health

Benefits of Physical Activity in Older Adults

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Benefits of physical activity in older adults.

Longevity

The association between physical activity and mortality and morbidity is well established. A 2023 meta-analysis of large prospective studies that examined dose–response found that physical activity levels equivalent to the recommended 150 minutes per week of moderate physical activity reduced all-cause mortality by 31% compared with no physical activity.12 The authors used metabolic equivalent of task (MET), the ratio of work metabolic rate to resting metabolic rate. One MET is equivalent to the energy cost of sitting quietly. A 2019 systematic review and meta-analysis found that, among middle-aged and older adults (aged ≥ 40 yr), higher levels of total physical activity were associated with reduced risk of death in a dose–response relation, such that the most, second-most, and third-most active quartiles were associated with 0.47, 0.35, and 0.28 hazard ratios, respectively, compared with the least active quartile.13 According to a large 2019 observational study, resistance exercise is also associated with reduced mortality independent of aerobic exercise.14 Two 2022 meta-analyses found, respectively, that 60 minutes of resistance exercise per week is associated with a risk reduction of 27% in all-cause mortality15 and that muscle-strengthening activities for 30–60 minutes per week is associated with a 10%–20% reduction.16

Cardiorespiratory fitness and peak exercise capacity are associated with mortality. Peak exercise capacity is a better indicator of risk of death than established cardiovascular risk factors such as smoking, hypertension, and diabetes mellitus.17 A study examining cardiorespiratory fitness in older adults found dose-dependent reductions in mortality across all age groups (including participants aged 60–69, 70–79, and 80–95 yr).18 Substantial improvements (approximately 16%) in VO2max (an individual’s maximum rate of oxygen consumption, a strong indicator of mortality19) in older adults can occur with only 90 minutes of submaximal exercise per week over 16–20 weeks.20

Strength is also associated with reductions in all-cause mortality in older adults. A 2022 systematic review and meta-analysis found a linear inverse relation between handgrip strength and all-cause mortality up to sex-dependent thresholds (42 kg for men, 25 kg for women) in older adults.21 In their 2018 systematic review and meta-analysis, the authors found both handgrip and knee extension strength to be predictors of all-cause mortality in adults, with most of the studies examining adults older than 65 years.22 – Move more, age well: prescribing physical activity for older adults CMAJ January 27, 2025 197 (3) E59-E67; DOI: https://doi.org/10.1503/cmaj.231336

Chronic Pain? Check This Out

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Curiosity is not a curse. I’ve been expanding my knowledge base this morning.

As I have written before, the key to treating chronic pain often lies in therapies designed to dampen the brain’s response to pain signals. In treating my own chronic pain, I benefited greatly from a mindfulness therapist who helped me develop techniques to redirect thoughts and feelings of pain, push them out of my body. In my case, I met virtually with the therapist, who expertly sussed out my situation and tailored her advice to my needs. She worked at Duke University, in one of their pain clinics, and was an expert at helping people like me. This Online Program Could Be The Solution To Your Chronic Pain – https://www.forbes.com/sites/peterubel/2026/02/07/this-online-program-could-be-the-solution-to-your-chronic-pain/

Here’s the link to Telehealth and Online Cognitive Behavioral Therapy–Based Treatments for High-Impact Chronic Pain A Randomized Clinical Trial – https://jamanetwork.com/journals/jama/fullarticle/2836795 Conclusions and Relevance  Remote, scalable CBT-CP treatments (delivered either via telehealth or self-completed modules online) resulted in modest improvements in pain and related functional/quality-of-life outcomes compared with usual care among individuals with high-impact chronic pain. These lower-resource CBT-CP treatments could improve availability of evidence-based nonpharmacologic pain treatments within health care systems.

Here’s the link to the online resource quoted in the Forbes article https://mypaintrainer.org/login-to-paintrainer/

Full disclosure:

I’ve had chronic pain since 1976 (or was it 1977?) when I had a near fatal encounter with a fast moving car while walking home. I don’t take any pain medications other than the occasional ibuprofen. I have been using an online pain management resource courtesy of my employer (not the resource linked above). A DPT (Doctor of Physical Therapy) and health coach are part of the resources at my disposal. I haven’t used any ibuprofen in quite some time, if that tells you anything.

I will be exploring https://mypaintrainer.org/login-to-paintrainer/ more but at the time of this writing have not looked into their services.

Remote Work – Not The Norm

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Nearly One in Five Americans Works From Home Regularly – https://www.statista.com/chart/35389/regular-remote-and-home-office-work/

I started writing my journal in 2005. One of the best things about keeping a journal is the ability to verify if memories from the past are accurate or the made up, mashups your brain creates as memories. Here’s my entry on Monday July 24 2006:

A 4:00 PM meeting with the Division head with an HR rep present is never a good thing. I immediately thought to myself:

“This is gonna suck.”

And it did, big time. I got whacked today.

And that’s how my WFH life began. When my work from home situation arises in conversation most are surprised to learn I’ve been WFH this long. I’m surprised how long I’ve been working from home!

I am convinced due to having a low stress working environment, better diet (NO office snacks/free food/lunches out), no commute, along with a host of other variables I just might be increasing my lifespan. I do know I get plenty of sleep on a regular routine basis.

Short sleep duration (< 7 h per night) was associated with a 14% increase in mortality risk compared to the reference of 7–8 h, with a pooled hazard ratio of 1.14 (95% CI 1.10 to 1.18). Conversely, long sleep duration (≥ 9 h per night) was associated with a 34% higher risk of mortality, with a hazard ratio of 1.34 (95% CI 1.26 to 1.42). Sex-specific analyses indicated that both short and long sleep durations significantly elevated mortality risk in men and women, although the effect was more pronounced for long sleep duration in women. Both short and long sleep durations are associated with increased all-cause mortality, though the degree of risk varies by sex. Imbalanced sleep increases mortality risk by 14–34%: a meta-analysis – Ungvari, Z., Fekete, M., Varga, P. et al. Imbalanced sleep increases mortality risk by 14–34%: a meta-analysis. GeroScience 47, 4545–4566 (2025). https://doi.org/10.1007/s11357-025-01592-y

Compounding Compounds the Problem

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Compound pharmacies that bulk produce weight-loss drugs without FDA approval are doing so without that oversight.  And because compounding pharmacies aren’t required to report instances of patient harm involving their medications, problems may go undetected.“It’s kind of like ‘Whack-A-Mole,’” said Al Carter, a pharmacist and executive director at the National Association of Boards of Pharmacy. He said state boards will only investigate when they receive a complaint.“There are bad actors out there, purporting to be compounding pharmacies that are licensed in specific states or have the credentials to be able to compound when in actuality they don’t,” said Carter. “My understanding is most licensed, legitimate pharmacies aren’t compounding” weight-loss medications. ‘Compounded’ weight-loss drugs are a growing problem for state regulators – https://stateline.org/2024/07/08/compounded-weight-loss-drugs-are-a-growing-problem-for-state-regulators/

A website sold patients obesity drugs at affordable rates. Now they’re paying the price.– https://www.npr.org/2025/02/08/nx-s1-5246124/a-website-sold-patients-obesity-drugs-at-affordable-rates-now-theyre-paying-the-price

“The two main goals of the medication are weight loss and diabetes management, so patients should stay on the lowest dosage possible until they feel like they’ve plateaued,” said Charu Sawhney, DO, MPH, an internal medicine physician with Harbor Health in Round Rock, Texas. When patients move up on the dosage too fast, they’re going to have more trouble, said Sawhney. “This is when we see the most severe side effects like the malnutrition and dehydration that can sometimes land patients in the hospital,” she said. Considerations for Prescribing GLP-1s Get More Complicated – Medscape – February 07, 2025 – https://www.medscape.com/viewarticle/considerations-prescribing-glp-1s-get-more-complicated

I admit as a Former Fat Man that the world of obesity and now a miracle drug to fight the disease fascinates the hell out of me. Caveat emptor!

It’s 8:00 AM…yes, I’m Thinking About Drinking

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Alcohol use is ubiquitous in the United States, with 84% of adults reporting use at some point. Alcohol use disorder (AUD) is a serious and persistent disease at the extreme end of alcohol use that contributes heavily to the burden on the healthcare system, with more than 200,000 hospitalizations each year due to the condition. About 6% of people in the United States have AUD. However, only 7.6% of patients with AUD seek treatment, although several pharmacologic and nonpharmacologic treatment options are available. Stephen Soreff. Rapid Rx Quiz: Alcohol Use Disorder Treatments – Medscape – Dec 30, 2024. https://reference.medscape.com/viewarticle/1002119

  • Overall mortality rates increased from 10.7 (95% CI, 10.6-10.8) per 100,000 in 1999 to 21.6 (95% CI, 21.4-21.8) per 100,000 in 2020, representing a significant twofold increase.
  • Adults aged 55-64 years demonstrated both the steepest increase and highest absolute rates in both 1999 and 2020.
  • American Indian and Alaska Native individuals experienced the steepest increase and highest absolute rates among all racial groups.
  • The West region maintained the highest absolute rates in both 1999 and 2020, despite the Midwest showing the largest increase. Edited by Lora McGlade. US Alcohol-Related Deaths Double Over Two Decades, With Notable Age and Gender Disparities – Medscape – November 21, 2024. https://www.medscape.com/viewarticle/us-alcohol-related-deaths-double-over-two-decades-notable-2024a1000l98?

Nearly 500 years ago, Swiss physician and chemist Paracelsus expressed the basic principle of toxicology: “All things are poison and nothing is without poison; only the dose makes a thing not a poison.” This is often condensed to: “The dose makes the poison.” It means that a substance that contains toxic properties can cause harm only if it occurs in a high enough concentration. https://www.chemicalsafetyfacts.org/health-and-safety/the-dose-makes-the-poison/

Dry January? If you’re doing this trendy behavior you know you drank too much this past holiday season.

Cancer warnings on alcohol? No one will read them.

Trust your intuition. If you’ve ever felt like you drink too much alcohol then you do.

1-800-662-HELP or text 988 for SAMHSA’s National Helpline.

Prostate Cancer Diagnosis? Eat Less Omega-6 fats and More Omega-3 fats

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To determine whether diet or supplements can play a role in managing prostate cancer, the UCLA-led team conducted a prospective clinical trial, called CAPFISH-3, that included 100 men with low risk or favorable intermediate risk prostate cancer who chose active surveillance. Participants were randomly assigned to either continue their normal diet or follow a low omega-6, high omega-3 diet, supplemented with fish oil, for one year.

The findings, published in the Journal of Clinical Oncology, show that a diet low in omega-6 and high in omega-3 fatty acids, combined with fish oil supplements, significantly reduced the growth rate of prostate cancer cells in men with early-stage disease.

University of California – Los Angeles Health Sciences. “A low omega-6, omega-3 rich diet and fish oil may slow prostate cancer growth.” ScienceDaily. http://www.sciencedaily.com/releases/2024/12/241213211326.htm (accessed December 13, 2024)

Another reminder I should get my PSA level checked.

My Fat Cells Have a Memory

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Even after drastic weight loss, the body’s fat cells carry the ‘memory’ of obesity, research1 shows — a finding that might help to explain why it can be hard to stay trim after a weight-loss programme.

This memory arises because the experience of obesity leads to changes in the epigenome — a set of chemical tags that can be added to or removed from cells’ DNA and proteins that help to dial gene activity up or down. For fat cells, the shift in gene activity seems to render them incapable of their normal function. This impairment, as well as the changes in gene activity, can linger long after weight has dropped to healthy levels, a study published today in Nature reports.

Fat cells have a ‘memory’ of obesity — hinting at why it’s hard to keep weight off – www.nature.com/articles/d41586-024-03614-9

For the geeks, here’s a link to the original study – https://doi.org/10.1038/s41586-024-08165-7

Even without this study I already knew my fat cells have a memory because they are constantly trying to make me gain weight.

GLP-1 – Compounded or Brand-Name?

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Caroline Apovian, MD, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School, Boston.

“Doctors who are obesity medicine specialists like myself in academic centers do not prescribe compounded semaglutide or tirzepatide,” she said.

Many of the compounded prescriptions, she said, come from telehealth virtual–only companies interested in profits.

GLP-1 Prescribing Decisions: Compounded or Brand-Name? – Medscape – November 14, 2024 – https://www.medscape.com/viewarticle/glp-1-prescribing-decisions-compounded-or-brand-name-2024a1000krd?

To be clear, all of my GLP-1 posts are not anti-pharma. If you can afford these medications and they work for you on your weight loss journey that’s great. Just be aware of the possible side effects and the fact these medications are for life. You will regain all that you’ve lost if you stop taking the drug.

Here’s the link to Complications? What Complications? (just another GLP-1 receptor agonist post)

Mind The Gaps

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The Food and Drug Administration is warning consumers not to use any drugs made by a compounding pharmacy in California after regulators realized the pharmacy was making drugs that need to be sterile—particularly injectable drugs—without using sterile ingredients or any sterilization steps.

The products made by the pharmacy, Fullerton Wellness LLC, in Ontario, California, include semaglutide, which is intended to mimic brand-name weight-loss and diabetes drugs Wegovy and Ozempic. Fullerton also made tirzepatide, which is intended to mimic weight-loss and diabetes drugs Zepbound and Mounjaro. Drugmaker shut down after black schmutz found in injectable weight-loss drug — https://arstechnica.com/health/2024/11/drugmaker-shut-down-after-black-schmutz-found-in-injectable-weight-loss-drug/

I’ve read the FDA advisory. The FDA warns patients and health care professionals not to use compounded drugs from Fullerton Wellness — https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-patients-and-health-care-professionals-not-use-compounded-drugs-fullerton-wellness

  1. If you’re injecting what you believe is a weight loss medication do you pay any attention to who the manufacturer is?
  2. Do you read any of the FDA drug alerts and statements?
  3. The FDA names the compounding facility but does not name of any clinics or online purveyors who may be selling you tainted and non-sterile drugs.
  4. If you ask your online provider questions will you get honest answers?
  5. Is losing a few pounds worth the risk?
  6. Have you considered the possibility that the side effects you’re having are not just normal side effects from a GLP-1 type compounded drug and may be from an impure product?

Yikes.

Cannabis and Impaired Brain Development

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The adolescent brain is particularly vulnerable to cannabis, especially today’s higher-potency products, which put teens at risk for impaired brain development; mental health issues, including psychosis; and cannabis use disorder (CUD).  That was the message delivered by Yasmin Hurd, PhD, director of the Addiction Institute at Mount Sinai in New York, during a May 6 press briefing at the American Psychiatric Association (APA) 2024 annual meeting. 

“We’re actually in historic times in that we now have highly concentrated, highly potent cannabis products that are administered in various routes,” Hurd told reporters. Tetrahydrocannabinol (THC) concentrations in cannabis products have increased over the years, from around 2%-4% to 15%-24% now, Hurd noted. High-Potency Cannabis Tied to Impaired Brain Development, Psychosis, CUD – Medscape – May 13, 2024. https://www.medscape.com/viewarticle/high-potency-cannabis-tied-impaired-brain-development-2024a1000935

Earlier posts on this topic:

Marijuana is Too Strong (THC turbocharged)

Cannabis Use and Psychosis Risk

Cannabis Use and Psychosis Risk (Aussie Version)

Reefer Madness