignificant without quality of life!

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What to Expect From Partial Knee Replacement Surgery

What are the advantages of a partial knee replacement?

There are many research studies available that support how a modern partial knee replacement performs superbly for a vast majority of patients. There are many advantages to having a partial replacement versus a total replacement of the knee. These include a quicker recovery time, less blood loss during the procedure, and less pain after surgery. Many report that a partial knee replacement feels more "natural" than a total replacement and the range of motion is often reported as "better".
 
Who is a candidate for a partial knee replacement?

The orthopedic specialist may recommend this procedure if you have severe osteoarthritis of the knee and have tried and failed with nonsurgical treatment measures. A partial knee replacement is only considered if your knee problems affect your quality of life and interfere with your daily routine. Also, your arthritis should be limited to one compartment of the knee, not the entire knee as seen with inflammatory arthritis. Those patients with significant knee stiffness or ligament damage are not ideal candidates.

What should I expect before the surgery?

Your orthopedic specialist, working closely with your family doctor, will determine which type of procedure you need. He may test your range of motion, the ligament quality, and assess your activity status. Patients who have pain located entirely on either the inside portion or outside portion of the knee are good candidates for a partial knee replacement. Those who have pain throughout the entire knee or in the front aspect are usually better qualified for a total knee replacement. You may have additional imaging tests on your knee to determine which surgery suits you best.

Before your operation, a member of the anesthesia team will evaluate you. Anesthesia will either be spinal (you are awake but numb from the waist down) or general (you are completely asleep). The choice will depend on your surgeon's preference and your health needs.

What happens during the surgery?

A partial knee replacement generally lasts 1 or 2 hours. The orthopedic specialist makes an incision at the front of your knee in order to explore the three compartments of the joint space. He uses a special saw to remove the damaged cartilage and knee components and caps the ends of the femur (thighbone) and tibia (lower leg bone) with metal coverings. These metal pieces are connected to the bone with a special type of cement. To create a smooth gliding surface, the doctor places a plastic insert between these two metal components.

What happens after surgery?

After your procedure, you will be taken to a recovery room and closely monitored. Expect to have an IV for around 24 hours to receive medicines for pain control and antibiotics. Once you are awake, you will notice a bandage on your knee and a small drain that collects fluid from the joint space. Some patients may be candidates to have this procedure on an outpatient basis, but most will need to be admitted to the hospital. You can expect to go home 1 to 3 days following a partial knee replacement.

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Getting Heart-Strong With Stats, Warning Signs, and Health Tips, Too

In case you missed it, red was the color of choice when choosing what to wear last Friday, as the first of February marked the tenth anniversary of the American Heart Association's National Wear Red Day. Its purpose: to help raise awareness of heart disease in women, while at the same time, launching American Heart Month.

Be aware, too, that The Million Hearts™ national initiative sponsored by the American Heart Association and others is also making headlines right now. Introduced by the Department of Health and Human Services in September, 2011, its aim is to prevent 1 million heart attacks and strokes in the U.S. over a 5-year period. To that end, this month Walgreens has engaged "its 26,000 health care providers to offer free blood pressure testing in consultation with a Walgreens pharmacist."

Is the need great? You bet. Just take a look at these unsettling facts of life about cardiovascular disease, the umbrella term for all heart and blood vessel diseases, including heart attack, stroke, high blood pressure, coronary artery disease, and aortic aneurism:

1. Heart disease is the leading cause of death for both men and women.
2. About 600,000 people die of heart disease in the U.S. every year-or one in four.
3. Every year, some 935,000 Americans have a heart attack; about 610,000 first-timers.
4. Coronary heart disease is the most common type of heart disease, killing more than 385,000 people every year and costing the U.S. $108.9 billion annually in services, medications, and lost productivity.

Meanwhile, recognizing the warning signs is key to survival; experience any of them and call 911 immediately:

• Chest pain or discomfort
• Upper body pain or discomfort in arms, back, neck, jaw, or upper stomach.
• Shortness of breath.
• Nausea, lightheadedness, or cold sweats.

Know, too, that while the most common sign is chest pain or discomfort, women are somewhat likelier to feel short of breath, nauseous, and/or experience jaw pain.

Meanwhile, be advised that lifestyle is a determining factor, so be forewarned if you don't exercise, enjoy a high fat, sodium, and/or sugary diet, smoke, are overweight/obese, and/or have diabetes. To be in the know, head to your primary care doctor for a physical and make it an annual event. These are the numbers you'll want to hear:

• A blood pressure reading less than 120/80
• A total cholesterol that's less than 200 mg/dl
• An LDL ("bad" cholesterol) that's less than 100 mg/dl
• An HDL ("good"cholesterol) that's more than 50 mg/dl for women and 40 mg/dl or higher for men
• Triglycerides that are less than 150 mg/dl
• Blood glucose levels that are less than 100 mg/dl

To get you there, take time to de-stress every day, allowing yourself some "chill" time to meditate, garden, walk, and so on. You get the idea. And then:

• If you smoke, promise to stop. There's lots of quitting help out there, everything from gums and lozenges to patches and hypnosis. Online assistance is right at your fingertips, too. Need motivation? Quitting before 40 reduces the risk of death by about 90% finds an American Cancer Society study. Plus, smokers die, on average, about 10 years earlier than non-smokers.
• Get moving, aiming for at least 30 minutes a day of low to moderate intensity activity. The upside: lower blood pressure and triglyceride numbers, as well as higher HDL levels. Do it all in one outing or break it up into 10- or 15-minute workouts that can include walking, jogging, dancing, gardening, even playing outside with the kids. Then add just two weight training sessions a week-about 20 minutes or so each-and you're on your way.
• Start every day with a heart-healthy breakfast, as in oatmeal, a smoothie made, for example, with frozen berries, a banana, yogurt, and skim milk, a veggie-filled egg-white omelet, or even peanut butter on whole wheat toast sprinkled with ground flaxseed. Tempted to skip it and go right for the coffee? Keep in mind that eating breakfast cancels out the need for a mid-morning pick-me-up or heavy lunch, thus helping prevent weight gain.
• Eat a heart-healthy lunch and dinner, too, ones that are rich in fruits, veggies, fiber, whole grains, low-fat, calcium-rich dairy, and lean protein. Aim for two servings of fish each week, too. Not sure how much produce you should be consuming every day? The CDC has the answer for you.
• Take an inventory of what's on your pantry shelves when it comes to snacks, soups, salad dressings, etc. and consider tossing a few of them. As you read the nutrition labels, keep in mind that you want to limit your daily sodium intake to less than 1,500 mg and less than 150 mg of cholesterol. Then opt for better-for you alternatives like baked chips, nutrition-dense granola bars, heart-healthy soups and frozen dinners, and so on. While you're at it, put away the salt shaker and replace sugary drinks with plain water or sparkling water with a spritz or two of lemon juice.
• Be heart-savvy when eating out, too. Need some help as you peruse the menus of your favorite restaurant chains? There's actually an app for that, and it's called "Restaurant Nutrition."

In the meantime, need an easy, heart-healthy recipe to get you started? 

You will need:

• 1 cup halved walnuts or pecan (unless allergic)
• 1 cup dried cranberries or cherries
• 1/2 cup crumbled feta or blue cheese (unless allergic)
• 2 cored, thinly sliced apples or pears
• 1 bag of pre-washed spinach (or salad greens)
• 1/4 cup of balsamic vinegar
• 3/4 cup of virgin olive oil

Steps to Take:

1. Place spinach or greens in large salad bowl.
2. Add nuts, dried cranberries/cherries, sliced fruit & cheese.
3. Toss.
4. Add the olive oil and balsamic vinegar and toss well.
5. Season with salt and pepper to taste.

As they say in France, à votre santé.

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The Curse of the Mummy: Heart Disease

A recent Lancet study titled "Atherosclerosis across 4000 years of human history: the Horus study of four ancient populations" purports to show that our ancient ancestors suffered from arteriosclerosis or "hardening of the arteries" just as we do. They concluded: "The presence of atherosclerosis in premodern human beings suggests that the disease is an inherent component of human ageing and not characteristic of any specific diet or lifestyle." In other words, go ahead and eat another Big Mac and wash it down with a supersized Coke because your arteries will eventually clog up no matter what you do. Thank you judge Tingling for cancelling Mayor Bloomberg's ridiculous super-sized soda ban, although looking at your picture I suspect that you may want to back off on super-sizing of anything, especially yourself.

Unfortunately this study largely ignores the actual disease process leading to heart attacks and strokes. This study documented calcium deposits in the arteries of mummies from four different variably ancient cultures: Egyptians, Peruvians, ancestral Puebloans and Unangans from the Aleutian Islands. Although it is likely true that as humans grow older they tend to accumulate some calcium deposits in their arteries, by itself this process won't likely lead to heart attacks and strokes. To turn arteriosclerosis into a deadly killer, you also need to add some inflammation.

It's All About the Details

To understand how this process works, we first need to review a little anatomy. Arteries are lined by endothelial cells that form a tight junction to keep blood elements from leaking into the surrounding tissue. These cells are coated with a hair-like protective surface called the glycocalyx. This layer keeps the flowing blood from coming into contact with the endothelial cells. It more or less acts like Teflon, allowing the blood to flow smoothly. Fats are transported in the blood stream as combinations of fat and protein called lipoproteins. Low density lipoproteins (LDL) carry cholesterol and fatty acids into cells and high density lipoproteins (HDL) carry cholesterol and fatty acids out of cells.

LDL cholesterol comes in two forms-small, dense LDL particles and fluffy, large LDL particles. When you consume a diet high in saturated fat, LDL particles migrate to the intima, the layer beneath the endothelium. Small, dense LDL particles tend to hang around longer and become oxidized, leading to inflammation. Oxidized LDL particles strip away the protective glycocalyx layer and damage the underlying endothelium, leading to endothelial dysfunction. White blood cells are attracted by this inflammation and migrate to the intima where they gobble up the oxidized LDL cholesterol, creating fat-ladened foam cells. This inflammatory mess can eventually lead to dangerous blood clots, so your body responds by walling it off with a layer of calcium and a fibrous cap. With a solid fibrous cap, blood continues to flow freely and everything is good-that is until you add more inflammation to the mix.

Harden My Arteries but Please Don't Give Me Inflammation

Many components of our modern diet can feed this inflammatory process, including trans fatty acids, excessive omega 6 fatty acids relative to omega 3 fatty acids, excessive fructose mainly from sugar and HFCS, and high glycemic carbohydrates mainly form grains. These dietary elements lead to high glucose levels, high insulin levels, high uric acid levels and systemic inflammation. Grains, legumes and dairy products can lead to a leaky gut, further feeding this inflammation. Consuming our Standard American Diet (SAD) is like throwing gas on a fire when it comes to feeding inflammation. All of this inflammation can eventually cause the fibrous cap to rupture, where all the pro-inflammatory foam cells spill into the circulation. This leads to a blood clot, your bodies' last brave attempt to seal off the damage. If the blood clot is large enough, it blocks the artery leading to a heart attack or stroke.

Although arteriosclerosis (hardening of the arteries) may be a normal part of human aging, heart attacks and strokes clearly are not. When the authors of this study examined the mummies with CT scans, they were documenting calcium deposits in their arteries. They could only document arteriosclerosis and as the discussion above describes, hardening of the arteries will never kill you without throwing in a lot of inflammation leading to rupture of the plaques. We really have no idea whether these mummies were prone to such events and this study is not helpful in this regard.

Did Mummy Ever Have to Dial 911?

It is possible that they did sometimes have heart attacks and strokes, because we know that all of these groups consumed some food items found in our modern diet. Three of the groups were already heavily into agriculture by growing and consuming grains. The Unangan's from the Aleutian Islands were presented as a group of hunter-gatherers, yet the mummies from this group died around 1900. Even though their traditional lifestyle involved hunting sea animals, fishing and collecting shellfish, by this time they had already been trading with Russians and other groups for several centuries. They traded animal pelts for subsistence items like food and clothing. Clearly we cannot classify this group as strictly hunter-gatherer.

This study made headlines around the world, implying that our ancient ancestors suffered from the same vascular problems that we do. This is simply poor science. In order to suffer from increased morbidity and mortality, you need to add inflammation to arteriosclerosis and this study doesn't discuss the issue of inflammation. Studying mummies can be exotic and fun, but let's not forget to include a little science and common sense in the discussion.

Headlines, Smeadlines

News articles about this study often concluded that because the mummies had arteriosclerosis, our modern diet likely is not contributing much to this process. In other words, go ahead and eat junk food because your arteries will harden no matter what you eat. Although this may be true, having "hardened" arteries or arteriosclerosis will never by itself kill you. Throw a pro-inflammatory modern diet into the mix and people start falling like flies from heart attacks, strokes and other modern inflammatory diseases.

Mummy, I need help!

So what's a confused, modern non-mummy supposed to do? To keep calcium from building up in your arteries, taking vitamin K2 as a supplement might be helpful. This form of vitamin K moves calcium out of your arteries and into your bones where it belongs. I recommend taking at least 1,000 mcg of vitamin K2 daily. More importantly, you should do everything possible to eat a diet that doesn't promote inflammation. A good starting point is to eliminate sugar and HFCS, two inflammatory bombshells in our modern diet. I also recommend keeping your fructose intake below 25 grams per day as Richard Johnson suggests in his books "The Sugar Fix" and "The Fat Switch". I also recommend reducing your intake of omega 6 fatty acids from vegetable oils and increasing your intake of omega 3 fatty acids. You can also measure your omega 3 index to balance your diet so your ratio of omega 6 to omega 3 fatty acids is between 1 and 3. For more information about fatty acids, I recommend reading "Toxic Fat" by Barry Sears or "The Omega Diet" by Artemis Simopolos. To learn more about the adverse effects of high glycemic carbohydrates, read "Good Calories, Bad Calories" and "Why We Get Fat" by Gary Taubes. Gary really understands the woes of carboholics.

I'm Not Your Mummy-If You Want to be Healthy, You Need to Take the Bull by the Horns

To keep damaging inflammation out of your body, you need to become self-educated and these books are a good place to start. Most physicians and dieticians still follow the government's nutritional recommendations like the disastrous Food Pyramid recently replaced by the incomprehensible Food Plate. These dietary recommendations are highly influenced by our modern food and agricultural industries, the very folks who have been peddling a pro-inflammatory diet for decades. If you are already suffering from inflammatory diseases like obesity, type II diabetes, hypertension, strokes and heart attacks, you might want to consider following a Paleo diet. This type of diet eliminates all pro-inflammatory grains, legumes, dairy and bad fats. For more information about going Paleo, read "The Paleo Answer" by Loren Cordain or "The Paleo Solution" by Robb Wolf. Even if you decide not to go full Paleo, moving in this direction will help to reduce dangerous inflammation in your body.

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How Natural Soaps Help Keep Your Skin Beautiful

Proper skin care is essential to having a great complexion. The first step to having a great complexion is having clean skin. It is important to cleanse your skin daily because every day your skin is faced with dust, dirt, cosmetics, and air pollution. It is important to get rid of impurities every day, but many soaps and cleansers can contain ingredients that can actually damage your skin instead of improve it. There are certain chemicals that can have an adverse effect on a person's skin. It can be difficult to find the right product that will cleanse your skin without damaging it.

The best way to cleanse your skin is by using natural soaps, as these use naturally available ingredients that provide many benefits to the skin and they don't contain harsh chemicals as many other soaps and facial cleansers do. The ingredients used in these type of soaps are from herbs and plants that people have used for thousands of years to care for their skin; the benefits of these ingredients have been time tested and proven to be effective. After you make the switch to natural soaps you will begin to notice how great your skin looks and feels.

Natural soaps do not contain toxins because the natural ingredients used to produce them are grown without pesticides, herbicides, or chemical fertilizers. Such soaps do not contain dyes or synthetic fragrances and are not produced using chemicals. There are some soaps on the market that contain natural ingredients, but the difference is that although some soaps incorporate naturally found ingredients, they do not leave out the harsh ingredients or may use natural ingredients grown with pesticides or other chemicals. Such products are not only made with natural ingredients, but also adhere to a strict code regarding the method of production.

Using natural soaps can improve your skin and will help you to avoid many skin ailments. Many of the problems you encounter with your skin could be from a reaction to the chemicals and toxins found in regular soaps. The first time you use an natural soap, you will notice that your skin feels different; you won't feel any residue as you would with other soaps. After using this type of soap for a couple of weeks, you will see overall improvement and your skin will begin to heal from the previous damage done by other soaps.

Once your skin has healed from the problems caused by other soaps, you need to continue to use the natural soaps to keep it soft and smooth. When you have good skin, it improves your overall appearance. Avoiding chemicals and toxins will keep your skin healthy and looking great. The benefits of the natural ingredients used in the natural herbal soaps will do wonders for your complexion. You will be treating your skin to its very own little health spa when you wash with natural soaps.

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