Pre-Thanksgiving Giving Thanks

by Baxter

Lanterns by Melina Meza

So, it’s one day from the annual gathering of families and friends that we in the USA call Thanksgiving, and it occurs to me that I haven’t yet thanked the staff here at Yoga for Healthy Aging, all of whom do their work for you as a labor of love.

I am so grateful for the staff of YFHA! We have grown in the past two-plus years to an impressive eight people who regularly contribute to the posts that you read each week. In addition to the original crew of Nina, Brad and me, Shari Ser, PT, Timothy McCall, MD and Ram Rao, PhD regularly write posts with unique perspectives that have enriched our offerings greatly. So a big thanks to this trio of insightful and talented yogis and writers!

Bridget Frederick, our copy editor, has been going over our posts regularly with a fine-tooth comb, which those in the biz know is essential for coherent and understandable writing. She also makes it possible for Nina to take occasional time off by doing behind the scenes blog maintenance work. Invaluable! Melina Meza has generously offered to share her beautiful photos with us, and they have started to adorn many of our weekly posts. Other photographers have contributed photographs as well, including Philip Amdal, Joan Webster, and Michele Macartney-Filgate. Thanks, team—you make this adventure of love a Walton’s Family style one!

Maybe as importantly, THANK ALL OF YOU OUT THERE who read us regularly—you are a huge inspiration for the posts you read here each week! You’re now part of the YFHA family, too.

Happy and Healthy Thanksgiving to all our readers!

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Memory Loss—Meditation to the Rescue

by Ram

Yellow Leaves by Melina Meza

Alzheimer's disease (AD) is an irreversible, progressive neuro-degenerative disease that is characterized by severe memory loss, unusual behavior, personality changes and a decline in thinking abilities. Death of neurons in key parts of the brain harms memory, thinking, and behavior. Neuronal death in the hippocampus area of the brain triggers short-term memory failure, and often the person's ability to do familiar tasks begins to decline as well. Alzheimer's disease also attacks areas of the cerebral cortex responsible for functions such as language and reasoning. Thus AD patients gradually lose language skills and judgment. Personality changes, emotional outbursts and disturbing behavior, such as wandering and agitation, appear and can happen more and more often as the disease runs its course. People with AD eventually require comprehensive care, so the disease presents a considerable problem in patient management. It is believed that therapeutic intervention that could postpone the onset or progression of Alzheimer’s disease would dramatically reduce the number of cases over the next 50 years.

While mutated genes may contribute to the development of Alzheimer's, scientific evidence shows that genes are neither necessary nor sufficient to cause the disease. Environmental as well as life-style practices may also contribute to the disease progression. There is growing evidence that an epidemic of AD may be around the corner and people are rightly concerned, since it threatens to spike in prevalence as the population steadily ages. The significant growth in the population over age 85 that is estimated to occur between 2010 and 2030 (from 5 million to 9 million) suggests a substantial increase in the number of people with Alzheimer's. AD affects over 5 million Americans--there is neither a cure, nor treatment to halt the progression of symptoms. The drugs currently available to treat the disease address only its symptoms and with very limited effectiveness.

Most of us can avoid the mind ravaging effects of AD by making healthy changes in lifestyle, remaining active, achieving ideal weight, reducing stress, and in some cases, supplementing with a diet, vitamins, herbs and/or nutraceuticals that are recommended to you by a physician or licensed practitioner. The brain, like muscles in the body, requires exercise to remain strong in function. Stimulation of the brain increases the branching of brain cells that support cognitive function, and these beneficial effects can be seen in people of all ages. Thus, it is important to pursue intellectually challenging activity throughout life. Maintaining mental agility and learning new tasks as we age is will also contribute to our own well-being and independence. This was clearly articulated by Baxter in his post The Importance of Independence and Nina in her post What is Healthy Aging, Anyway? as they defined healthy aging.

Meanwhile here’s some good news for us yogis with regard to AD. A new pilot study led by researchers at Beth Israel Deaconess Medical Center suggests that the brain changes associated with meditation and stress reduction may play an important role in slowing the progression of age-related cognitive disorders including Alzheimer's disease. The authors of a new research article demonstrated that stress reduction through meditation also improves cognitive reserve.

Approximately 50 percent of people diagnosed with mild cognitive impairment—the intermediate stage between the expected declines of normal aging and the more serious cognitive deterioration associated with dementia—may develop dementia within five years. Additionally, as people with mild cognitive impairment age, there's a high correlation between perceived stress and AD. The authors wished to know if meditation reversed this process. They evaluated adults between the ages of 55 and 90 and included 14 adults diagnosed with mild cognitive impairment in the study. All participants were randomized to two groups: one group that participated in Mindfulness-Based Stress Reduction (MBSR) using meditation and yoga, and a second control group that received normal care. The study group met for two hours each week for eight weeks. They also participated in a day-long mindfulness retreat and were encouraged to continue their home-practice for 15 to 30 minutes per day. All participants underwent a functional MRI (fMRI) before the onset of the study and then again after eight weeks to determine if there were any changes in the structures of the brain or in brain activity.

The results of MRI imaging showed that the group that engaged in MBSR had significantly improved functional connectivity in the hippocampal areas of the brain that is responsible for emotions, learning and memory. Furthermore, those who practiced MBSR experienced less degeneration of the hippocampus. In addition, the data also suggested a trend toward improvement for measures of cognition and well-being.

What a cheap but effective method to reduce hippocampal degeneration and improve functional connectivity in the same areas of the brain that is affected by Alzheimer's disease! Meditation and yoga are some of the simplest intervention modalities with very little downside that may provide real promise for AD individuals that have very few treatment options. In addition to beneficial changes in the brain, yoga and meditation will stimulate the three aspects of healthy aging namely: decreased morbidity, independence and mental equilibrium (equanimity). Indeed, a very good deal!!

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Bhramari Pranayama with Mudras

by Timothy

Recently in a post (Pranayama for Everyone), I wrote about the "buzzing bee breath," Bhramari. I taught a simplified version so that people could get used to it, and feel this practice's almost immediately palpable soothing effects. A reader wrote in with a question about the mudra (in this case meaning a hand position) often taught as part of the practice. So today, I'll teach two more advanced versions of Bhramari, in which the hands are used to deepen the effects.

The fifth limb of the eight-limbed path of yoga as taught by Patanjali is pratyahara, which I like to translate as "turning of the senses inward." Most of us living in the modern world lead lives of nearly constant sensory overload. Phones ring and buzz, TVs blare in the background, and even gas pumps impose video commercials on us. It's hard to escape the visual and aural onslaught. A beautiful antidote is Bhramari, particularly when it's taught with Shanmuki mudra.

Shanmuki mudra is designed to close the gates of perception: the ears, eyes, nose and mouth. It noticeably heightens the power of Bhrmari to internalize the awareness, and you'll notice that the buzzing sounds louder. But before we try the full mudra, let's begin with a modified version.

Bhramari with Modified Shanmuki Mudra

Sit in a comfortable seated position, with the spine upright but relaxed. Place the pad of each index finger on its respective ear, on the tragus, the skin-covered tab of cartilage near the front of the ear, just above the earlobe.

Using gentle pressure, use the tragus to block sound from entering the ear. Try a few rounds of Bhramari, making a medium-pitched buzzing sound on each exhalation. Compare the effects when you occlude the ear and when you lift the fingers.

Bhramari with Full Shanmuki Mudra

In full Shanmuki mudra, instead of the index fingers, use the tips of the thumbs to push down the tragus. The index fingers exert mild pressure on the upper, inner eyelid. Be careful not to press too hard. You want the pressure to feel soothing to the eyes. The middle fingers are placed on either side of the nose, above the nostril and below the nasal bone. You'll know you're in the right place, when gentle pressure on the fingers slightly occludes the passage of air through each nostril. The ring and pinky fingers are placed on either side of the midline just above and below the lips, respectively.

Once you've successfully got the mudra in place, try anywhere from one to five minutes of Bhramari, then lower the hands. You may want to continue to sit in meditation for a few minutes after you finish.

Therapeutic Benefits

Bhramari very quickly shifts the autonomic nervous to parasympathetic dominance. The practice can be useful for anyone with a stress-related condition, and particularly when demands and sensory input make you feel overwhelmed. It may be especially useful conditions like anxiety and insomnia, and even autoimmune conditions.

If you're using Bhramari to reduce symptoms of a cold or sinus infection, either skip Shanmuki mudra entirely or only use the modified version above. Ditto if you feel claustrophobic with the mudra.

While high blood pressure can have multiple causes, many cases of so-called "essential hypertension" (which make up the vast majority of cases), are characterized by heightened activation of the stress response. Thus the regular, ideally daily, practice of Bhramari and other calming yoga techniques may be very effective both at keeping your blood pressure down, and helping reduce it if it's high.

Note from Nina: For more about the yogic approach to high blood pressure, please check out Timothy's upcoming webinar on Yoga U, at an online educational resource. It will be held on two consecutive Saturdays at 12:30 eastern and 9:30 pacific time, starting November 30, 2013. Click this link for more information.

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Friday Q&A: Kyphosis (Dowager's Hump)

Q: I teach chair yoga for older people. Several of my students have pretty bad kyphosis, a rounded curve in the upper back. They are not yet into a dowager's hump but they are on the way. When we do down dog with a chair, their upper backs are very humped. If I have them try to do cat/cow stretches with hands on the chair seat, their upper backs barely move. I have suggested that they try to lie on their backs with a small blanket roll under the bottom tips of the shoulder blades. Do you have any suggestions for how they might try to reverse this curve or at least stop it from getting worse?

A: This is an interesting question: what to do with the student who has kyphosis of the thoracic spine, the part of the spine in the area of the rib cage? What can we do as yoga practitioners to prevent the progression of the spinal changes we are seeing, and is it possible to reverse the excessive posterior curve in the upper back?  And should we be more attentive to this area when we are younger and possibly avoid this kind of change in the upper back (yes!)?

As we have discussed in the past, the normal anatomy of the spine involves a gentle, undulating set of curves from head to tail. From the backward curve of the back of the skull, as we move into the cervical (neck) spine, the spine curves forward toward the front of the body.  As we travel down into the thoracic (rib cage area) spine, there can be a natural backward curve, although in indigenous peoples and from ancient sculpture there is evidence that minimal curve in this area might be a healthier variation (see the work of Esther Gohkale). As we proceed further south and enter the lumbar (lower back) spine, the spine curves toward the front of the body once again. Finally, the sacrum curves backwards to complete the serpentine trail of the spine.

According to the Mayo Clinic website (I love these folks!):

“Kyphosis is a forward rounding of your upper back. Some rounding is normal, but the term "kyphosis" usually refers to an exaggerated rounding — sometimes called round back or hunchback. While kyphosis can occur at any age, it's most common in older women where the deformity is known as a dowager's hump.” 

Today, I am interested in kyphosis that occurs in older adults. In my experience, I have encountered this pronounced curve in both older men and women. The Mayo clinic notes that it occurs more often in women, likely due to the earlier onset of osteoporosis (OP) in women. What’s the OP connection?

The most common site of fracture in people with osteoporosis is the spine, and more specifically the thoracic spine. The typical fracture in the area is called a wedge fracture, in which the body of the vertebrae, that kidney bean-shaped biggest part becomes so thin that the front part collapses, and when seen from the side, it looks like a wedge. If you get several of the vertebrae in a row doing that, then the whole upper spine begins to bow forward like the Kokopelli image.

In some instances this will result in stiffness and difficulty maintaining an upright posture, and for some pain will also arise. Along with pain, in more severe cases of kyphosis, the change in spinal curve can affect your lungs, nerves, and other tissues and organs. So we need to do at least one important thing before we start moving these students of our reader around a lot: have them see their family doctor for an X-ray of the thoracic spine to see if fractures have already happened and get a DEXA scan to rule out OP if this has not been done. Once you know their OP status, you can make better decisions around yoga poses and practices.

Two other important factors that can contribute to kyphosis in older adults are disc degeneration (we have written about this, too) and cancer and cancer treatments (which can weaken the vertebrae and contribute to fractures as well).

Your western doctor may recommend certain treatments:

• If there is OP present, medications to treat osteoporosis might be prescribed.
• If pain is present, pain relieving meds could be recommended. 
• If the person’s condition is compressing a nerve or causing some other significant problem, surgery to fuse bones could be suggested, but the risk of complications is high and tends to minimize this option.
• Physical therapy exercises are prescribed to improve flexibility in the spine, as well as ones to strengthen the abdominal muscles to help support better posture.

Obviously, this last area, improving flexibility of the spine and strengthening abdominal muscles, is where yoga practice could be helpful.

If you don’t yet have a copy of Loren Fishman’s book Yoga for Osteoporosis and you are working with older adults, perhaps today’s the day to order it! It is a good resource of suggested poses and ways of doing them that you will likely find invaluable. A valuable piece of advice from the book regarding patience with these students is:

“Although yoga can be slow, requiring months or even years to achieve major effects, the trip is pleasant…”

So, with patience in mind, in regards to the reader’s observations, I’d suggest that for Downward-Facing Dog with the chair, if they are putting the hands on the seat of the chair, bring them up to the back rung, and if already on the back rung, do a higher version of Half Dog Pose at the Wall.

Half Dog Pose at the Wall

Let them bend their knees a bit and focus on lengthening their spines to whatever degree they can pain free. Even if not much seems to be happening in Cat/Cow pose, keep doing it anyway. I like the effect of dynamic movements like that for loosening tightness up gently. Along those lines, have them stand in Mountain pose with their backs to the wall, perhaps with the kyphosis lightly touching the wall. Then have them inhale one arm forward and up overhead and exhale it back down. Repeat with the other arm. Do several sets of these. The mere act of taking the arm overhead will begin the encourage extension of the upper back, exactly what you are looking for here, and strengthen the upper back muscles that assist in this goal. You could obviously do this sitting as well. 

If they can easily get down to the floor for Savasana, I find that no lift is needed under the thoracic spine, but a lift is definitely needed under the head so it stays level with the chest. Over-extending the neck has its own set of worries you don’t want to cause! In that reclining position, you can again have them work the arms as we did in Mountain pose.

To strengthen the abdominals, you could create a variation of Boat pose (Navasana) done sitting at the front edge of a chair, lifting one bent leg up a few inches and holding it in position for a few breaths, then lowering that foot to floor and repeating with the second leg. Again, if they can get to the floor and you can teach them Locust pose (Salabasana) or even one-legged Locust (which takes the spine into extension), you can have them do that at home or even in bed if they have a firm mattress.

One-Legged Locust Pose

I’ve already gone on a bit too long today, but I do believe that by intervening now and getting these people to practice at home as well as in class, you have a good chance of stopping the progression of the kyphosis and in some cases, where no wedge fractures have altered the anatomy, maybe even helping to reverse it! Please let us know how things go.

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Meeting Death at the Front Door

by Nina 

by Melina Meza

"Research shows that most Americans do not die well, which is to say they do not die the way they say they want to — at home, surrounded by the people who love them. According to data from Medicare, only a third of patients die this way. More than 50 percent spend their final days in hospitals, often in intensive care units, tethered to machines and feeding tubes, or in nursing homes.” —Dan Gorenstein from “How Doctors Die”

Yesterday I heard a very moving piece  How Doctors Die on NPR that made me think again about an issue close to my heart: being able to face death with courage.

My mother died of breast cancer at age 85, and she was able to die with hospice care at home without any invasive procedures, any time in a nursing home or being “tethered” to any machines. Because I was talking to her doctors for her and coordinating her care, I can testify that this was only possible because my mother was clear-eyed about her condition and was willing to admit she had a terminal condition. In fact, one of the requirements for beginning hospice care is for the patient to agree to no more potentially “curative” treatments (hospice provides comfort care only). So this means being willing to face the fact that you are dying.

The piece on NPR and the companion piece in the New York Times article How Doctors Die: Showing Others the Way made the same point. The doctors in the article were able to choose the way they died—and lived while they were in the process of dying—because their medical knowledge helped them face the truth of their situations. Realizing that her condition had become terminal, Dr. McKinley decided to turn down more treatment and to begin hospice care.

"What Dr. McKinley wanted was time with her husband, a radiologist, and their two college-age children, and another summer to soak her feet in the Atlantic Ocean. But most of all, she wanted “a little more time being me and not being somebody else.” So, she turned down more treatment and began hospice care, the point at which the medical fight to extend life gives way to creating the best quality of life for the time that is left."—Dan Gorenstein

While some people do very much want to die in a hospital, I believe that most of us do not. And to make that happen, either for ourselves or for our loved ones, we must be as clear-eyed and honest with ourselves as my mother and the doctors portrayed by NPR and the New York Times were. That takes a lot of courage.

"BRAVE. You hear that word a lot when people are sick. It’s all about the fight, the survival instinct, the courage. But when Dr. Elizabeth D. McKinley’s family and friends talk about bravery, it is not so much about the way Dr. McKinley, a 53-year-old internist from Cleveland, battled breast cancer for 17 years. It is about the courage she has shown in doing something so few of us are able to do: stop fighting." —Dan Gorenstein

How can yoga help you be brave? Of course I can’t write about my own death, but I did help both my parents die at home (and have all the clear-eyed conversations that entailed), so I know it is a very stressful process. So I expect that stress management, of whatever kind works for you, would be valuable. I tried to stay as calm as possible when I was helping my mother and found myself every day doing very long sessions of Legs Up the Wall pose combined with breath work (extended exhalation). And sometimes when I’m doing my breath work these days, I consider that this is a practice I will probably have access to until the very end. For information on various options for stress management, see The Relaxation Response and Yoga. Anxiety—which is fear of things to come—can also be a problem, and yoga can help soothe you when you’re anxious. Baxter and I have done a whole series of posts on anxiety, so see Yoga Solutions for Anxiety and check the index on the right side of the blog under the label "anxiety."

I also hope that yoga philosophy will come to my aid. The Yoga Sutras actually describes abhinivesha or “clinging to life” as one of the impediments to samadhi, describing it as inherent tendency.

Yoga Sutra 11.9 [The tendency] of clinging affects even the wise; it is an inherent tendency.  —trans. by Edwin Bryant

But the Yoga Sutras also tells us that truthfulness (the yama satya) is a crucial part of yoga practice. This is one aspect of the universal “great vow” that is the second branch of yoga.

Yoga Sutra 2. 36 When one is established in truthfulness, one ensures the fruitions of actions. —trans. by Edwin Bryant

And it seems that truthfulness—being willing to hear the truth as well as to tell it—will help you face your death and die the way you want to, and to be able to help your loved ones as they die. Just the other day a friend told me how she was trying to help a friend of hers who was dying. “But he won’t admit it to himself,” she told me. “And that makes it impossible for his friends to help him."

So it's my feeling that you have face the truth yourself. That you have to tell your family the truth. That you have to insist your doctors—and your loved ones—tell you the truth. And if you are helping someone else who is dying, facing the truth about their condition will allow you to provide them with the help they need.

In the audio version I heard, Dr. McKinley called her approach to her impending death as “Meeting Death at the Front Door.” Besides being able to do the things you love as you age (see Being Able to Do What You Love), isn’t an essential part of healthy aging being able to die the way you want?

"The front door at Dr. McKinley‘s big house was wide open recently. Friends and caregivers came and went. Her hospice bed sat in the living room. Since she stopped treatment, she was spending her time writing, being with her family, gazing at her plants. Dr. McKinley knew she was going to die, and she knew how she wanted it to go.

“It’s not a decision I would change,” Dr. McKinley said. “If you asked me 700 times I wouldn’t change it, because it is the right one for me.”

Dr. McKinley died Nov. 9, at home, where she wanted to be." —Dan Gorenstein

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Differences Between Male and Female Pelvic Structures

by Shari

This is the second part of my response to William Broad’s assertion that women—because of their inherent flexibility—are more apt to injure their hips in a “dangerous” yoga class or perhaps during a home practice. I think it is important to understand that whether or not women are more inherently flexible than men, there are significant physiological and anatomical differences in the male and the female pelvis. Have a look at these two pictures!

Female Pelvis

Male Pelvis

As you can see here, the female pelvis is typically larger and broader than the male pelvis, which is taller narrower, more compact and stable. The female pelvis is thinner and it is more mobile partly due to hormonal changes that a woman cycles through and partly due to inherent structural attributes. There is also a difference in the size of the pelvic outlet specifically due to the reproduction capacity of the female The weight-bearing surfaces of the pelvis are larger and more irregular in the male, whereas the female pelvic joint surfaces are smaller and flatter. This structural difference is specifically important in how the sacroiliac joints “lock down” to form a stable weight bearing arch linking the legs with the torso.

The way weight is transmitted through the pelvis is different with the male pelvis having a more vertical weight-bearing loading and the female having a more posterior weight-bearing load. Of interest, male pelvises are often fused after the age of 50 in 50% of males whereas only less than 1% of women’s are fused at or after the age of 50.

The acetabula are wider apart in females than in males. In males, the acetabulum faces more laterally, while it faces more anteriorly in females. Consequently, when men walk the legs can move forwards and backwards in a single plane. In women, the legs must swing forward and inward, from where the pivoting head of the femur moves the leg back in another plane. This change in the angle of the femoral head gives the female gait its characteristic swinging of hips.

So if we really want to be anatomically correct, it becomes obvious that women need to do their standing poses differently than men specifically because of our anatomical differences in our structure. In particular, it is wise to leave room for your hips in your standing poses by changing your stance. In poses such as Triangle pose, Extended Side Angle pose, Warrior 1, 2, and 3, Revolved Triangle pose, Pyramid pose (Parsvottanasana), instead of aligning your feet as we are typically instructed to (with your front heel aligned with your back arch), try widening your stance a bit by aligning your front heel with your back heel. Otherwise, if your base of support is too narrow side to side, a lot of accommodations will occur with torqueing and twisting of various body parts that could lead to injury over time.

In addition, these differences in our morphology are important because this—not just inherent flexibility as William Broad claimed—may possibly lead to more injuries for women and therefore they need to be especially careful. A post from me on Healthy Hips, which applies both to women and men, will be coming soon.

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Whey Protein increases Glucose carriers for greater muscle glycogen replenishment. By Veeraj Vic Goyaram

Supplement Research Update

Whey Protein increases Glucose transporters for greater muscle glycogen replenishment

By Veeraj Vic Goyaram

I am very pleased to report this study because it involves Glucose Transporters in skeletal muscle, the same molecules that I do research in.  In this study, researchers from the University of Campinas in Sao Paulo showed how whey protein improves glycogen (stored muscle carbohydrate) replenishment following exercise, allowing improved recovery. They showed that this happens by improved activity of glucose transporters named GLUT4 in a rat model which received whey protein following exercise.

What is GLUT4?

The main transporter of glucose in muscle is Glucose Transporter 4 (GLUT4). GLUT4 is found inside the cell in the resting state of the cell. After a meal or after an exercise bout, these GLUT4 molecules move to the surface of the cell  where they take up glucose from the bloodstream. The fact that exercise can do this is fantastic news for diabetics and exercising individuals because it means better blood glucose control and muscle glycogen replenishment, respectively. If you need more info on the topic please contact me.

In the right picture you can see that the GLUT4 molecules (stained in green) have moved to the surface of the cell following exercise or a meal. This movement allows glucose to be taken up by the cell from the bloodstream. 

What the researchers did

The researchers, Morato and colleagues had three groups of rats fed experimental diets containing  (A) Casein, (B) Whey Protein and (C) Whey protein Hydrolysate. The animals were subjected to exercise protocol (60min of treadmill running at a speed of 15m/min) and then sacrificed 16 hours later. Their muscles were taken out and analysed.

What was found and what are the implications?

• In rats fed Whey protein and Whey protein hydrolysate, GLUT4 levels on the cell membrane was higher following after exercise compared to rats fed casein. 

• This increased level of GLUT4 at the cell surface membrane allowed more glucose to be taken up after exercise for better recovery and the replenishment of muscle glycogen used during exercise.

• This research study shows the importance of taking a whey protein supplement post training although further research is needed in this topic in human athletes and in diabetics because the latter have reduced GLUT4 movement to the cell membrane.

Exercise increased GLUT4 protein levels in the muscle cell membrane in
all rats. However, this increase was more pronounced in rats fed whey protein and whey protein hydrolysate than rats fed casein

Anything you don't understand or want to know more? 

Please free to drop me a line on vicgoyaram@gmail.com. Don't go ask the wrong persons. 

Reference

Morato PN, Lollo PC, Moura CS, Batista TM, Camargo RL, Carneiro EM, Amaya-Farfan J. Whey protein hydrolysate increases translocation of GLUT-4 to the plasma membrane independent of insulin in wistar rats. PLoS One. 2013 Aug 30;8(8):e71134.

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The Importance of Independence (and Interdependence)

by Baxter

Bee & Flower by Melina Meza

Yesterday Nina dove into three key aspects of Healthy Aging, and I wanted to pick up the ball on the middle concept, that of maintaining “independence.” As Nina mentioned in her post What is Healthy Aging, Anyway?, one goal of aging well is to “continue to live independently and care for ourselves as long as possible. And Nina outlined many of the independent skills we would ideally love to preserve as time goes on: “the basic daily self care activities, such as dressing, going to the toilet, getting up and down from a chair, doing light housework, and so on as well as the ability to continue to do the activities we love.” And indeed, a regular asana practice that is appropriate for our stage of life, as well as our unique health and physical challenges, will likely keep us on track in maintaining our independence. 

As I have mentioned in previous posts, loss of independence in my patients can be one of the most dramatic and potentially devastating changes that they will face in their lifetime. The more significant the loss of function, whether physical, mental or emotional, the more likely the individual will require intensive help from others to deal with the daily issues of life, possibly requiring in-home or nursing home care to stay safe and alive while recovering or adjusting to their new reality. Anything we can do to preserve independence is really crucial the older we get.  As we discussed a few months back (see From Independence to True Longevity), the simple ability to go from standing to sitting on the floor and back to standing is also a predictor of mortality, or the likelihood of death. The study done in Brazil noted that the worse you scored on the rating scale of what we call “transfer ability,” the more likely you were to die in the six years the study lasted.

So lately in my teaching, I have been emphasizing yoga postures that contribute to the ability to get up and down from the floor with greater strength, balance and ease. Variations of Powerful Pose (Utkatasana) seem to be popping up in just about every class I teach. In my Back Care class, we even practice transferring from standing to sitting in a chair and back to standing, keeping the feet symmetric, finding the safest alignment of the spine and pelvis, and maintaining as much control of the speed of descent and ascent when sitting and standing. And because of the high rates of osteoporosis in both women and men (50% of women over 65 and 25% of men over 65), that kind of control may translate into fewer falls for those with or without OP, and fewer fractures. If you don’t fracture your hip, you are much more likely to be around in two years than if you do! 

The other place were we want to be independent is on the mental level. Maintaining mental agility and learning new tasks as we age is going to also contribute to our independence. As an online educational text from the Cleveland Clinic noted:

“Decline in cognitive abilities contributes to decline in functional independence. With normal aging, processing speed of the brain declines and recall time increases.”

The researcher pointed out that western medicine deals with this not in preventative way, but by treating conditions like dementia after they arise in a patient. As they clearly note : “Current research has been focused on treating the consequences of dementia, but no treatment modality is currently available to reverse the process or halt its progression.”

Could yoga be that modality? Something as accepted and commonplace in our culture as using a computer or smart phone can be daunting to use or learn for some as they age, but utilizing the practices of yoga that cultivate mental and emotional calmness and lower our perceived stress levels can contribute to better and faster learning skills. And a recent study has showed that meditation practice may actually strengthen the brain (see Meditation and Brain Strength). Researchers found that long-term meditators have larger amounts of gyrification (“folding” of the cortex, which may allow the brain to process information faster) than people who do not meditate.

And the ability to maintain emotional equilibrium that Nina mentioned in relation to “Equanimity” yesterday, I believe, will also contribute to overall independence. It is also important to stress that when I talk about independence, I don’t necessarily mean living alone as we age.  Studies show that men live longer when married versus single, and women tend to live longer if they have a strong support community versus being in or feeling like they are in isolation. So we are talking about having a good degree of personal independence while acknowledging the importance of interdependence and community. In fact, a 2005 study done in Israel, looked at the factors that influenced genetics in contributing to longevity in adults from 70-82 years of age.  They found that “Increased physical and social activity is an important tool to lengthen the span of robust function.” So the group dynamics and sense of community of our modern yoga classes could actually be another way to feed that social factor that can also contribute to maintaining independence as we age.

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What is Healthy Aging, Anyway?

by Nina

Dahlia by Melina Meza

It has only struck me recently that while we’ve written about what aging is and the many ways yoga can help foster healthy aging, we’ve never really addressed what “healthy aging” is. So I thought I’d take a moment to give an overview of the thoughts that Baxter and I currently have on this topic. At this point—we’re still just discussing these ideas—we consider healthy aging to have three important aspects:

• Compressed Morbidity
• Independence
• Equanimity

And the reason why we’re such proponents of yoga for healthy aging is that we believe yoga can help with all three of these aspects of healthy aging. For now, I’ll just give you a brief overview of how.

Compressed Morbidity. Last week I wrote a post Longevity vs. Morbidity comparing the difference between longevity and morbidity. The medical term “morbidity” refers to the period of time you spend in ill health before you die. Obviously we all would like—both for ourselves and for our loved ones—to keep this period of ill health as short (that is, compressed) as possible. A well-rounded yoga practice, especially one that includes stress management, can help by preventing some of the diseases, such as heart disease, high blood pressure, and diabetes that plague people during their older years.

Independence. Another goal I think we all share for ourselves and our loved ones is that we can continue to live independently and care for ourselves as long as possible. From our point of view living independently includes both the basic daily self care activities, such as dressing, going to the toilet, getting up and down from a chair, doing light housework, and so on as well as the ability to continue to do the activities we love (which I wrote about in my post Being Able to Do What You Love) for as long as possible. A regular asana practice—even one that is modified over time—will help keep us able bodied, rather than sliding into the stiffness and weakness that results from a sedentary lifestyle.

Equanimity. For me, maintaining emotional stability as we age is the most important aspect of healthy aging. For even if we can “compress” morbidity, we will certainly have to go through poor health at some point. And even if we can prolong our independence into old age, we may eventually have to face the loss of that, however briefly. In addition, even if we are ourselves blessed with long and healthy lives, we’ll all have to deal with losing people we love. So being able to handle the challenges ahead with balance and grace is crucial. But I also believe that this is where yoga has its greatest strength. Stress management practices help reduce stress, anxiety and depression. And meditation and yoga philosophy can help us keep grounded and strong. At least that is my fervent hope.

Baxter and I will be writing more on these topics in the weeks to come, but we’d also love to hear your thoughts, ideas and personal stories.

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Caffeine allows you to get more reps and feel less pain. By Veeraj V. Goyaram

Supplement Research Update

Caffeine: Less Pain and More Gain.
By Veeraj V. Goyaram

In this edition of our Supplement Science Update Bodybuilding Mauritius brings you a latest scientific study which further backs the efficacy of Caffeine as a workout booster. It is interesting to note that most caffeine-performance studies were done with aerobic-type exercise and it is nice to see some studies that concern us, iron enthusiasts. The study I report here was done in people who lift!

Duncan and colleagues from Coventry University in England looked at what caffeine, taken at 5mg/ kg body weight, does to:

a. The number of reps performed until failure is reached.

b. The perception of pain while repping to failure.

Findings:

a. More reps thanks to caffeine: For the four exercises tested (bench press, deadlift, prone row and back squat), caffeine allowed participants to get more reps until failure (19.6±3.7 and 18.5±4.1 respectively in caffeine and placebo groups). 

b. Less pain perceived: the perception of muscle pain was also lower in the caffeine group in all exercises. The the scientists among you I am including this nice little graph below. 

Add caption

Some important lessons:

• Caffeine is a great resistance training booster. That is why most preworkout supplements have caffeine as the main ingredient. Most of the other ingredients are just for show on the labels. I said most, not all.  

• Caffeine works by reducing the perception of pain.

• 5mg/kg of Caffeine may be a bit high for certain people. The authors accept that they must look at smaller doses. You must also experiment to find your appropriate dose. 

• If you don't have the cash for expensive preworkout formulas (neither do I), get hold of coffee or inexpensive caffeine tablets. 

Click to read larger abstract. Email me if you want full article

Reference

Duncan MJ, Stanley M, Parkhouse N, Cook K, Smith M. Acute caffeine ingestion enhances strength performance and reduces perceived exertion and muscle pain perception during resistance exercise. Eur J Sport Sci. 2013;13(4):392-9

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