Older Bolder Life

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Question of the Day

Question of the Week: Masking in the Car

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From a friend and former client in Dallas several days ago –

…I probably just had one of the most bizarre experiences of a very bizarre 2020 so far. I had driven to the upscale grocery we usually shop near home, pulled into a parking space and before I could shut off the engine and grab my mask (hanging clearly exposed from the rear view mirror), a young woman hustled to my passenger side window, banged on it with a fist, and began shouting.

I rolled the window down a couple of inches to see what all the hubbub was about, and she was literally screaming about me not wearing a mask while driving alone in my own vehicle. Gov. Abbot has mandated mask-wearing in public spaces where close contact might be expected, but in no way does that mean my damned car, right?…

The Short and Sweet Answer About Masks in Cars, With a But…

Hell no, you don’t in any way, shape, or form have to wear a mask when traveling alone in your own vehicle. Most authorities on masking extend not wearing a mask acceptability to include when traveling with members of your own household or family in a personal vehicle.

Anecdotally here locally I don’t see as many folks as even two weeks ago wearing masks in a vehicle when traveling alone, but there are some who choose to do so every day I’m out and about.

There are of course some exceptions to the no need for a mask in the car approach, most of which are simply common-sense, which clearly seems to be lacking in the majority these days.

If you’re traveling with or transporting someone who is sick, masking is of course a reasonable idea, as is protecting yourself when traveling with folks from multiple households, like in a carpool, though from what I hear and read, carpools have for the most part gone the way of the dinosaur. Perhaps just as common (or moreso today) is using a ride-share service; while I’ve not seen formal studies of how contaminated ride-share vehicles are with regard to COVID-19, taxis and ride share vehicles are often viral and bacterial incubators and anecdotally I’d personally avoid them like the plague (no pun intended) currently.

There are those I suppose who draw some sort of personal comfort from the idea of wearing their masks full time, including in the car; given the actual problems associated with chronically wearing masks – particularly cloth masks that attract all sorts of viral and bacteria bad-guys when damp – it’s quite easy to build an argument that living in fear and ignoring the science of when not to mask is not a healthy behavior and needs to change.

Arguments could be made that for those who make multiple stops during a day, for example a delivery driver, staying masked makes sense so potentially contaminated hands aren’t manipulating a mask dozens (if not hundreds) of times a day. (Next time you’re out, sit a minute and watch how frequently mask-wearers touch their face and masks – it’s astounding.)

I haven’t wanted to go there on the blog, but of course there’s a pile of solid, historically validated science out there that would blow the “everybody mask all the damn time” mandates out of the water; I haven’t had time to go there in detail here, but perhaps will post a compiled list of some of the more illuminating data out there in the next few days.

Stay safe out there my friends.

A Novel Thought: What If We Taught People (All People) How to Eat for Health?

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In today’s cultural (some might even say political) soup in which we find ourselves swimming today, it seems no matter where one might turn – sports, health and wellness, finance, the food industry, education, and more (the list is potentially endless) – there’s vehement discussion about real and perceived inequalities, systematic failings, prejudice, and pain.

In the context of the work we’re doing here at Older Bolder Fitness and my prior career as a physician, I’m particularly fascinated by the discussions coursing through the medical and health and wellness arena addressing many of these issues. It goes without saying that some deeply rooted, critical issues are finally being pushed to see the light of day, and as well some of the chatter out there is simply outrageously misinformed, misdirected, and most critically – badly misses the mark of truly improving health and wellness (and perhaps even societal integrity) for all in society.

Those genuinely interested in improving health and wellness for all will be hearing much more about today’s hot topics, including health disparities for people of color, social determinants of health, the purported linkage of health and social justice, medical comorbidities and differential outcomes by race, and of late, differential COVID-19 mortality rates by race.

IMHO much of today’s discussion is long on vivid and moving recitations of problems and pathology and damned short on genuine, boots on the ground, practically implementable solutions.

In particular, today’s stodgy, monolithic medical establishment, increasingly corporate owned and managed, has become much more of a “repair shop”, utilizing often amazing technology to address the inevitable consequence of lifestyle diseases, worsened by abysmal nutrition and a dearth of physical activity. This same medical establishment has presided over the greatest decline in health and wellness of the American population in the nation’s history over the past 30-40 years, at the same time watching the cost of care explode at an alarming rate, sadly yet to be addressed by “organized medicine” or politicians of any stripe.

On one hand, you could argue the situation looks grim; on another hand, what if there were solutions at hand that could tangibly produce results within a few short years?

What If We Taught People (All People) How to Eat for Health?

If one were to believe and implement the principle that the simplest solution is most likely the right one (a permutation of Occam’s Razor, and yes I understand that his original constructs were much more complex), what if we taught all people how to nourish their bodies for health and wellness?

[An aside – if you really want to talk about social equity and justice, you’re by definition talking about everyone in said society. I get the current environment that we’re operating in these days, and that the emotional currency of the day is about people of color. That said, societal health and wellness is an all color, all race, all people issue, plain and simple. Arguments to the contrary (when it comes to societal health and wellness) are based on other agendas, agendas that won’t lead to productive solutions.]

The shockingly simple act of reducing/ceasing the consumption of refined carbohydrates, shifting to whole food carbohydrate sources in thoughtful moderation, eating moderate amounts of nourishing proteins, and eliminating the consumption of toxic, refined seed oils and replacing them with easily-proven healthier fats would improve the health (addressing many of the problematic co-morbidities you’re hearing so much about these days) of millions of people.

Add in simple exercise, walking being perhaps the simplest form of exercise available to almost everyone on the planet today, and the improvements would be even more impressive.

The savings in health care dollars expended would in all probability count in the billions in a matter of a few short years (ie, cut the number under treatment for T2DM in half in two years), and the improvement in quality of life would be immeasurable.

Empowering individuals to take charge of their own health and wellness is an incredibly powerful concept, and there’s plenty of room for adjusting best practices to address unique cultural influences. Is it truly possible? Hell yes it is. Is it likely to happen? We’ll see….

Older Bolder Question of the Week: Is It Time to Panic Yet?

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From reader AB in Alabama yesterday –

…we’re both in our 50s, pretty healthy though my husband is a former smoker who suffers from a bit of COPD that’s always set off by seasonal allergies in the spring. We’re dedicated LCMPHF eaters, and are both avid walkers. Reading media reports, and talking to several friends who are full blown panic over the virus situation this weekend, my husband at one point turned to me and asked if it was time to panic yet? Is it? Should our daughter with two young children panic now?…

In a nutshell, no, it’s not time to panic.

Here’s several data points that you’ll find of interest and hopefully comforting, gleaned from CDC, WHO, and other medical reporting this weekend.

Young children (particularly those under 4) appears to have been thus far minimally impacted by the SARS-CoV-2 virus; I can find no record of deaths related to the virus in this age group as of yesterday morning.

Ordinary, otherwise healthy adults under 65 (give or take a few years pending metabolic fitness) appear to be at very low risk of having a serious (hospitalization required), critical (intensive or extraordinary support), or fatal outcome if infected by the SARS-CoV-2.

Of note, those older than 65, and particularly those older than 75, have been much more impacted by the SARS-CoV-2 virus (causing what is being termed the COVID-19 disease process), and the risk of a bad outcome rises almost exponentially with advancing (>65) age.

Also of critical note, those with significant medical conditions (co-morbidities in medical lingo) – particularly those co-morbidities which impact cardiopulmonary function, for example COPD, chronic asthmatics, concurrent pneumonia or other pulmonary dysfunction from yet another viral process have been impacted at higher rates, though people who are markedly above ideal body weight and those with T1DM or poorly controlled T2Dm appear to be at notably higher risk as well.

Again, given the information you’ve provided in your question – it’s not time to panic, but….

It is time to use common sense with regard to exposure risks? Hell yes, and count me – at least given the information available today – among those who agree that exposure to large groups, closely associated as in a church, concert, or movie venue for example, very likely offers an unacceptably high risk for those with elevated risk factors (age, the co-morbidities listed above). Any relative, friend, acquaintance, or co-worker who exhibits symptoms or is known to be infected MUST be avoided.

The vital importance of hand-washing simply cannot be overemphasized; make sure those grandkids understand that too.

Is it prudent to lay in a couple of weeks of any medications you take, food stocks, and household goods to tide you over through an (as of yet in North America) unlikely imposed home-based quarantine? Of course it is.

Stay with your healthy eating plan, and as the season turns to spring, keep walking, and make sure you’re pursuing a well-rounded (don’t forget to lift heavy things and sprint occasionally) fitness program. Your overall fitness, and metabolic/functional capacity, is one of the critical keys to battling off insults like this.

And finally, exercise caution in terms of what sources you consistently read and trust regarding news on the virus. By all indications, this will not lead to the collapse of civilization as we know it, despite the insistence by some in the media that’s the case. Those preaching that SARS-CoV-2 is the advent of the apocalypse should probably be avoided. My most trusted mentors continue to insist the biggest impacts will be financial over the long haul, and I’m inclined to agree at this point, despite the terrible medical burden some will bear.

No doubt, the virus is a damned serious one, and will be devastatingly impactful for those with cardiopulmonary compromise and the very old. Be vigilant, stay informed, and recognize that there’s still a truckload that we still DON’T know about this virus.

Question of the Week: A Few Quick Thoughts on the Coronavirus Story

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Over the past few weeks I’ve had a number of friends, family, and clients asking what I’m seeing and thinking about the coronavirus story that’s (at least now and again) dominating the news cycle of late. The question I’m hearing most often is some version of “should I be worried about the coronavirus outbreak?”

The honest answer, from the perspective of a medical scientist/ physician at least, is at this point in time, it’s damned hard to really tell, though there are some caveats to consider.

From a medical science standpoint there’s much about the coronavirus story that’s absolutely fascinating, yet objectively, there’s very little known about the virus itself and the syndrome it inflicts, particularly considering the news flowing (leaking) out of China.

The data out of China is highly suspect; everything from numbers of cases, rate of growth, the frequently discussed “R naught” values, death rates, quarantines of huge blocks of the billion plus citizens of China is clouded in secrecy, and some of it (the perfect quadratic growth of death rates for instance) is all but impossible to achieve in nature and strongly suggest data smoothing/modeling/manipulation.

The fact that China has refused to allow virology teams from the CDC to investigate is damning; apparently other offers from nations around the world have also been refused.

You’ve most likely read the virus appears to access the human system via the ACE2 (angiotensin-converting enzyme 2) receptors in the lung (not their only occurrence in the body, but theorized to be the viral portal of entry). There’s anecdotal discussion out and about that there are significant ethnic and sex influences on ACE2 receptor density (Asian males with the highest levels), though there’s much more conclusive evidence that smoking drives ACE2 receptor generation in lung tissue, with another pertinent hypothesis suggesting that exposure to particulate air pollution (rampant in China) might induce similar impacts.

Though several medical channels I’m also hearing discussion of concerns there’s a virulent fecal load of the virus, contaminating water supplies, exposing caretakers to aerosolized viral particles, etc.

The key point is that without corroborating, detailed, sophisticated analysis of the coronavirus, clearly requiring assistance from and expertise held by teams outside of China, theories and conjecture will continue to run wild.

News media and some governments around the world are also clearly providing misleading information, some even along the tune of “nothing to see here, more along”…

So finally, back to the question of the week, should I be worried about the coronavirus?

Part of the answer to that question depends on where you happen to live. For example, most of our readers here live in North American, Europe, and Australia where the viral incursion has been limited thus far. Readers in those regions aren’t going to see a viral disaster unfold in the immediate near term.

I’d suggest that one invest a bit of time every few days reading updates from reliable, scientifically sound sources, like the CDC resource page here, the Johns Hopkins COVID-19 heat map (that’s their latest update from this morning above, and perhaps even NextStrain’s mapping project.

Mind your travel to higher risk areas (if there’s any question, see the Johns Hopkins heat map above), and recent experience would suggest cruises in the Far East to be a lousy idea.

IF the virus is as virulent (or even more so) than some hypothesize, under-developed/third-world regions (India and Africa being the ones most often referenced in discussions I’ve read) may be devastated, further generating travel risk and exposure.

For those still smoking, if you ever needed a kick in the pants to push your cessation program into motion, here it is.

Standard and time-tested protocols for managing flu risk certainly aren’t harmful to consider these days, and while many scoff at the idea of having a few weeks worth of food and water stored in case you needed to hunker for a time, count my family among those who have prepped for such a need (it’s far, far more simple than you might think).

One of the most interesting aspects of this story, at least from where I sit, is the fact that this all could change quickly if and when we learn more about the true nature of the coronavirus; it will eventually be studied by cooperative scientists and we’ll understand more about the natural history of the infection. Stayed tuned.

Post script – given the role that China plays for much of the world as a manufacturing hub, the economic impacts from COVID-19 may be more substantial for many around the world than the infection itself. This part of the story is just beginning to unfold as well.

Question of the Week: Living a Demanding Life

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In response to yesterday’s post briefly explaining my absence from the blog here on the Older Bolder Life for a few weeks, reader Paul offered this comment / question –

And there in lies the rub. How do advise your clients who live demanding lives and want to remain healthy? I am on tour for 3 months with an outdoor show and I can tell you the diet is the first thing to go.

Upon seeing Paul’s comment early this morning, my initial response was “what a great question”, and it resonates very well with commentary I hear literally almost daily from friends, clients, and family. After thinking about it for a minute, I thought it worthy to respond in a bit more detail, channeling (at least attempting to anyway) what I’d say to Paul if we were sitting in the coffee shop (or a drift boat on the river) enjoying a break and a cup of hot coffee. During that hypothetical conversation I’d offer up the following points…

Real Life Happens (Almost Every Damned Day) In Ways We Hadn’t Planned For

Most of us, at the least the people that I run with and help through Older Bolder, have to work for a living to pay bills, buy groceries, keep a roof over the family’s head, and educate the occasional offspring. Work tasks often vacuum up huge chunks of time as well as physical, emotional, and cognitive resources we’d prefer to spend in other places, doing other things.

I get that point, and understand damn well that real life rarely proceeds according to the plans we’ve laid out – whether it’s for the day, week, year or whatever time frame you’d care to define. (Working in medicine, it was absolutely guaranteed that urgencies and emergencies would interrupt every single day – it wasn’t a matter of would it happen, it was just a matter of when).

Some changes in the daily life game are more or less voluntary, like my excursion into the world of a commercial kitchen laid out yesterday; many (perhaps most) bumps along life’s scheduling road are simply out of our control.

One of, and by no means the only one, the key points to be made here responding to Paul’s comment is this – there will always be daily challenges and obstructions to living the healthiest lifestyle we can. Some days (weeks, or even months) we win the battle, some days it’s a draw, and some days we get hit below the belt and stumble. It happens, and will happen again to all of us.

How we prepare for, and respond to those eventualities, is where we all have, at least in my humble opinion, the greatest opportunity – and like most things in life, making the most out of those opportunities requires sharpening a few skills…

Hone the Art Being Brutally Objective About Yourself

As I shared yesterday, I got into a bit of trouble physically last quarter because I really wanted to learn the ins and outs of working in an upscale, busy, creative commercial kitchen. Of the many lessons I learned, one was this – there’s a reason you don’t see a lot of 60+ year olds in busy restaurant kitchens. The work is fast, even furious at times, and often amazing physical. As much as a I really really wanted to dive in and do that, given the bundle of other business and family responsibilities I have on my plate (as do we all), it took me a while to listen to my wife and objectively measure the pros and cons of my little adventure.

Like most humans walking the planet today, I had developed a bit of a blind spot that allowed me to wander down a path that ultimately wasn’t the best one for me now, and like most of us, there was a price to be paid. Being objective about things we need to face up to in our lives can be damned hard – things like am I over-working, overweight, eating or drinking the wrong things, under or over active, and so on so forth.

Hone the art of being brutally objective about yourself, and find a partner, mentor, or friend who will pull alongside and steer you back to reality.

When Sh*t Happens, Flex and Pivot

When life throws those curve balls, sometimes we need to flex and / or pivot. For example, when I found my activity demands changing rapidly, and after struggling for a few weeks, I began to fiddle with my macros (upping carbs and good fats) in response. Flexing my macros and my eating schedule (I’m a long time time restricted feeding fan) made significant improvements; one of the most interesting parts of health and nutrition game is that sometimes we all have to run that N=1 experiment to see how we can make this human machine run optimally.

Sometimes we need to pivot; for sake of discussion here I’m using pivot to denote making a bigger change for our long term good. Sometimes making a pivot means leaving the good behind for the better ahead.

Metabolic Flexibility Still Wins the Day

At least from where I sit, the absolutely most critical thing anyone can (and really should) do to improve their health and function in life is to develop a robust ability to be metabolically flexible.

For sake of discussion here, let’s define that as developing the metabolic machinery (hello mitochondria!) to process multiple substrates to provide energy for our daily function, namely the fats we all so efficiently and amply store, and not just exist from one glucose spike to the next, stuffing our faces with fast-burning carbs every two hours every danged day.

Being metabolically flexible brings a host of benefits to the table, though I’d argue that top of the list is experiencing more even, sustained energy production, effortlessly by the way, which opens up a whole new world of ability to complete life tasks – actually doing things every day – which is what life is all about.

Developing metabolic flexibility is within the reach of just about every human on the planet, but you’ll have to be intentional about it, and be willing to spend a bit of time in nutritional ketosis.

Functional Fitness Still Matters

Another point I’d make to Paul in response to his question is so simple as to be in essence common sense – the point being that functional fitness really does matter.

All of us, regardless of age, need varied, interesting, and sustainable exercise that promotes strength, endurance, cardiovascular condition, and flexibility. What does that look like for you? YOU get to decide what your program looks like; and you don’t have to spend thousands on gyms, gear, or coaching to get it done, you just have to do it.

Functional fitness still matters, and always will; figure out how to make it a non-negotiable part of your day and week. (Think you don’t have time? How much screen time do you spend waste each day?)

Mind the S’s (Stress and Sleep)

Though it occasionally garners an eye roll from coaching clients, I’d gently remind Paul that many of us, due to the demands of the day, neglect managing stress and sleep. These are big topics, bigger than space and time allow for deep exploration here, but suffice it say that unmanaged stress and disordered or too little sleep can have profound impacts on health and wellness.

Two Final Thoughts…

Finally, I’d close my hypothetical chat with Paul with these two encouragements. One, life can, at times, be a bitch, throwing us curve ball after curve ball that we can’t hit. Relish the victories, dust yourself after the losses, and get back in the game. Sisson opines that we should strive for 80% compliance with a healthy lifestyle; I’d argue 90% or better is just as easy and still allows for that occasional stumble.

And two, always be exploring, learning, and testing. There’s a wealth of great free information available today at your fingertips, experts to query, and consultants to engage. Ask questions, experiment, make changes in your diet and routine, and pay damned close attention to what your body is telling you. It’s NEVER too late to make changes that will lead better health and rewarding function.

Git ‘er done.

Question of the Week: What is Mechanical Low Back Pain?

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From a client this week –

…my husband finally went to see our internist about a nagging low back pain that just won’t go away. He’s 80 pounds or more overweight, sedentary, and thinks Ibuprofen is something we all just have to take constantly to get by. His doctor’s PA told him he had “mechanical low back pain” and that it would just go away with time, what does that mean?…

A Quick Primer on What “Mechanical Low Back” Pain Means

Before a quick overview of what the term mechanical low back pain might refer to, of course I have to remind you that I’m not providing medical advice here, simply reviewing key concepts related to the question above.

In the arena of spinal pain and symptoms, one way to describe discomfort (or symptoms) is to divide them into one of two types (though they can both occur at the same time) – mechanical symptoms versus what are described as radicular symptoms (you might hear the term radiculopathy used).

Radicular symptoms refer to those symptoms generated when a nerve is irritated, and usually occur somewhere along the specific nerve’s course through the body and limbs. Think of a herniated disc “pinching” a nerve; let’s use as an example a far lateral disc herniation at L5S1 (the lowermost disc in the entire spinal column between the 5th lumbar vertebra (backbone) and the sacrum, pushing on the exiting L5 nerve root at that level. There may be some back pain produced in this scenario, but symptoms (could be pain, numbness, tingling, weakness) would potentially show up in the hamstring region, the front of the lower leg, and maybe even the top of the foot (all areas involved with the L5 nerve root).

Mechanical pain, on the other hand, typical represents symptoms produced by irritation or dysfunction of any other structure that’s NOT nerve tissue.

The most likely suspects are muscle, ligament, bone, joint, and the discs themselves (they’re a type of joint actually between the backbones (vertebrae) – a jelly like center (the nucleus pulpous) surrounded by a very interesting, multilayered harder (and specialized) cartilage-like casing. Most spine gurus agree that at least the outer third of the disc shell is supplied by nerve tissue and can generate pain; for a time it was thought discs didn’t have a direct nerve supply.

By far and away the lion’s share of mechanical low back pain is generated by muscles and ligaments, though as we charge through life we all accumulate some “wear and tear” changes in these spinal structures, that can (at least now and again) get inflamed, generate pain, and limit our function.

The good news here is that almost all of us will have a spell of mechanical low back pain at some point in our lives, and the overwhelming majority of the time, symptoms go away pretty damned quickly, and without much attention or intervention. Consider those episodes a proverbial “shot across your bow” imploring you to optimize your health, nutrition, and fitness if you’re not living that way now.

On the other hand, mechanical low back (or other spinal) pain that won’t respond to rest or a brief period of decreased activity, perhaps a very short course of anti-inflammatories, and maybe simple local measures (icing/heat) – and that continues to impact daily function – probably needs to be looked into with more than a pat on the head and encouragement that “it’ll get better in a few days”.

We’ll be digging into the topic of spinal pain more deeply through the fall…

Five Signs You’re at An Awesome Farmers Market

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This week a client peppered me with questions about farmers markets; questions like how to find a good one, how to pick through the bins, how to haggle, how to best manage shopping logistics, and more. Here are a few of the tips I shared on finding a great market…

The Produce is Sorta Funky, with Irregular Shapes and Sizes

Real small farms produce “real” produce; in fact, those accustomed to shopping the in the world of mass produced foods where all the cucumbers and carrots look exactly the same might not even realize massive farms yield produce that’s picked (and often otherwise manipulated) to look exactly the same every time (uniform size, shape, ripening window, etc.).

Shop the markets that have vendors selling irregular – even ugly – produce, think curvy cucumbers and forked, stubby carrots for example. Vegetables picked at the peak of freshness don’t all look the same.

The vendor selling perfectly symmetrical, same-sized veg may have actually bought a load at wholesale from another vendor, maybe not even locally, and be passing it off as small farm treasure.

The Produce is in Season and Fits Your Locale

Just for example, we live in North Texas, in a region that has definite seasons; it’s pretty easy to follow what should be coming in from local farms, give or take a few weeks pending the specific weather.

A local vendor was trying to pass off avocados as being a local crop at a market nearby the other day – ain’t no way avocados are being harvested in North Texas in August. The boxes stacked behind the stand we’re even labelled as being from Mexico, yet she stuck to her story and even sold a few as I quizzed her. (She asked us to move along…).

The Vendor is Happy to Talk About Their Farm

We’ve yet to meet a genuine small farm producer who doesn’t love to talk about their farm, their farming practices, their favorite crops, what work they’re doing now, and how the weather’s been.

Any time a vendor doesn’t want to answer questions about their produce or operation in detail, move on down the aisle. Local producers want to teach you, and hear how much you enjoyed their food; everyone is allowed a bad down now and then, but the vendor who doesn’t want to talk about their produce is waving a warning flag…

The Produce Might Just Seem a Bit Pricy Compared to Your Favorite Grocer

My friend Chef Libby scolded me one day in Austin after I haggled with a vendor over something in her stand (I can’t even recall what it was); I’ve tended to be a be a value shopper over the years, and I thought the farm stand pricing was too high.

Libby’s two points have stuck in my head since: one, it’s damned hard to make a living as a small farmer, and most are simply neither able nor inclined to sell the fruits of their hard-earned labor at the cheapest possible price. And two, you’re going to pay a premium, albeit a small one hopefully, for the very best, freshest ingredients, often grown with extraordinary care. The overwhelming majority of the time – it’s worth every penny.

If you run across a bin of goods at the market that appears oddly inexpensive, take note; you may be looking at a reseller or otherwise sub-optimal goods.

The Bins are Full of Fresh Produce and Meats, and Not Much Else

The best farmers markets sell fresh produce and meats – that’s was what drove their creation and very existence in the first place. Beware markets packed with prepared food vendors, arts and crafts, and stall after stall of unrelated goods.

Don’t get me wrong, they all can be damned interesting, but when you’re after the very best, and freshest, foods to put on your table, you want the market’s objective to be the same as yours – to present to you and your family the best options your local farms have on hand that very day (or weekend) in a format that makes shopping fun and interesting. And a little friendly competition is good for everybody in the game, and your budget as well.

Healthy and fun farmers market shopping this week.

Reclaiming Health and Fitness After 40: Five Quick Thoughts

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A couple of weeks ago I had a chance to reconnect with a friend from residency days back in Salt Lake City in the mid-80s; we were residency mates there in the University of Utah hospital system before he headed back home to San Diego to set up his practice and later found his own company.

My friend had something of an unusual story; he was a gifted mechanical engineer who later went into medicine with a goal of designing adaptive equipment for people with profound neuromuscular disease and injury. He was a delight, one of those rare hyper-intelligent and inquisitive people we all (rarely) have occasion to meet, and was an uber-fit skier, distance runner, and surfer.

Without boring you with details, through a mutual connection in England, he’d heard of my recent health transformation, and ended up calling to chat one afternoon. We covered a lot of ground in an hour, but he was particularly interested in what I’d done to reclaim my health and lessons I’d learned along the way. He shared that he had an adult “child” in her mid 40s who desperately needed a lifestyle and fitness change, and he was at the end of his rope trying to encourage her to start. He shared, among other things, that she felt she was “too far gone” to ever make a meaningful impact.

Thinking about it on the fly as we talked, I offered him five quick thoughts about reclaiming health and fitness after 40 gleaned from my own experience.

It’s Never Too Late to Start

I am profoundly and utterly convinced that it’s never too late to jump in with both feet, start moving physically, and reshape one’s approach to nutrition. At 57 I did just that, and started from a point of metabolic and physical disaster – 412 pounds, unable to tie my own shoes some days, with so many aches, pains, and symptoms I’m embarrassed to list them all. Now, just a bit over three years later, I’ve lost nearly 200 pounds and 20+ inches at my waist, am more fit than ever, and am even training for sprint competition in Senior track and field events upcoming.

Clearly your mileage may vary, but I have clients now in their 80s who’ve made similar changes and reshaped their approach to life. It’s never too late.

Reclaiming Health and Fitness After 40 Is a Long Game

Expectations can be an interesting beast to tame, at least for most of us. We’re an impatient society, and often fall prey to tall tales and crazy promises to shed improbably amounts of excess weight and gain extraordinary levels of fitness over very short time frames (30 days wonders) by following some magic diet, taking a wonder supplement, or copying the routine of a sculpted gym barbie with an Instagram following.

Attaining optimal health, fitness, and wellness at any age is a long game, most often measured in months if not years, but particularly for those of us north of 40. It’s a lot more enjoyable journey if you embrace the long view, and don’t sweat the day to day and week to week stuff.

Reclaiming Health and Fitness After 40 Might Take Baby Steps, But Take ‘Em

Talking with my friend, we agreed that life in today’s world, at least for the majority, is astoundingly sedentary. Many sit all day at work, commute sitting, come home and eat a poorly composed meal, and then sit on the couch for the next four hours before tossing and turning at night and starting it all over again.

Thoughtfully incorporating movement into the day can make a world of difference when starting from fitness ground zero; we’ve all heard the suggestions (park at a distance and walk in, get up and walk 10 minutes every two hours, etc), and these steps are easy to incorporate into one’s day. I’m a HUGE fan of walking outdoors, still do it daily to start my day myself, even on sprint training days, and just about every one on the planet can do it with minimal investment in time and equipment.

Baby steps turn into meaningful fitness routines over time.

Reclaiming Health and Fitness After 40: Embrace the Aches and Modify

One of the things I learned with my 30+ years in medicine is that the human body, despite its astoundingly complex design, function, and capacity to repair itself, is nonetheless designed to wear and tear over time. It’s inevitable, though manifests differently and at unique times for all of us.

The point: we all have our various aches and pains, joints that have been injured or have advanced markers of degeneration (read wear and tear); some days you’re going to be more sore and achy than others. Accept that reality, and modify, modify, modify exercise and fitness to accommodate your function on a given day. Remembering that you’re playing a long game makes this strategy more sensible too.

Personally I’ve been astounded at what a difference rebuilding functional strength has made in my own “aches and pains” related to prior orthopedic injuries, and just general activity and functional tolerance. Of course, that’s in part related to the last point…

Personally Optimizing Nutrition Makes Life So Much Better

Finally, I suggested my friend gently remind his daughter that there is a far, far better way to fuel the human machine than via the SAD (standard American diet). The point I tried to convey was simple from our perspective – the food we eat now is so much tastier, interesting, and flavorful than any we’ve consumed over the years, AND is so much healthier – less inflammatory (there’s that aches and pains concept again), less atherogenic, and more physiologically sensible given the science that has evolved over the past twenty years.

Personally I think for almost everyone walking on the planet, metabolic flexibility is the holy grail of nutrition – not being in ketosis or rigidly adhering to some arbitrary set of dietary rules. There is no one size fits all nutrition plan. Metabolic flexibility is key for anyone at any age, but perhaps even more meaningful for those of over 40, busy with all that life has to offer.

The challenge, of course, is to find the nutrition plan that resonates with your own particular physiology and metabolism, and make the tweaks and adjustments that work for you. It can be done, and again, it’s never too late to start.

Enjoyed the call JS, best of luck with your daughter and I’m happy to help any way I can.