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Saturday, April 27, 2019

Easy exercises for couch potatoes

I’ve never been much of a tea drinker. To me, the flavor is reminiscent of twigs soaked in warm dishwater. I don’t mean to disparage the tea enthusiasts who “ooh” over their oolong and cherish every drop of their chai. Quite the opposite, in fact. I’m as green as Japanese sencha every time another study emerges, steeped with praise about the health benefits of the beverage I’m not drinking.

This month my envy was particularly strong, when The American Journal of Clinical Nutrition featured not one, but 11 new studies highlighting the many ways in which tea can supposedly improve our well-being. The research was originally presented at an entire symposium devoted to Tea and Human Health, held in Washington, DC.

A few of the highlights:

    Tea drinking appears to lower the risk for heart disease and stroke.
    Natural compounds called polyphenols in green tea might protect against several cancers, including those of the prostate, GI tract, lungs, breast, and skin.
    Caffeine and antioxidants called catechins found in green, oolong, and white teas may increase metabolism and promote weight loss.
    Tea polyphenols are thought to strengthen bones and protect against fractures.
    People who drink tea could see improvements in mood, concentration, and performance.

Is tea uniquely healthy?

Not being a tea enthusiast, I immediately wondered whether any other foods could offer the same health boost. But it looks as though tea is distinctively rich in healthful properties. “Tea is uniquely plentiful in catechins, and especially epicatechins, which are believed to be the component responsible for many of its purported health effects,” says Dr. Howard Sesso, associate professor of medicine at Harvard Medical School and associate epidemiologist at Brigham and Women’s Hospital.

The less processed tea leaves are, the more health-promoting catechins they contain, Dr. Sesso says. Green teas have the most nutritional benefit, followed by oolong and black teas.

I also had to ask whether it’s possible to capitalize on tea’s healthful properties without actually drinking the stuff—say, by popping a pill? “More studies are needed that directly compare the effects of tea drinking versus tea extracts or supplements,” Dr. Sesso says. To harness all the healthful components of tea into a pill, we’d need to know exactly what those components are, and we’re not there yet. Another reason to avoid tea pills, or even to start drinking tea for health, is that although many studies show an association between tea drinking and health, they can’t show cause and effect.
Not your cup of tea?

If you’re a tea drinker, continue to enjoy your Darjeeling, Earl Grey, or Lapsang souchong. If you’re not into tea, don’t use the research as a reason to change your drinking preferences. “It is too preliminary to conclude that everyone should regularly drink tea,” Dr. Sesso says.

It’s not a good idea to resort to additives to make tea more palatable. I’ve heaped in spoonfuls of sugar, and tried the cloyingly sweet facsimiles sold in supermarkets and at Starbucks to make tea go down easier. “Sweetened tea beverages introduce calories, fat, and other ingredients that get away from the basic premise that the tea leaf may be responsible for any health benefits,” Dr. Sesso says. You can add a little honey or lemon to taste without compromising the purity of your tea, but stop there.

If you just can’t stomach the stuff, don’t fear that you’re missing out on a healthy beverage. Coffee—which research is finding may protect against diseases like type 2 diabetes and some forms of cancer—is a perfectly reasonable and possibly equally healthful alternative.
A longer lifespan can be a double-edged sword. You live for more years, but the later years may not necessarily be what you had in mind. A new study suggests that two-thirds of Americans over age 65 need help doing everyday activities such as eating, bathing, and getting in and out of bed or a chair.

We’ve known for some time that about 25% of older Americans can’t perform some activities of daily living without help. But we don’t know much about the other 75%. Are they getting along fine, or do they, too, need some help?

A new report based on data collected as part of the National Health and Aging Trends Study offers more detailed information on the state of seniors. Researchers interviewed more than 8,000 older Americans, most of them living at home, about activities of daily living. The participants also completed tests of physical and mental skills.

From the data, the researchers determined the percentage of older adults in five categories of function or adaptation:

    31% were as mobile as they desired and performed all activities of daily living without any assistance
    25% were as mobile as they desired and performed all activities of daily living but needed help from one or more devices, such as canes or bathroom grab bars
    21% needed someone to help them get around or with one or more activities of daily living
    18% said they had trouble being mobile or performing activities of daily living, even with assistive devices and changes in the home
    6% limited their activities and mobility, even with assistive devices and changes in the home

The study participants’ abilities varied by activity. Among those who said they were fully able, 90% had no trouble with eating. In the other four categories, under 10% said they could eat without help. Similar trends were seen for going to the bathroom, bathing, getting dressed, and getting in and out of bed.

Ability also varied by age. Among those aged 65 to 69, 45% said they didn’t need any help, compared to 4% of those aged 90 or older. The report was published online yesterday in the American Journal of Public Health.
Invest in yourself

Many people begin financial planning for retirement in their 30s and 40s. That’s also the perfect time to begin physical planning for retirement and old age. The key to remaining independent is to stay as free of disability as possible. Although your genes determine part of how well—or how poorly—your body and mind will age, much of that is under your control.

There are a number of things you can do to help ward off becoming frail or disabled, or prevent either from getting worse. These include:

    Staying active. Exercise and physical activity are as close as we can come to preventing disease and disability. It’s best to start early to make physical activity a habit, but you’re never too old or frail to exercise.
    Maintaining a healthy weight and choosing a healthy diet. Eat a variety of healthy foods, and don’t skip meals. If you don’t feel like eating or if you lose weight unexpectedly, see your doctor. The culprit could be illness, medications, depression, or possibly dental problems. Your doctor or a nutritionist may recommend a high-calorie supplement.
    Practicing fall prevention. Frailty can cause falls. But it works the other way, too: falls can lead to frailty. If medications affect your balance or alertness, discuss a lower dose or different medicine with your physician. Have your vision checked regularly. Clear your home of clutter and loose rugs or wires. Good lighting is essential; use night-lights in bathrooms, hallways, and, if needed, your bedroom. Wear flat-soled shoes or boots that grip. In bad weather, exercise indoors.
    Making connections. Relationships can keep you active and help ward off depression. Dining with others may encourage better eating. And an exercise or walking partner can help you stick to your program.
    See your primary care doctor, eye doctor, and dentist regularly. They can identify conditions that contribute to frailty, such as heart disease, and vision or dental problems.

The earlier you start financial planning for retirement, the more money you are likely to have put aside for it. The same holds for physical planning: the earlier you start, the more likely you are to live independently in your later years. I come from a family of champion snorers. Mother, father, brothers—we all broadcast nightly like buzz saws. But by 2006, my snorking and snarking took an unhealthy turn. Instead of merely driving everyone nearby to distraction, I began to stop breathing for short periods. Dozens of times per night, my upper airway fell slack like a worn-out garden hose, which pinched off the flow of air and jarred me awake. Blood oxygen plummeted and adrenaline surged into my bloodstream, making blood pressure swing up and down.

After a sleep study in which I slumbered overnight at a special clinic while wired up to various gadgets, my doctor offered an explanation for my increasing fatigue and mental fog: obstructive sleep apnea (OSA).

Not surprisingly, I read with great interest a study published today in the Journal of the American Medical Association (JAMA) which reported that treating OSA can help people with very hard to control blood pressure. Many people with this so-called treatment resistant hypertension take several medications but their pressures remain stubbornly high. Many people with treatment-resistant hypertension also have OSA.
Healthier BP with CPAP

Could treating their OSA help? To find out, researchers in Spain provided the standard treatment for OSA to nearly 200 men and women for 12 weeks. The treatment was continuous positive airway pressure (CPAP), which uses a facemask and bedside air pump to inflate the upper airways enough to prevent the collapse of soft tissue in the upper throat that obstructs airflow.

After 12 weeks of CPAP, average 24-hour blood pressures in the study participants were a few ticks lower. They also had more healthy nighttime blood pressure patterns.

The improvements, though modest, are still important. Nighttime interruptions in breathing, or “apneas,” starve the brain of oxygen and stress out the cardiovascular system. Inadequately treated OSA comes with a higher risk of heart attacks and strokes. Another hazard is next-day drowsiness that predisposes people to accidents.
What it means for those with OSA

To get the bottom line on the study for OSA sufferers, I talked to Dr. Atul Malhotra, an expert on sleep apnea and associate professor of medicine at Harvard Medical. He’s also the chief of Pulmonary and Critical Care Medicine at the University of California San Diego School of Medicine.

“The wrong message is to say CPAP is weak,” Dr. Malhotra says. “Blood pressure medications offer a bigger bang for the buck to reduce daytime blood pressure, but it’s important to say that when you treat sleep apnea there are a lot of other benefits that are not necessarily related to daytime blood pressure.”

I’ll say! I was absolutely miserable pre-CPAP. But now I sleep like a lamb (well, probably more like an helium-inflated Macy’s Day Parade lamb). Every night I strap on the headgear of what I affectionately call my “astronaut machine.” A small high-tech bedside air pump monitors my breathing and adjusts the flow of filtered, humidified air to my nose. A microchip in the machine tracks my breathing patterns and adjusts the flow throughout the night to compensate for shifts in body position.
Overcoming CPAP roadblocks

But not all of my brother and sister CPAPers are as lucky. Some can’t get used to the mask and tend to tear it off in their sleep or simply don’t wear it at all. But most people can adapt to CPAP.

“Strapping a mask to your head is not ideal, but in some people adherence is extremely good,” Dr. Malhotra says. “They wear it all night every night and couldn’t get to sleep without it. Then they get transformative benefits from it.”

How do you get to that point? A critical factor is mask comfort. “The key is just to find one you like,” Dr. Malhotra says. “It’s like going to Baskin Robbins. There are 31 flavors, and you just have to try different flavors before you find one you like.”

Fortunately, the Baskin Robbins of CPAP is well stocked these days with a variety of mask options. It includes nasal masks, full face masks, and twin tubes that deliver air to each nostril.

Mask fitting can be a trial-and-error process, and you may have to try different ones until you find the right match. “If you try pistachio at Basin Robbins the first time and don’t like it you may never come back,” Dr. Malhotra says, “but some people try pistachio the first time and like it.”

Me, I like vanilla—the smaller, lighter nose-only nasal mask. My brain learned quickly to keep my mouth closed and breath through the nose. Later I found better-designed headgear and an accordion-like mask that maintained its seal better despite my occasional tossing and turning.

Dr. Malhotra urges those going on CPAP not to quit if the first taste isn’t pleasing. “Even if the first experience with CPAP doesn’t go well,” Dr. Malhotra says, “it’s very important to keep trying.” Untreated or inadequately treated sleep apnea can have devastating effects on health and quality of life, but there is usually a solution. If you have trouble finding the motivation to break away from the television and exercise, try couchersizing—staying on or near your couch and exercising during commercial breaks. Why bother? As I write in the December 2013 Harvard Health Letter, a growing body of evidence links the amount of time spent sitting to illness and even death. “Minimizing long periods of inactivity, like exercising during commercial breaks, can help reduce the risk of injury and may even help you live longer,” says Kailin Collins, a physical therapist at Harvard-affiliated Massachusetts General Hospital.

You can work many different muscle groups while seated upright on a couch. Want to get your heart rate up, work the oblique muscles on the sides of the abdomen. To whittle your waist, try twisting your torso from side to side for the length of a commercial break. You can even exercise while lying on the couch: with your legs extended, squeeze the quadriceps on the front of the thigh for a count of 10, then relax. Repeat several times. Try leg lifts while lying flat to build abs, or side lifts to strengthen hip muscles.

Here are more ideas for the couch potato set. Consider trying some of these exercises during the typical three-to-four-minute TV commercial break.
Sit to stand

Why it helps: This exercise works the quadriceps in the front of the thigh and gluteal muscles in the buttocks, which helps protect your ability to get up from a chair, out of a car, or off a bathroom seat. “In addition, it’s possible to use repeated repetitions of this exercise to get your heart rate up,” says Collins.

How to do it: Go from sitting to standing to sitting again, 10 times in a row. Rest for a minute, then repeat.
Calf stretch

Why it helps: “Keeping your calves optimally flexible can keep your walking stride longer, reduce your risk of tripping over your toes, and reduce your risk for common foot injuries such as plantar fasciitis,” says Collins.

How to do it: Sit on the edge of a couch with your feet flat on the floor. With one leg, keeping your heel on the floor, lift and point the toes toward the ceiling, so that you feel a stretch in your calf muscle. Hold for 30 seconds, then do the same with the other leg, three times per leg.
Stand on one leg

Why it helps: “Balance gets better if you practice it, which can decrease the risk of falling,” says Collins.

How to do it: Holding on to the back of a chair for stability, lift one heel toward your buttocks. Hold for 30 to 45 seconds, three times per leg. To improve your balance on unsteady surfaces, try this with shoes off on a balled-up beach towel.
Shoulder blade squeeze

Why it helps: “This can help prevent that rounded, shoulders-forward posture that can develop from many years of sitting, especially at a computer,” says Collins.

How to do it: Pinch your shoulder blades together, but not up (don’t shrug). Hold for 10 seconds, then repeat 10 times.
Hand squeeze

Why it helps: “Keeping your grip strong makes it possible to turn a door knob, open a jar, and grasp a gallon of milk,” says Collins.

How to do it: While seated upright, hold a ball (the size of a basketball) over your lap with both hands, then squeeze the ball as if you’re trying to deflate it. Hold for a few seconds, then release. Repeat 10 times, rest, then do another set of 10 repetitions. You can also improve your grip strength by squeezing a small rubber ball in one hand.

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