For the latest installment of our series Balance, which is dedicated to nutrition, health and exercise, we explore aging. Co-hosts Erin Howie Hickey, associate professor of exercise science at the University of Arkansas, and Jamie Baum, assistant professor in the U of A Department of Food Science and director of the Center for Human Nutrition at the University of Arkansas, invited Michelle Gray to come to our studio to talk about aging. Michelle is director of the Department of Health, Human Performance and Recreation at the University of Arkansas.
Michelle Gray: I would say my colleagues study aging as maturation — with childhood aging, etc. I study aging after we've matured, and then we're going into adult and later adult and older adulthood. We define older adulthood as over the age of 65. But a 65-year-old could look very different from another 65-year-old. One could have mobility issues, one could be running marathons. Age is one number. I study aging in terms of physical function — how well you move about in your space and navigate society and the built environment.
Kyle Kellams: Ideally, we're not thinking about life after 65 on our 65th birthday. Ideally, we're thinking about that in the years or decades approaching.
Gray: Sure, we should be. When I talk to my students who are predominantly 21, 22 years of age, I ask them if they want to be old. Most of them say no. The alternative is that you die young, and they also don't want to do that. So I really focus on physical activity — exercise in particular, strength training, muscular power training — as a modality to improve our physical function throughout the lifespan. Physical function is kind of like a bank. We need to build up as much as we can. We can do that through different types of exercise modalities. We can improve our physical function, our muscular power, our muscular strength much easier when we're a younger adult than we can as an older adult. But I do want to point out that it's never too late. We can always have improvements in all of those arenas.
Jamie Baum: For the average person listening, what do you mean by physical function?
Gray: The ability to live at home alone for a long period of time. If I were to define one type of functional activity that I think is the most important, it would be rising from a chair. If you can't translate your body from a chair, you probably can't live by yourself, because you can't go to the bathroom and you can't translate onto and off of a toilet. You can't drive because you can't get into and out of a car independently. That's how I personally define physical function.
Kellams: What do you do to make sure that you can rise up out of the chair? Do you need leg strength? Core strength?
Gray: All the above. Most of us think that rising from a chair only utilizes our legs. That's not true. If I were to ask you to get up from a chair right now, you'd probably put your hands on the table or on the arms of the chair. So definitely some upper body strength, definitely core strength, but also lower body strength. Power is also very important — how quickly we can move. And then once we rise from the chair, it's important that we maintain our balance and stability. We not only need to get out of the chair, but we need to move about in that space appropriately as well.
Kellams: For the last three or four years, whenever I get out of a chair, I try not to use my arms to push off.
Gray: Good for you. You're doing it right. That translates into greater lower body physical function, strength and power.
Kellams: Whether you're in your 20s, your 50s, your 70s, doing that helps deposit into that bank and makes sure that you can stay as physically independent as long as possible.
Gray: The literature says it doesn't matter what you do, as long as you continue to move throughout the lifespan. But in order to add to the bank, it really is resistive-type activity. Lifting weights is one type of activity that improves muscular strength and builds the musculature. I've built my career on muscular power, so I'm going to come back to it over and over again. It's very important for an older adult to have an adequate amount of muscular power to maintain physical independence and improve or maintain their physical function. Speed of movement is also very important, and we tend to reduce the number and volume of speed-of-movement activities we do throughout the lifespan. I'm talking about jumping, for example. When was the last time you jumped and your feet left the floor? That is a power movement, a speed of movement. It requires muscular strength, but it also requires you to move your body very quickly.
Baum: Say someone is listening to this and they're maybe in their late 40s or early 50s and have no experience with resistance training. A gym could be scary. What are some things they could safely do at home or start doing to start building their power bank?
Gray: I would say you can certainly start at home, but I would invest in a personal trainer and go to the gym and get over the fear of the equipment and learn how to set up the equipment appropriately. Once you learn the generalities of equipment, you can usually go into any gym and come up to speed pretty quickly. But if someone is so frightened that they won't go to a gym, or personal training is expensive and maybe you can't afford that, one of the things I recommend is standing without using your arms. That will improve your lower body strength. You can also be super creative in your everyday life and do resistive-type activities. Push-ups may be very difficult, but you can do wall push-ups and start somewhere and then progress with the intensity as you get a little better. Core exercises are pretty easy to do. I would also encourage folks to move to single-legged activities. You could go up on your toes starting with two feet, and then as you progress, if you don't have weights at home, you can do that on one leg and it kind of doubles the intensity that way.
Howie Hickey: Are there any resources for older adults in particular in the area, so they don't have to go to Planet Fitness with all the college students?
Gray: There are a ton in Northwest Arkansas. The Rogers Adult Wellness Center is very reasonable if you live in the city of Rogers — it's subsidized by the city. It's been a minute since I've been in that facility and known the pay structure, but it used to be $25 a year. It was very, very reasonable. There's also a program called SilverSneakers, which is funded by the federal government, and you can go into many different types of gyms — Planet Fitness would be one — and you pay $25 a month, the government pays the rest of that monthly or annual fee. There's also the Washington Regional Adult Fitness Center, I believe it's called, that is for individuals specifically over the age of 50.
Kellams: When we're talking about working with weights, how much weight should a person do? Is it the movement, the repetition? Do you need some resistance?
Gray: It's all the above, but you do need some resistance in order to improve muscular strength and build those muscles. You do need some sort of external stimuli or resistance. It drives me a little bit crazy when folks say just grab the soup cans. It's not heavy enough. That's not enough of a stimulus in most instances to cause an increase in muscular strength or improvements in function. Dumbbells are relatively inexpensive if you wanted to do this at home. You can go into Academy or Walmart or even Play It Again Sports if you want to get something used and build your own home gym.
Howie Hickey: How do you know, if you're just getting started with dumbbells, what weight is the right weight to start, and when is it time to increase?
Gray: I use a formula that has been adopted for a long time and endorsed by the American College of Sports Medicine. I usually start with eight repetitions — eight to 10, I would say you're in the right range. If you can do 50 repetitions, it's way too light and we need to increase the weight. Once someone can do eight repetitions, I usually prescribe three sets of eight repetitions. Once they can do that safely and feel like they can do a ninth or 10th rep, once they get up to 12 for all three sets, I say it's time to increase the weight. That can be tricky depending on the muscle group. If we're talking about the biceps, maybe I increase by 2½ pounds, which is a significant increase in intensity. But if we're talking about squats or leg press, we might be able to increase 20 or 30 pounds once we get to that desired set and rep prescription.
Kellams: Does the brain work the same way as the rest of your body — when you're in your 20s, 30s and 40s, are you also depositing something into a brain bank for your 60s and 70s?
Gray: Absolutely. It's called neuroplasticity — use it or lose it. We can talk about bone, muscle, brain, whatever it is. Increase neuroplasticity. The more you read, the more you do, the more you exercise actually increases your brain blood flow. There's a fair amount of literature saying that if you increase the blood flow to your brain, it can increase the good stuff and reduce the bad stuff in the brain. The more you use it, the better it gets.
Kellams: We've been told for a long time, do a crossword, do those things — and that can help.
Gray: Sure can, but the problem with that message is we say do the crossword, do the Sudoku, it doesn't matter, but once you have achieved a certain level of difficulty, you need to continue to increase that difficulty in order to still realize those improvements in brain function. It's like physical activity — use it or lose it.
Howie Hickey: You've done some work on mental health as we age, like Alzheimer's disease. Can you tell us a little more about your research or what the literature says about physical activity?
Gray: The research I've done has been more recently, over the last five years or so. We actually implemented a health education and a health coaching intervention. We followed the same folks for 24 months, and these folks had normal cognition — they did not have mild cognitive impairment, they did not have diagnoses of any dementia or Alzheimer's disease. We didn't really anticipate that we would improve their cognition, but we did over the course of two years, for both the health education and the health coaching. The health coaching had a greater improvement in cognition compared to the health education group.
Health coaching is not anything like any intervention I've ever implemented in the past. Dr. Howie Hickey — she's an exerciser. We don't have to talk to her about improving her physical activity and exercise. She knows all of those things, she's adopted that lifestyle. But maybe she needs help in other places. Maybe she eats too many French fries like I do. The health coaching intervention was really meeting the participant where they were. If they needed help with physical activity and exercise, that's where we would start. Maybe they were eating all the right things but not nearly enough protein. Or maybe they would improve by eating more fish and less red meat or fatty meats. We meet them where they were.
Kellams: What about laughing, or being with friends? Can those more ephemeral qualities help you age better?
Gray: 100 percent. In particular, social engagement. That was an important part of the health coaching intervention as well. We see it a lot with adults who transition out of the workforce — they come home and they don't have that social integration that you're forced to have in many workplaces. They retreat, they have a much smaller unit and much smaller circle. Cognition will decline, social isolation goes up, and those aspects change after a person retires. Definitely social integration and engagement is very important.
I'm a clinical exercise physiologist. I got my start in hospitals working with folks who had cardiovascular disease — heart surgeries, heart transplants, etc. We brought in a psychologist once a month. He would talk about laughter being the best medicine. Definitely laughing and having a good time and increasing those endorphins. Especially for folks who have somewhat of a negative view on things in the world today — putting those things aside and really looking at the bright side is very important.
Kellams: Trying to limit your stress.
Gray: I really appreciate the language that you use, but we can turn a negative into a positive as much as we can and really look for the good in things. There are going to be negatives in the world, but not really focusing on those so much.
Michelle Gray is director of the Department of Health, Human Performance and Recreation at the University of Arkansas. Co-hosts for the series Balance are Erin Howie Hickey, associate professor of exercise science at the University of Arkansas, and Jamie Baum, associate professor in the U of A Department of Food Science and director of the Center for Human Nutrition at the University of Arkansas. You can hear previous Balance conversations about exercise, nutrition and health here.
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