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By Glen Bergeron
Mar/Apr 2019

From the moment we are born, we start to age.

In terms of health and wellness, that's not really a problem for the first 30 years of life. Research suggests that people get stronger as they get older, hitting their peak bone and muscle mass between 20 and 30 years of age.

But soon after that, things start to change. By the time the average adult hits the middle years - 45 for women, 55 for men - the aging process and inactivity start to take a bit more of a toll.

Slowly, but surely, we start to lose the bone and muscle we have been building over the years. Other functions, like vision and hearing, also become impaired. As a result, we become weaker, less agile, and more prone to losing our balance. This increases the risk of falling, or getting hurt from a fall. It also decreases our quality of life, making it more difficult to do activities that we enjoy, and live independently.

To understand how the aging process works and its implications for our health and well-being, it helps to think of our body as a bank account, with muscle and bone mass as our currency.

As children, our bodies put a great deal of effort into making bones and muscle that are strong and able to support our active lifestyles. Bone and muscle respond favourably to forces and grow stronger with vigorous activities such as jumping, running, dancing and lifting or carrying. This type of physical activity is known as "weight bearing" because our body weight is being supported by our legs. As a result, more bone and muscle mass is being "deposited" than is being "withdrawn" from our account.

But by the time we hit the middle years, we often become less active. In fact, 87 per cent of Canadians over the age of 60 are not getting enough physical activity. As a result, we start to withdraw more bone mass and muscle than we deposit. This loss is compounded by poor nutrition, such as a lack of adequate levels of bone-building calcium and Vitamin D.

Ongoing research continues to affirm that the easiest way to stay healthy and vital longer is to exercise.

Consider these numbers: On average, we lose about 10 per cent of our peak muscle mass by age 50, and 50 per cent by age 80. Bone mass disappears at a rate of about one per cent per year from the age of 30 in females and the age of 40 in males. Females undergo an increased rate of bone loss of up to three per cent a year for five years following menopause for hormonal reasons.

The loss of bone and muscle mass contributes to other problems associated with aging. Some older adults find that they can no longer do the simple things they once did, such as lifting bags of groceries or getting up from and down onto the floor.

Good balance is an integration of reliable sensory input from three important body systems: our vision, the balance system of our inner ear, and the sensors in our muscles that tell our brain the position of our limbs. When seniors experience vision changes (cataracts) and muscle and joint changes (arthritis, muscle weakness), they are at greater risk of having a fall.

The good news is that there are things we can do to slow down the aging process.

Ongoing research continues to affirm that the easiest way to stay healthy and vital longer is to exercise. In fact, experts suggest that by simply walking a bit more and adding some weight-bearing activities, you can manage weight gain, and increase heart and lung capacity, strength, agility and balance.

That's because even as people age, the ability to build better bones and muscles does not go away. There is a natural amount of bone and muscle tissue lost with age, but if a person is regularly active, they lose far less bone and keep far more of their muscle tissue.

The payoff is huge. Older adults who exercise two to three times per week can expect to get better at activities of daily living such as walking, climbing stairs, standing up from chairs and performing self-care.

So how can you start taking control of the aging process?

First, you will need to do some type of aerobic activity on most days of the week. This helps prevent many chronic diseases, control weight, and build a stronger heart and lungs.

Examples are brisk walking, jogging, cycling, dancing and swimming, or any activity that makes us breathe a bit harder than at rest. Nearly all major health organizations recommend setting a goal of 150 minutes of aerobic activity per week. To achieve the benefits of exercise, try to be active for at least 10 minutes at a time. If this seems like too much, start with less and work your way up to 10 minutes. Even if you challenge your body a little more than it is used to, you will still get benefits.

Another way to measure activity is by counting steps. You have probably heard that 10,000 steps per day is a good target to achieve. This provides similar benefits to 150 minutes of exercise per week. If this seems like a lot, remember that the average Canadian over 60 takes about 7,000 steps per day (and 10 minutes of walking is about 1,000 steps). A pedometer (or step counter) can be used to keep track of the number of steps you take and is a tremendous motivational tool. (For more information, check the fact box on page 47.)

Second, do some activities to build stronger muscles at least two days a week. Use your own body weight or purchase some rubber tubing or small dumbbells to exercise your legs, hips, abdominals, chest, shoulders, and arm muscles. The aim is to make the main muscles of your upper and lower body work harder. Our muscles will get stronger if we do each lift or motion 10 to 12 times, and repeat twice (one to two sets of 10 to 12 reps).

In response to the extra work, your muscles will become stronger, which will help with daily activities and prevent falls. It is very important that you maintain good form when doing each exercise. If you get tired and find yourself "cheating" to get the exercise done, you should stop at that point. No need to go to the point of pain. A great place to start is to consult with an exercise professional and your health-care provider, and check out community programs. Remember that alternate forms of activity, such as going up and down stairs, repeatedly standing from a chair, carrying your groceries, raking and gardening, can also promote muscle strength.

Last, if you're worried about falling or feel unsteady on your feet, include some balance activities. Examples include walking backwards and sideways, standing on your toes, walking on your heels or toes, or standing on one foot at a time. Make sure you are wearing good, supportive footwear and standing near a stable object that you can grab so you don't fall while challenging your balance. If you initially have difficulty maintaining your balance, you should have someone at your side to support you should you start to fall. (For more information about how much activity is recommended, see the fact box.)

Older adults who exercise two to three times per week can expect to get better at activities of daily living such as walking, climbing stairs, standing up from chairs and performing self-care.

Along with bone and muscle improvement, regular exercise reduces the risk of more than 15 chronic diseases associated with aging. Being physically fit enhances the immune system's ability to protect against disease. It also reduces stress that is thought to be a major influence of chronic disease and illness.

Many people may not realize that exercise also helps people recover from disease. There is now convincing evidence that exercise can be very effective medicine. For example, exercise reduces pain from chronic back problems and osteoarthritis, and improves function after major surgeries, like hip replacement.

Even for conditions where walking is difficult - like heart and lung disease, or claudication (cramping in the legs from poor circulation) - exercise is beneficial, helping people walk longer and with less pain.

In fact, exercise is a medicine with very many benefits and very few risks or side-effects. To learn more about exercise as medicine, visit exerciseismedicine.org.

Finally, even when someone isn't sick, or is otherwise "healthy," exercise still provides benefits. In fact, this is one of the most rewarding (and well-established) parts of physical activity. Exercise can even improve sleep, mood, mental health and mental function. So, although there are very few cure-alls in life, exercise is pretty close. It has positive effects on many different parts of the body - effects that can improve quality of life, regardless of age.

Dr. Glen Bergeron is a full professor in the Gupta Faculty of Kinesiology at the University of Winnipeg. Andrea Bedard, Dr. Fred Gutoski, Dr. Robert Pryce, Ben Trunzo, all of the Department of Kinesiology and Applied Health, and Naniece Ibrahim, of the University of Winnipeg's Communications Department, contributed to this column, which was originally published in the Nov/Dec 2013 issue of Wave.

Safety first

But before you start exercising, it is wise to consider how best to be safe. Inform your doctor before you begin, especially if you have any ongoing health problems. Are there activities you should avoid? Should you adjust your medication schedule? Do you have long-term aches and pains that might get worse if you become more active? A trip to your local physiotherapist or athletic therapist may be in order before you start.

Stop exercising immediately and speak to your doctor if you feel dizzy, short of breath, feel chest pains or pressure, or experience a cold sweat. You may need to scale down your activity or try a different one. Wait to work out until you feel better if you have had a cold, flu, or another illness. If you take a break for more than two weeks, start slowly again.

How to slow down the aging process

Older adults can help stay younger longer by exercising regularly. Here are a few tips:

• Take part in at least 2.5 hours of moderate- to vigorous-intensity aerobic activity each week.
• Spread out the activities into sessions of 10 minutes or more.
• Add muscle- and bone-strengthening activities using major muscle groups at least twice a week. This will  help your posture and balance.
• Find an activity you like, such as walking, swimming, cycling or dancing.
• Minutes count - gradually increase your activity level minutes at a time. Every little bit helps.
• Active time can be social time - look for group activities or classes in your community, or get your family or  friends to be active with you.
• Walk wherever and whenever you can.
• Take the stairs instead of the elevator, when possible.
• Carry your groceries home.
• Start slowly.
• Listen to your body.
• Track your steps. There is no shortage of technological options when it comes to tracking your movements.  Pedometers - devices that can keep track of the steps you take throughout the day- can be found in  smartphones and wristwatches. Some devices can also provide information on the intensity of the activity,  the calories you burn and your sleeping pattern.
• If you are setting out to walk 10,000 steps a day, remember to:
  
  
  • Start slow: Rather than shooting for 10,000 steps right away, start with a more manageable goal. Then  try to increase this number every week or so by a reasonable amount (say 500 to 1,000 steps).
  • Keep going: Remember that the benefits of physical activity don't stop at 10,000 steps or 150 minutes.  More activity will mean more benefits.