Staying Healthy Requires Action

By JENNIFEFR BREWER For The Maine Sunday Telegram

Staying healthy as we age is about more than treating illness.

As University of New England’s Dr. Bruce Bates explains it: "Health is not the absence of disease. Health is maximal functional capacity. If I don’t have heart disease it does not mean that my cardiac function is as good as it could be."

Bates, chairman of the Department of Family Medicine and Division on Aging, and director of MatureCare clinical services, strongly recommends building up health in order to delay or avoid disease.

Sometimes, preconceived notions can get in the way of optimal health.

"Our society has socially constructed aging to fit the disease and decline model," says Marilyn Gugliucci director of Geriatric Education and Research at University of New England, and president of the Association for Gerontology in Higher Education.

For example, although muscle mass and respiratory function typically decrease with age, Gugliucci does not consider these declines inevitable.

"If we don’t exercise, we have a propensity for losing muscle mass, but that doesn’t need to be the case," she says. "I know people in their 70s and 80s who have better cardiovascular fitness than younger people."

She emphasizes healthy self-esteem and a positive attitude are central to both physical and mental health.

"Critically important to healthy aging is recognizing that we do have control of what we put into our mouths and how we spend our day," she said.

According to Bates, a truly healthy person "has the ability to meet functional goals, (with) full range of motion and no restrictions on lifestyle." He recommends a combination of exercise, healthy eating and a lifestyle that is active both mentally and physically.

Standard guidelines call for 30 minutes of aerobic exercise three times per week, says Peter Allen, fitness manager for Lifeline Center for Wellness and Health Promotion at University of Southern Maine, and a lead trainer for the Matter of Balance program.

It’s important to work toward the 30-minute goal at your own pace, he adds, and also to consult your physician to determine your optimal heart rate during exercise.

"Listen to your body and don’t push yourself. It should be a slow, continuous rhythmic exercise that you can sustain for 30 minutes," says Allen. At the right intensity, you can feel some effort, but aren’t struggling.

"If you are panting, you’re exercising too hard," says Bates.

A generally active lifestyle isn’t a substitute for aerobic exercise, but it’s better than nothing.

"Active people have better health maintenance, but aerobic exercise is about improving, not just maintaining, health," Bates says. Fortunately, it can be as simple as taking a walk. "Walking is as good an exercise as there is," he says.

Aerobic exercise should be augmented by strength and flexibility training. Strength training maintains and increases muscle mass and bone density. Adequate flexibility helps maintain normal range of movement. Both are important bases for safe aerobic exercise and for avoiding falls in daily life. Both should be started gently and increased slowly, to avoid straining muscles.

Maintaining a healthy weight is key to overall health, and should involve both diet and exercise.

"When you’re overweight, all your systems work harder and wear out more quickly," says Allen. "Too much body fat leads to both heart disease and diabetes, which is expected to triple in the next three years because of obesity."

A good diet doesn’t have to be about deprivation, says Bates. Except in cases of disease, such as diabetes, he recommends simple common-sense moderation and basic attention to nutrition.

"Follow the food pyramid, and avoid refined carbohydrates" such as white flour and sugar. "Most people overdo starchy foods and fatty meats, and miss their fruits, vegetables and fiber," he adds. He calls trans fats "the latest enemy of health, associated with cardiovascular disease" and recommends avoiding foods with these fats.

Bates also cautions against over-salting food, saying that the average person needs no more than two milligrams of sodium per day, but that this amount may be present in one serving of fries.

"Our taste buds get accustomed to salt, and we think we need more. Also, as we age our taste buds become less sensitive to salt," Bates adds.

Help is available for those who are unaccustomed to reading food labels for nutritional information. Allen recommends Hannaford’s Guiding Star system, which gives dietitians’ rankings for different foods, and offers free seminars on nutrition. Whatever foods are chosen, most "Americans should cut their portions in half," Allen says. "It takes 20 minutes for your stomach to tell your brain that you’re full."

In addition to exercise and a healthy diet, Bates believes that a small dose of aspirin (such as a baby aspirin) decreases the likelihood of stroke and heart attack in people without blood- related conditions. Calcium and vitamin D supplementation work together to protect the bones, he says. He recommends the tetanus- diphtheria vaccine every 10 years, flu vaccine yearly, the Pneumovax (pneumonia vaccine) at least once after age 65 and the herpes zoster (chicken pox) vaccine at age 65 to prevent shingles.

Each recommendation is part of a larger whole, Bates says, rather than a "magic bullet" on its own. Furthermore, true health includes mental fitness as well as physical fitness.

"Exercising the mind is just as important as exercising the body," he states. "It sharpens your whole attitude, gives you a spirit of inquiry and sensation of health, keeps you engaged and feeling useful and helps you enjoy a better quality of life. Invariably, long-life studies find octogenarians (and older people) are active and engaged in what is important to them."

[Sidebar]

HEALTH-SCREENING TESTS

DR. BRUCE BATES offers a list of tests that are important as we age. The recommended ages and frequencies noted here are general guidelines, intended for those without personal or family history of disease, and are in line with Medicare coverage.

WOMEN: Pap smear every two to three years, mammogram yearly after age 40, bone density measurement every two years from menopause.

MEN: prostate exam yearly after age 50.

MEN AND WOMEN: colorectal exam every 10 years starting at age 50, glaucoma eye exam yearly after age 50.

PHYSICAL EXAMS should include standard blood tests every three years, cholesterol testing every five years, a cardiogram and a mental status exam.

PETER ALLEN adds body composition analysis to this list, to determine percentage of body fat. "Weight charts and body mass index calculations aren’t as helpful as body composition analysis. It’s possible to have a dangerous percentage of fat even when you have a ‘healthy’ weight on weight charts," he cautions.

(c) 2008 Portland Press Herald. Provided by ProQuest LLC. All rights Reserved.