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Vanishing Flesh

This is my upcoming contribution to the NWTC newsletter for October:

Don’t you just hate it when someone tells you “I told you so,” knowing full well that you know that they know that they were right. Well, when I wrote The Relativity Diet over three years ago, I placed a great deal of emphasis on resistance training, as a component to weight-loss and a healthy lifestyle; and now that particular issue has become all the rage in the medical community. There is effort afoot to categorize the age-related loss of muscle as a disease. A disease to be known by the name of Sarcopenia, which is a word derived from the Greek words for “vanishing flesh.”

It will become the new Osteoporosis. Everybody knows what osteoporosis is. I can’t remember the last time I reviewed the medication record for an elderly woman and didn’t see some sort of a calcium supplementation, which is a good thing because osteoporosis is bad, and much attention is paid towards it. Most women should have a bone density test at some point; it’s almost as common as a mammogram now. So we agree, having a nice strong skeleton, with thick bones stronger than limbs of oak, is good; but, what good is that nice skeleton you have there if you don’t have good muscles to move it around? People don’t say, my, my… look at that nice skeleton as you collapse breathlessly in your reclining beach chair on a hot summer day at Murphy Park, after a hard mile swim in the bay, your muscles swollen from their effort-induced tumescence; no, they say something more like, wow, look at that six-pack…she must work out.

Vanishing flesh… sounds absolutely ghastly, an appropriate topic for the scary month of Halloween, and if you’re beyond thirty and don’t participate in resistance training, you are already vanishing, maybe not your fat mass, but at least your muscle is. Beyond thirty, the loss of muscle mass is 10% per decade; from 60-70 it accelerates to 15% per decade; and beyond that it’s approximately 30% per decade. Scared yet? Are there goose bumps on your arms? I hope so, because this is important. It has everything to do with countering the deleterious effects of aging and loss of functionality, and quality of life.

I have written that resistance training is not as intuitive as aerobic training. When most people think of exercise, the first thing that comes to mind is walking or jogging or bike riding; all of which are good—for cardiovascular health; but abysmal for maintaining muscle mass. Although sarcopenia is multi-factorial, having causes other than simply lack of resistance training, resistance training is the most important, and identifying and treating any of the other factors is useless without exercise.

So, what are the other factors? There are dietary considerations of course, the most important being an adequate protein intake, which might very well be deficient in older adults. Another factor is the age-related decline in certain hormones such as; Growth Hormone and testosterone. Did you know women need testosterone too? Although they need less, it is as essential to their health as it is for men. There may be a role for nutritional supplements such as; creatine, vit. D, whey protein, acetyl-L-carnitine, glutamine, and potassium bicarbonate.

Now, please don’t rush out and by bottles of all this stuff, you know how I feel about that, if you’ve read my book. The great majority of folks who eat a healthy, balanced diet, as I describe in The Relativity Diet, would be unlike to have any deficiencies, other than hormonal, perhaps. Your doctor can run the appropriate blood tests necessary to diagnose a hormonal deficiency, and if present, Hormonal Replacement Therapy (HRT) can be given consideration.

You and your doctor have been worrying about your skeleton for years, now it’s time to start worrying about your muscles. Although it is easier to prevent sarcopenia that it is to treat it, it is treatable, and it is never too late to start. So, it’s time to get off the couch, pick up a weight or resistance band, and get busy living…and don’t say I didn’t tell you so. 

Question about cardiovascular adaptation to exercise

A question from a very intelligent and motivated reader:

“…we started using the advice in your book as far as meals and exercising.  The first 4 or 5 days I couldn’t do more than 2 mph on the treadmill (30 min. miles).  After the 6th day I could do 3mph (20 min. miles) without a problem.  Exactly what happens to the cardio-vascular system to cause this?  Granted, I’m not quite ready for the Door County Triathlon, but I’m heading in the right direction. Weight 10 days ago, [censored] {6 pound loss}; height is still the same.”

Source material for the below is Exercise Physiology, Sixth Edition; McArdle Katch, and Katch.

It is absolutely amazing, the capacities our bodies have to adapt. One of the quickest adaptations is in the metabolic machinery in the cell—within 5-10 days of training there is an increased mitochondrial capacity to generate ATP aerobically (ATP is the energy currency of our bodies–it is to the human body as gas is to a car). The enzyme changes result from increases in total mitochondria, which are those little things in the cellular cytoplasm that look like little ovals with a “maze” inside of them. With this change, a person has an increased aerobic capacity within a number of days of starting a training program.

Another fairly immediate change is in the plasma volume (the fluid that comprises the vascular volume within which are all the red blood cells, white blood cells, and lots of other stuff)—after 3-6 aerobic sessions there is a 12-20% increase in the plasma volume; in fact, there is a measurable change within 24 hours of the first exercise episode. This effect enhances the stroke volume and oxygen transport during exercise. Unfortunately, the expanded plasma volume returns to normal levels after one week of no exercise.

The most significant adaptation in cardiovascular function with aerobic training is an increase in the cardiac output, which is the amount of blood that the heart can pump throughout your body, measured in liters/minute (Max Cardiac Output for Sedentary Adult is 20.0 L/min: for Athlete it is 30.4 L/min). Aerobic training also increases the amount of oxygen that can be extracted from the circulating blood. This is because there is an improved cardiac output distribution to the active muscles, and those muscles becoming better at extracting and processing the available oxygen.

There are many other benefits, both immediate and long term. For instance, after two years there is nearly a 50% increase in the capillaries (tiny blood vessels) in the muscles, which allows for more oxygen delivery to the tissues (20% after 2 mo.). In my book I discuss at length the underappreciated benefits of exercise; increase in metabolic rate, anti-depressant effect, and anti-inflammatory effect.

You would think that if more people knew of this, there’d be a lot more exercising going on. The truth is, most of our health ills today are largely self inflicted; smoking, drinking excessively, and obesity. If folks would not smoke, drink in moderation, maintain an appropriate caloric intake and exercise regularly, there would be much less of a need for doctors.

Ssshhh…don’t tell anybody–I still have to put beer in my cooler.