My doctor recently retired and last week I met with a new personal care physician. I told her that my goal is to be as healthy, fit and active as possible into my 90s and then to drop dead, which is called squaring the geriatric curve.
I explained to her that I try to follow the American College of Sports Medicine’s (ACSM) recommendations. My goal is to exercise at least 10 hours a week, including many of its specific recommendations.
For overall good health, the ACSM recommends year-round:
- Cardiorespiratory: I should accumulate a minimum of 150 minutes / week of cardio exercise up to 300 minutes / week, or 75 – 150 minutes of intense exercise or a combination of the two most days of the week.
a. I usually do at least five hours a week of road and MTB riding, hiking, swimming, cross-country skiing and snow-shoeing. The MTB and XC skiing provide good intensity without doing structured workouts. - Strength training: I should do strength training two to three days / week, which should include exercises for all the major muscle groups (shoulders, arms, chest, core, hips, and legs). 30 minutes / session is plenty.
a. I only do an upper body workout once or twice a week saving my legs for riding, skiing, etc. I work on strength carrying wood (legs and upper body), chopping wood (upper body), weed whacking (core) — all of these count as part of my 10+ hours a week.
b. The doctor and I agreed that I should hit the gym and /or do heavy chores at least twice a week and that I should work on my core (not my favorite) at least three times a week. - Stretching/flexibility exercises: I should stretch all parts of my body at least four times a week.
a. I stress the importance of this to my athletes but only do so a couple of times a week. Time for the coach to get with it — stretching only takes 5 – 10 minutes per session! - Weight-bearing exercises: Riding — even sprinting — doesn’t load the skeleton as much as plain walking! After breaking my ankle in January I had my bone density tested. I have a little osteopenia (loss of bone mass). I should do 30 – 60 minutes a day three to five days a week of weight-bearing exercise. Carrying a pack while hiking, snow-shoeing and XC skiing count as does lugging firewood. Adding lower body strength training also help to strengthen my bones.
- Balance exercises: I practice Tai chi most mornings, which is great for balance and also my flexibility.
Flattening the geriatric curve includes both staying as fit as possible by meeting the ACSM recommendations and a healthy lifestyle. I told my doctor that I eat Mediterranean-type diet and don’t use alcohol and tobacco.
Family history is another factor. My mom died of colon cancer in her 70s, and I get a colonoscopy every five years. My dad lived a healthy lifestyle walking daily and maintaining a healthy weight. His only vices were red meat and eggs. He died of a heart attack in his 80s and I figured I was stuck with his genetics.
Although I exercise regularly and eat a healthy diet, my cholesterol is a little on the high side. My doctor told me that I have a 12 – 14% risk of dying in the next ten years. I’m right that my above normal cholesterol is due to my genetics. However, the doctor informed me, I can do something about that. She suggested taking a statin, which would lower my risk to a 7 – 9% risk of dying in the next 10 years. Possible, although not frequent, side effects of a statin include muscle aches (not severe pain) or an upset stomach. If one of these afflicts me she’ll change the prescription.
Another downside is that experiments with large groups of individuals indicate that people on statins don’t improve as rapidly from a structured exercise program as people who don’t take statins. As the doctor and I talked I thought about the implications. I don’t race so achieving a high level of fitness isn’t essential. More importantly, gaining a little less fitness but reducing my risk of dying by 35-45% seemed like a good deal.
I also have had several basal cell carcinomas. These are a low risk type of skin cancer; however, if not removed one could metastasize into other parts of the body and become more serious. I check my skin monthly and see a dermatologist twice a year. I wear sun-protective clothing from Boure Sportswear and put on sunscreen every 80 minutes, as recommended.
To flatten your geriatric curve, see your physician and find out all the things you can do to prevent a premature death.
My eBook Anti-Aging: 12 Ways You Can Slow the Aging Process includes interviews with two MDs: Gabe Mirkin (82) and Malcolm Fraser (68). Each describes his exercise program and gives recommendations for a long, healthy and active life. Anti-Aging also includes interviews with 10 other male and female roadies ages 54 to 75. They describe their exercise programs in terms of the ACSM recommendations. They talk about changing exercise goals over time. They emphasize the value of intrinsically enjoying an activity rather than doing it because it’s good for you. They describe many ways to adapt positively to the aging process. The 106-page eBook Anti-Aging: 12 Ways You Can Slow the Aging Process includes is available for $14.99.
Did your doctor bother to do a profile of your LDL to see if your diet and exercise resulted in mostly large molecules which are harmless? Normally LDL isn’t even measured, but derived, and I have never known a doctor to request the specific test for the LDL profile unless asked. Your “risk” is probably different from the general population who do not follow your diet or exercise routines. I have reduced carbs and sugars without diet restriction and lost 35 pounds (now 6’3 and 175). I have ceased taking statins and will have my annual physical tomorrow so will see how my cholesterol numbers look shortly.
Just to clarify, I am an engineer, not a doctor. I have become more skeptical about drug use. At 70 I do not take any prescription meds other than a bit of Vitamin D. I have found that most aches and pains have decreased with the change in diet and weight loss.
I (Lars) agree about taking the cholesterol blood test that shows if the molecules are the dense, dangerous ones versus the large and fluffy type. Mine test showed that they were the large type, as you describe. I paid for the drug test myself through Life Extension or one of those other companies and it was not expensive. Sometimes a doctor will not be willing to give you a more specific test and does not like a patient trying to steer treatment. When I cut back on sugar and wheat, my triglyceride numbers plummeted.
I’ve found the low carb- paleo way of eating with lots of healthy fats has worked great for me. Nutrition has made big discoveries in the last few years. I’m waiting for the medical community to recognize that a lot of problems can be solved with food and not with more drugs.
Statins have some very serious side effects and have not proven to extend life significantly.
I’m with you on wanting a long life but I want it to be a healthy, as drug free as possible, life.
Anyone gauging their cardiac health on a total cholesterol reading, is way behind the curve. It is a very poor predictor of cardiac events and overall health and many have proven that the reading itself can vary drastically over just a few days time. Look into getting a Cardio Scan for a calcification score. That is an affordable, easy way to get the best available picture of your cardiac health. $50 where I live and takes just minutes.
A study a few years ago showed dramatically increased risk of developing ALS (Lou Gehrig’s disease) when taking statins. Depending on the statin, the risk is 800% to 10,000% times higher.
https://www.ncbi.nlm.nih.gov/pubmed/17536877
https://drmalcolmkendrick.org/2018/04/09/statins-and-amyotrophic-lateral-sclerosis/
Very helpful article; however you should correct your comment on basal cell carcinomas.. The do not “metastasize into other parts of the body” but can be very locally destructive if neglected.
It seems a bit misleading to call a drop from 13% to 8% a reduction of risk of dying by 35-45%
“I only do an upper body workout once or twice a week saving my legs for riding, skiing, etc.” Don’t you mean lower body?
To minimize cancer and heart disease risk (your cholesterol is somewhat high) go on a plant based diet with a B12 supplement. Most Americans die of cardio-vascular disease or cancer. These are largely lifestyle induced ….. live like an American, die like an American.
While perhaps true I do not understand how cycling is not effective in terms of bone stress especially if x-country and some other forms of activity are reported effective. Maybe they assume better roads then those I ride on —taking impacts weight bearing–on one of other leg! Personally think any diagnosis of osteopenia is suspect with little evidence to support any cut off value of use.