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Over 40

Health and Fitness After 40: Managing the Expectation Game

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The Cambridge Dictionary defines the word expectation in several ways, and there’s a slight twist when comparing the US vs. the British definitions…

US: the feeling or belief that something will or should happen

UK: the feeling that good things are going to happen in the future; the feeling of expecting something to happen, what you believe or hope will happen in the future

At the risk of sounding a little too old school, I’d venture that – when it comes to personal health, wellness, and fitness – many of us have allowed the impatient, “I want it right now, dammit” tone dominating society now to impact how we view our own approach to, and our progress in, an effort to up our game and live healthier.

The longer I actively practiced medicine the more convinced I became that, for a variety of reasons we’ll talk about over the next several weeks, most of us have expectations regarding health, fitness, and function that are hugely divergent from our own personal realities, and if you’re not a thoughtful steward of expectations – lousy results often follow, many times leading to failure and disaster.

Here’s an example of what I’m talking about. During the last fifteen or so years in practice, I focused on the conservative management of spine disease and injury. Most of the patients I treated were older than thirty-five, overweight – some massively, poorly conditioned, sedentary or close to it, consumed some variation of the Standard American Diet, and many engaged in some other high risk health behavior, smoking and recreational drug use being the most common.

Most of the patients I treated stepped into my office with the expectation that, with some wave of the technological magic wand helped by some pharmacologic sorcery, their pain would somehow be resolved with minimal effort otherwise on their part.

Managing these expectations was in reality perhaps my biggest challenge in the medical game; it required patient, consistent, endless education, helping people understand what was wrong, why it happened, how recovery and restoration of function actually happens, and what the potentials were down the road for improvement and gains.

You can guess how the story unfolded; a minority really dug in, listened, learned, made life and activity changes, and genuinely improved. A bigger group went through the motions, did the minimum to quiet the problem at hand, and resumed their destructive lifestyle to return with another back pain crisis a few months down the road. Another minority refused to engage, and went off seeking the holy grail of a no-effort recovery, usually unhappy, bitter, and disparaging on the way out the door.

Health and Fitness After 40: Managing the Expectation Game

Over the next few weeks we’re going to tackle some of the expectations those of us over 40 (you could argue over 30 for most in America today) have regarding our own personal health, wellness, and fitness; of course we all want to be more fit, closer to our best weight, sharper, more engaged and energetic, and live as long as a highly functional – and happy – human as we possibly can.

Before your expectations derail your progress on your journey, let’s spend some time looking in more detail at some common areas where our expectations can quickly breed frustration. We’ll start with a fairly candid look at weight loss expectations next week, followed by a number of other topics in the weeks to come.

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.