What We Mean By Healthy Aging

by Nina

Melitta teaches "Granny Yoga" to her mother,  aunt, and aunt's friend

For us, the life story of our friend Melitta’s mother Nancy is a perfect example of “healthy aging.” Born in San Francisco on December 12, 1921, Nancy died on August 27, 2015, age 93 (or 93 and a half as she liked to say). She was very active all her life. She played sports in school, and was her high school and college track and field champion in shot put and discus. She loved skiing, sailing, hiking, horseback riding—all things outdoors. She even worked as a wrangler at ranches around California. 

Even in her last years, she walked three miles every morning with her walking buddies Elaine and Ellen, power walking along the beach and greeting the other regular walkers. She did have some back problems with spinal stenosis, so Melitta gave her a yoga mat and some back care yoga poses to do. Nancy did them faithfully every morning, and was so pleased that they really improved her back.

Nancy also loved traveling, and during her lifetime, she traveled around the world, visiting every continent. In 2011, she returned to her favorite country, Turkey, and traveled around Eastern Turkey. In 2012, she did her last safari in Africa, and then gave up long haul travel, though she continued to travel within the US to spend time with family. She volunteered at her church until about age 91, and had an amazing network of friends and family. 

She lived independently in her apartment until her last few days. At age 90, she had made her own decision to stop driving. Although she didn’t have any hired help, her friend Elaine, a true force of nature, looked in on her regularly (and considered it an honor to do that). Elaine also helped her by taking shopping after she stopped driving and would send her husband Lloyd over to help her with tech stuff, such as her computer and printer. 

It was only in the last year of her mom’s life that Melitta noticed her mom was slowing down. She and Melitta did discuss her fear of decline, and Melitta’s fear of her decline. She had some gallbladder issues, and in July 2015 she had a bile duct blockage and had surgery. Then, in August 2015, she had emergency surgery for gallstones, but she also developed sepsis. She was in ICU for four days, and although doctors "threw all the antibiotics" they could at her, her organs were failing, so the family followed her directives and discontinued care. When Melitta first got to the hospital, Nancy was still conscious but unable to speak because she was intubated. In the joking way they had with each other, Melitta said, "it must be bad if I am here." Nancy laughed as best she could. She died two days later, with her children holding her as she moved on. 

In our post What is Healthy Aging, Anyway?, we defined what we mean by "healthy aging," describing its three basic components:

Compressed Morbidity. This is the time out of your life span that you spend in ill health. Nancy had a lifetime of excellent health, with some slowing down and her only serious problems limited to her last year of life. (This is generally the best-case scenario for people who live as long as she did.)

Independence. This means not just being able to live on your own, but being able to continue to do the activities that you love and that give your life meaning. And Nancy was not only able to stay in her home until the end of her life, she was able to keep up her active life almost until the end, including walking on the beach with her friends, traveling, volunteering at her church, and spending time with friends and family.  

Equanimity. This means being able to face difficulty and handle challenges with balance and grace. Although there’s much we don’t know about her life and how she faced earlier challenges, we think it’s worth considering how Nancy dealt with the challenges of being older. It sounds like she faced them head on! She realistically decided to stop overseas travel and driving when the time was right. And she was able to discuss her fears of decline and to confront her death. That allowed her to leave directives for her family and to die on her own terms. Finally, being able to laugh at her daughter’s joke at the very end sounds like she was she was able to stay engaged in life and family for all her days. How beautiful!

Thanks, Melitta, for sharing this story with us.

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Free-cycling vs. Recycling Books on Aging

by Nina

In my neighborhood, we’re big into free-cycling. For those of you who don’t know what that means, for us in Berkeley free-cycling means putting things you no longer want or can’t use—clothes, household goods, knickknacks, books, CDs, furniture, etc.—on the sidewalk so that anyone who wants them can simply pick them up and take it home. I’m both a giver and taker (have found some interesting things!), but mostly a giver. I’m so dedicated to this practice, that it almost hurts me to actually just recycle something (or, God forbid, throw something out). In fact, when a friend of mine was downsizing recently due to a divorce and I heard that she was planning to her old books to the dump, I begged her to give them to me so I could “get rid” of them for her by free-cycling them. And indeed as odd a collection of books as it was—old, new, fiction, non-fiction, obscure, common, young adult, super sophisticated.—it only took a matter of days before those hundreds of books were completely gone. 

So when Brad came home the other day with a stack of books on aging that a colleague of his had left behind, I sorted them into two piles: 1) scientific books about mechanisms of aging that I wanted to keep and 2) mass market books on “how to stay young forever” that I intended to free-cycle. Now if you’ve read our posts about aging you might be able to guess why I didn’t want to keep those stay young forever books. As I said in my post, What is Aging, Anyway? 

“if someone out there tells you they can “stop” or even “reverse” aging—I've heard both claims myself—you should be very skeptical. Because right now with so much unknown about aging, there is no proof that any of these anti-aging solutions are effective (and, in some cases, like overuse of certain supplements or human growth hormones, they could actually harm you).” 

And, of course, the very person who helped me understand the importance of that message and encouraged me to spread it was none other than my husband, Brad (aka Dr. Bradford Wayne Gibson), who for 16 years studied aging as a medical researcher at the Buck Institute for Research on Aging.

Anyway, after making my two stacks, I checked with Brad to see whether he agreed with my assessment. He gave me the thumbs up, except when I went to take the “how to stay young forever” books outside for free-cycling, he quickly grabbed them away from me. He said, “Oh, no, you don't. I don’t want ANYONE to read those books” and he tossed them all into the paper recycling bin. Whoa. I was shocked for a moment, but then the importance of his action really struck me. Yes, the irresponsible snake oil about aging that is written and published by people out to make a quick buck really does deserve to be reduced to a pulp. 

On Friday the recycling truck took away all the stay young forever books for processing, and one day soon they’ll have promising new lives as fresh, blank paper.

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How We Age

by Baxter and Nina

"And you may find yourself

Behind the wheel of a large automobile

And you may find yourself in a beautiful house

With a beautiful wife

And you may ask yourself, well

How did I get here?" — from “Once in a Lifetime” by the Talking Heads

All living things age, and every species has a natural, built-in life span. Although a giant tortoise and koi carp can live up to 200 years, the average life span of a human being is around 79 years, a cat lives to around 20, a dog to around 10, a mouse to around 2 years, a worm to only 10-30 days, and the legendary mayfly only a single day. But, no matter how brief, all these living things go through a natural aging process during their life spans (yes, even worms get all wrinkly in their old age), similar to the ones that we ourselves go through.

Life Span of a Worm by Arvind Ramanathan

So what exactly is this natural aging process? Many of us have been able to observe the entire arc of the process as we raised our family dogs. Do you remember something about how it went for Fido?

At the age of two, Fido was a young, healthy adult, with tons of energy, good eyesight, keen senses of smell and hearing, and a shiny coat. He was able to learn and remember quite a few commands, like “sit,” “down,” “fetch,” and “off.” His mind was alert and attentive to you and his environment, and there was an obvious delight in new discoveries and exploration. 

But by the age of five, Fido was already entering middle age, and his energy and vitality were probably noticeably slower. Although he still loved to go on those long hikes with you, you may have noticed that he was bounding less and just focused on maintaining a steady pace. And when he jumped up onto the couch or bed, he wasn’t quite as spry. There were other changes, too, like maybe his digestion wasn’t what it once was or he started having trouble with bladder control. And with his immune system beginning to age, maybe your once super healthy dog started experiencing more illness or infections.

By the age of eight to ten—depending on his size—Fido had become an old dog with a gray muzzle, heading into his final years. His energy and vitality were reduced even more, and though he still loved to go out and sniff things, those long hikes were a thing of the past. And he walked more slowly and stiffly, too, as his strength, flexibility, balance, and agility began to wane, and perhaps arthritis set in. His respiratory functioning diminished, so when he was very active, he became short of breath. And his keen hearing and eyesight also began to worsen (dogs even get cataracts, as do we). 

You might have needed to take Fido to the vet more often at this stage, as he developed more frequent infections or chronic illness, or any number of age-related conditions, such as heart problems, diabetes, digestive issues, obesity, or cancer. Perhaps even Fido’s mind wasn’t what it once was. He may have developed symptoms of cognitive dysfunction, such as confusion or disorientation, restlessness at night, loss of house training, decreased attentiveness, or not recognizing friends or family members.

Eventually the really sad part came, when you had to say goodbye. Fido died while you were still young, probably of a fatal illness, such as cancer, an overwhelming infection, or just heart failure due to old age. Yes, we know, it was a bit difficult to witness, wasn’t it? After Nina’s family dog died, her mother said there would be no more family dogs because the thought of going through that whole thing again was just too painful. But remembering it now will help you understand quite a lot about how humans age, something we’ve been getting into a lot lately on the blog (Your Immune System and Aging, Balance and Aging, Flexibility and Aging, and Aging Changes to Your Brain and Nervous System, among others).

As for why this happens, well, that’s a whole different story. See What is Aging, Anyway?

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Latest Info on Muscle and Bone Strength!

by Baxter and Nina

Strong Dream by Paul Klee

Just as the natural aging process affects all organs, structures, and systems of your body, aging also affects the strength of both your muscles and bones. Because both your muscles and bones contribute to your overall strength, loss in one is typically associated with loss in the other, so it’s equally important to actively maintain the strength of both. Fortunately, using yoga to maintain your muscle strength will help with bone strength and vice versa.

For our long-time readers, it’s true we’ve written about how aging affects strength a few times before. But recently, due to Nina’s fortuitous meeting with an expert in sarcopenia and age-related muscle loss, Dr. Christopher Adams (see Age-Related Muscle Loss: An Interview with Dr. Chris Adams), we realized that most of what we’ve written in the past wasn’t quite accurate. So this is our official redo! We hope this information clarifies things for you. What hasn’t changed, however, is our understanding of how effective yoga can be for maintaining both muscle and bone strength as we age. And Chris told Nina he had recently become convinced that he should start practicing himself!

Muscles

We have over 640 muscles in our body, and starting as early as our thirties, these muscles gradually lose strength. This natural aging process, called “skeletal muscle atrophy,” causes your muscle cells and fibers to become smaller and weaker, leading to a loss of muscle mass, quality, and strength. The rate at which we lose muscle strength varies from person to person, and is also influenced by:

• Behavioral factors. Working at a sedentary desk job or not exercising are the most obvious behaviors that contribute to loss of strength over time, although these can be counteracted by becoming more active.
• Genetic factors. Your body type can influence how weak you become with age, due to the natural size of your muscles when you are younger. If you tend to have larger muscles as a young adult, you simply have more muscle mass to lose as you age before you become weak. On the other hand, if you’re someone who tends not to bulk up easily, without intervention, you may become weaker more quickly as you age. Although you cannot change your body type, if you have not already started to do so, you can begin building up your muscles now as a preventative measure. Yoga’s strength building poses and techniques provide an excellent way to do this (see Techniques for Strength Building with Yoga). All things being equal, men and women likely have a similar rate of loss of muscle strength as they age, that is until women reach menopause, at which time the more rapid loss of bone they experience (see below) contributes to greater loss of muscle strength as well. So at that phase of life and even leading up to it, women need to be particularly focused on maintaining muscle strength.
• Environmental factors. Scarcity of healthy food (malnutrition, for example, worsens skeletal muscle atrophy) and environmental toxins are the most obvious environmental factors that can contribute to loss of strength, so if possible, try to keep yourself protected.

Although skeletal muscle atrophy is caused by aging itself, other factors, such as muscle disuse (sedentary lifestyle, joint injuries, arthritis, strokes), certain illnesses that affect nerve and blood supply to muscles or have other negative effects on muscles (diabetes, cancer, and chronic infections like HIV/AIDS, to name just a few), and medications that can weaken or damage muscles (such as prednisone and chemotherapy agents) can accelerate this process. So if you have any of these conditions, using yoga to address them—whether that means by simply start to move again or by actively improving your health, such as improving diabetes control through stress management and exercise—could slow down loss of strength over time. 

Sarcopenia. For some people—whether due to illness, long-time inactivity or just very advanced age—loss of muscle mass can become a serious problem if it falls well below the average muscle mass of the general population. This advanced stage of skeletal muscle atrophy is sarcopenia. Sarcopenia is the disease stage of skeletal muscle atrophy, just as osteopenia and osteoporosis are two disease stages of aging-related bone loss. 

Naturally, this serious loss of muscle mass—which is accompanied by significant muscle weakness—is something we want to avoid if at all possible because serious muscle weakness is of the main factors that can lead to loss of independence, not to mention of enjoyment of activities that you love. Fortunately, gentle forms of yoga can help even very elderly and weak people regain strength.

Bones

We have 204 bones in our skeletons and, like our muscles, those bones undergo changes as we age. Bones slowly and gradually become thinner and weaker as we age, though it is only when they reach a certain degree of thinness that a you are at greater risk of a fracture from a fall or prolonged poor postural habits (for example, wedge fractures in the thoracic spine). The rate at which we lose bone strength varies person to person, and is influenced by:

• Behavioral factors. The same behavioral factors that have a negative effect on muscle strength—such as working at a sedentary desk job or not exercising —contribute to bone loss over time, although these too can be counteracted by becoming more active.
• Genetic factors. Your body type can influence how weak your bones become with age. Some people just naturally have thinner bones, so they have less bone mass to lose before bones become weak and brittle. And for women hormonal changes during menopause accelerate the rate of bone loss, which is why more women develop osteoporosis after their fifties. Although you cannot change your body type or gender, if you have not already started to do so, you can begin strengthening your bones now as a preventative measure. Yoga’s strength building poses and techniques provide an excellent way to do this (see Techniques for Strength Building with Yoga).
• Environmental factors. The same environmental factors that have a negative effect on muscle strength—such as scarcity of healthy food and environmental toxins—can contribute to bone loss, so for both muscle and bone strength, try to keep yourself protected.

Osteoporosis. While everyone’s bones thin somewhat as they age, for many people, due to advanced age, illness or medications, or menopause for women, bone thinning can reach a critical point, called osteoporosis. At this stage, the bones are more vulnerable to fractures, which can then be slower to heal due to the bone’s thinness. (Osteopenia is the stage of bone loss just before full osteoporosis, when you are already starting to be at risk for fractures from falls, but not to the same degree as with osteoporosis.)

Because body type and gender influence how weak bones become with age, smaller-boned people and women in general are at greater risk of developing osteoporosis at younger ages than those with thicker, bigger bones or men. However, for people over 65, developing osteoporosis is very common, with up to 50% of women and 25 percent of men developing it. 

For those with osteoporosis, the bones of the thoracic spine (your mid-spine) are at greatest risk for fracture, followed by the wrist bones and the femur bone (thigh bone) in the hip joint. These fractures can lead to ongoing chronic pain, physical disability, and, particularly with hip fractures, premature death. Naturally this is something we’d all like to avoid. Fortunately, yoga strength building poses and techniques can actually reverse bone loss (see Techniques for Strength Building with Yoga) , and practicing yoga balance poses is helpful for preventing falls (see Techniques for Improving Balance).

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How You Feel About Aging

by Nina

 “Scientists are discovering something very peculiar about aging: How we feel about getting old matters. A lot. In test after test, researchers are finding that if we think about getting older in terms of decline or disability, our health likely will suffer. If, on the other hand, we see aging in terms of opportunity and growth, our bodies respond in kind.” —Anne Tergesen from “To Age Well, Change How You Feel About Aging.”

I think we all understand that the tendency of media to portray only thin, young white females doing yoga is not a good thing, as it makes people who don’t fit into that limited category (most of the world’s population!) feel as if yoga might not be for them. And, of course, that’s sad because this stereotype of who can do yoga means that a lot of people who could benefit from the practice will be missing out. But now I’ve learned that these kinds of stereotypes can be particularly harmful to older people. According to a recent article in the Wall Street Journal To Age Well, Change How You Feel About Aging (which cited several scientific studies), negative stereotypes about aging affect the beliefs of older adults about the aging process, potentially causing them to do serious harm to their health without realizing it. 

“Scientists aren’t sure exactly how holding negative stereotypes affects health, but they say it’s clear that there is a connection, and it isn’t simply correlation. In test after test, negative stereotypes have been shown to lead to poor health results. Over the past two decades, dozens of studies from psychologists, medical doctors and neuroscientists have shown that older people with more negative views of aging fare more poorly on health than those with less-pessimistic attitudes.

“Even when study participants have similar health, education levels and socioeconomic status, those with more negative outlooks about aging show greater declines in a variety of areas over time. They have shakier handwriting, poorer memories, higher rates of cardiac disease and lower odds of recovering from severe disability, according to studies by Prof. Levy. They are less likely to eat a balanced diet, exercise and follow instructions for taking prescription medications as they age. They even die younger—the median difference in survival rates is 7.5 years.”

Well, all that certainly makes me feel good about our ongoing photo contest, showing people over 50 doing yoga (see Photo Contest Open for All People Over 50). But, of course, a single photo contest isn’t going to counteract the negative stereotypes of older people we are bombarded with on a daily basis, whether it’s through exclusion (lack of older women in Hollywood movies, for example) or through portrayals that show older people as ridiculous or incapable. So what can we do about this?

The Wall Street Journal article actually provided four steps for counteracting these negative stereotypes. Because each step relates directly to a yogic concept or technique, I’m going to summarize the steps for you here, adding my own interpretations about how they relate to yoga (see  To Age Well, Change How You Feel About Aging for complete information on the steps). 

1. Understand the myths vs. the facts. Rather than simply accepting received wisdom about what getting older means, you should actively inform yourself. In yoga, educating yourself is an important aspect of svadhyaya, or self study (see The Power of Svadhyaya (Self Study), Part 2). On our blog, we’re providing you with a wealth of information about what is known about the aging process and how yoga can help foster healthy agiing. But reading more general information about aging and health elsewhere seems like a good idea. I was interested to read in “To Age Well, Change How You Feel About Aging,” that “our moods, relationships and overall sense of well-being actually can improve with age, as can knowledge and certain types of intelligence.” I know that this had been my own experience, but it was good to learn that other older people in general have similar experiences.

2. Recognize stereotypes in everyday life. Because we are bombarded by negative views of aging without being aware of it (the ads during a football game come to mind), paying attention is an important way to lessen the impact. So if you haven’t been observing this phenomenon, start by noticing. The next step is to become more aware of your own thoughts about older people and aging. This is another form of svadhyaya (see The Power of Svadhyaya (Self Study), Part 1). Use your witness mind to observe your thoughts regarding aging, particularly noticing the stereotypes you yourself have regarding aging and whether you tend to blame things automatically and reflexively on age. 

3. Substitute positive images for negative stereotypes. After you’ve noticed the negative stereotypes in the culture at large as well as in your own mind, you can actively counteract them by intentionally searching for better role models, whether they are older family members or friends or people in public eye. This step directly ties into the yogic concept of pratipaksa-bhavanam, or cultivating the opposite, which I discussed in my post The Biochemical Basis for Gratitude:

II.33 Upon being harassed by negative thoughts, one should cultivate counteracting thoughts. —translated by Edwin Bryant 

Here’s are some photos to get you started. 

Nonnina Victoria, Age 101

George Boskoff, Age 90

Or, maybe you just need to look in the mirror. I’ve seen your photos, yoga friends, and you’re all looking pretty wonderful.

4. Accept the aging process. Of course, it is also important not to expect an entirely positive experience of aging because that is as unrealistic as expecting only a negative experience, and so is bound to bring difficulties. As Anne Tergesen put it, “The key is to hold both positive and negative in balance and really understand and own the aging process.” That sounds like the niyama santosha (contentment), which TKV Desikachar defined as:

“Contentment or the ability to be comfortable with what we have and what we do not have.” —TKV Desikachar

See Yoga Philosophy: Contentment for information about cultivating contentment.

Interestingly, according to Anne Tergesen, one good way to cultivate contentment with the aging process is by exercising. She cites a 2012 study Views on aging and emotional benefits of physical activity: Effects of an exercise intervention in older women that showed exercise can cause people feeling better about the aging process, saying, “These women were more physically fit, more alert and had better executive functioning. The positive experience of exercising affected their well-being and improved attitudes about aging.” So practicing asana, which tends to make people feel good in general, is also going to help you feel better about the aging process.

Fighting the negative stereotypes in our culture about aging and older people isn’t necessarily an easy task. But, fortunately, as you can see, yoga provides a wealth of options for helping us to feel differently about aging, including our asana practice as well as mindfulness practices, cultivating the opposite, and contentment practices.

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The Worm & Fly & Science Problem

by Nina

Just a part of NY Times Diagram

As some of you may know by now, my husband, Dr. Brad Gibson, is a medical researcher who works at a research institute where the focus is on aging and age-related diseases. So I hear about a lot of studies that claim to have discovered this or that supplement or food that will slow aging or lengthen our life spans. We are often quite skeptical, especially when we learn about how the studies were done. Because it is expensive and time-consuming to test human beings (and sometimes unethical), these studies are often done on worms and flies. And concluding that the effects are going to be the same on human beings is rather a stretch. 

I was motivated to write about this today after seeing a wonderful graphic in the Sunday New York Times in the article A Handy Guide to Longer Living Through Science! (I'm pretty sure the title is ironic.) I actually started to laugh when I read that the study that proved green tea extends life was done on flies (and the one that proved that it won’t was done on mice). A lot of the other studies on supplements were done on worms.

There’s a reason for this. Worms and flies have very short life spans and also visible signs of aging. Yes, older worms get quite wrinkly, for example. So it’s easy to change something about their diet and then see an obvious result, either in a longer-than expected life span or some other physical change. But does that mean the same thing would happen in a human? 

Brad says:

"I suppose its no accident that the artist who created the graphic used a "mouse maze" of conflicting, supporting or just plain absurd experimental results that have been published in the last three years alone to illustrate the disarray of lifespan research. While we all would have our favorites, for example, "worms live longer in outer space" or "men decrease women's life spans" (sorry, dear), these studies point to several underlying assumptions (or misassumptions) about how scientists go about studying longevity or health span. For one, we use a number of model organisms, with worms, flies and mice being the favorites. This is obvious to anyone thinking about conducting such a study, as these animals live anywhere from a couple of weeks to 2-3 years at most. Two, as we compare results of similar regimens across these organisms, we get a lot of contradictory results—maybe not a huge surprise. However, the more troubling truth is that even when we use the same model organism, the results can be very different (Rapamycin slows aging in mice, Rapamycin doesn't slow mice aging). The reasons behind this are complex, but could be due to differences in mouse strain, or the lab they are raised in (different gut microbiome!). My read on this? Here goes: avoid gimmicky lifespan-increasing supplements and drugs and, of course, get plenty of exercise like yoga, as all studies seem to indicate a big beneficial effect in daily exercise." 

So have fun looking at this graphic summary of recent studies on aging. I myself was thrilled to see that the study that showed coffee extends life was done on humans! But wait—there was another study done on humans that shows coffee decreases life spans. Sigh. 

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Yoga May Slow Age-Related Changes in Healthy Adult Men

by Baxter

The Three Ages of Men by Giorgione

I am always excited to have good news to share with my male students about how yoga can improve their health, and when recently I learned about a study done in India that looked at yoga’s potential beneficial effects on aging for healthy men, I decided to check it out! I first read about the study “Age-related changes in cardiovascular system, autonomic functions, and levels of BDNF of healthy active males: role of yogic practice” on a web site. (I’ll get to what BDNF is in minute!) The web site discussed the findings of the study, but only positive information about the study presented and there was no mention of any limitations of how the study was done or whether its design would allow for us to draw comparisons to large groups of adults doing yoga. To me, this was a bit of a red flag. On the one hand, I was excited to see a study done that was checking blood chemicals, EKGs, and other signs of stress related to aging. Because I wanted to know more about the study, such as the actual number of participants and how long they were followed and if there was any long term follow up, I went the source, the actual paper itself. (Although you can’t access the paper yourself, you can find the abstract here.)

The first sentences of the abstract for the study gave me a good starting point on why the researchers were doing the paper. My translations of the scientific language into more accessible terms are in brackets.

“Aging is associated with decline in cardiovascular, autonomic function, and brain-derived neurotropic factor (BDNF). [this is what we know from present research on aging] Reports are scanty regarding whether yoga can improve age-related degenerative changes in healthy active men. [this is what we don’t know yet] This study is designed to appraise the role of yoga in improving age-related degenerative changes in cardio-metabolic risk profile, autonomic function, stress, and BDNF. [this is what scientists plan to look at] 

And I have to say that these researchers checked a lot of stuff in the participants to assess their goals—quite impressive! But how did they choose the men in the study? These were their criteria:

“Inclusion criteria included (1) normal healthy and physically active male; (2) absence of disease which could have contributed to obesity, hypertension, and neurological disorders; (3) not on medication; (4) no prior knowledge of yoga; and (5) smokers, alcoholics, and tobacco eaters (in India, where the study was done, they eat tobacco!) were excluded from study.” 

This seems reasonable: healthy, active men who have not done yoga before. However, one immediate problem was the small number of men in the study, only 60 in total. The authors looked at three groups of healthy men, 20 in each group, with age ranges of 20-29, 30-39, and 40-49. This is a concern because the smaller the numbers of participants, the less compelling the results of any study are. 

In studying this group, the scientists checked a variety of data related to aging, including blood tests for quite a number of markers, such as cortisol, and a brain substance called BDNF, or brain-derived neurotropic factor, which normally drops as we age. (BDNF is a key mediator of neuronal plasticity in adult, adult neurogenesis, and brain aging.) “Blood samples were collected in the morning after overnight fasting before and after 3 months yogic practice for biochemical estimation.” And the results are quite encouraging! Heart-, metabolic-, and neurologic-related aging changes were better in their study group.

So how much yoga and what kind of practices were these men doing? I was curious about what the yoga practice looked like: was it a simple beginner practice, and was it well rounded in poses, breath work and meditation?

According to the paper, “In addition to their routine activities, participants practiced one hour of yoga for 3 months in the morning with ambient temperature under supervision of qualified yoga instructor.” And here is what they did:

Table 2 Details of yogic module

Cleansing processes (2 min)

Kapalbhati (Rapid shallow breathing) 

Yogasanas (yogic postures): Total of 40 minutes

Suryanamaskar (sun salutation in 12 different postures, 1 round)

Padmasana 

Yogamudra

Matsayasana

Suptapavanmuktasana

Pavanmuktasana

Paschimottanasana

Vajrasana

Suptavajrasana

Gomukhasana

Sarvangasana

Halasana

Karnapedasana

Bhujangasana

Shavasana (relaxed supine posture)

Pranayama (breathing exercises): Total of 10 minutes

Bhastrika (forceful expulsion of breathing)

Anulom-vilom (alternative nostril breathing)

Bhramri (producing buzzing sound of bee with closed ear and lips)

Meditation: Total of 8 minutes

Omkar meditation (Om Chant)

Total session 60 minutes.

Although this protocol includes poses, breath work and meditation—a good balance—I’m concerned about the poses they practices, which are all symmetrical poses and are either forward bends or backbends, with no twists or side bends included. And many of the poses are intermediate ones, which someone unfamiliar with yoga might have trouble with, such as full Lotus, Shoulderstand and variations, and Reclined Thunderbolt pose, to name the most obvious. This could limit the applicability of this particular practice for the general population. 

To their credit, the authors do cite some of the limitations of the study, including the lack of control group (a control group is a similar number of healthy active men that did not do yoga and were evaluated with the same tests-this study does not have one): 

“The present study suffers from some limitations that need to be acknowledged and addressed. One of these is the relatively small sample size in each group. An additional limitation is that this study is a single-arm study without any separate control group.” 

And their final conclusion is also fairly accurate: 

“Based on the results of the present study, it may be concluded that the aging process has an active role on degenerative changes in cardio-metabolic risk factors, autonomic functions, and monoamines as well as levels of BDNF, which may revert back towards normal or near-normal levels through yogic practice in healthy active males. (bold is mine)” 

But the limitation that they did not mention is that we only know what the effect was at the end of three months of practice. We don’t know if these beneficial findings would be persistent at 6 or 12 months, let alone after 1, 2, or even 5 years. And would there be any persistent benefits if someone lapsed in their yoga practice or only did yoga two times a week? As with almost any yoga study I read these days, I am on the one hand encouraged by the positive results of this one for giving healthy men some compelling reasons to take up yoga, and on the other hand am reluctant to sound the horns of triumph until larger follow-up studies support these initial findings. And that, sadly, costs a lot of money to do! Any billionaires out there looking to support some good works in the world?

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Friday Q&A: Aging Muscles, Bones and Joints

Adam and Eve by Lucas Cranach the Elder

Q: You all have been writing a lot about muscles and bones lately. I was wondering, how exactly does aging affect our musculo-skeletal system? And how can we influence the aging process with yoga and our lifestyle choices?

A: The process of aging affects our musculo-skeletal system in several particular ways. As I have written about previously, as muscles age, especially after about the age of 50, we start to lose muscle mass in a process called sarcopenia (see Strength and Aging). Sarcopenia is considered a normal part of the aging process, one that can lead to visibly smaller skeletal muscles—the ones that move our body and limbs around—which are then also going to be weaker. It is usually a slow, gradual process, but unchecked could lead to a point in a person’s life when the weakness could negatively impact his or her daily activities. According to an article Aging changes in the bones – muscles – joints from the National Institutes of Health: 

“Changes in the muscle tissue, combined with normal aging changes in the nervous system, cause muscles to have less tone and ability to contract. Muscles may become rigid with age and may lose tone, even with regular exercise.”

The body’s soft tissues tend to mostly made of water, and as we age, we also gradually experience a decrease in the amount of water in the muscles and the connective tissues (fascia and tensions) that surround the muscles and attach them to the bones, as well as the ligaments that connect bones to bones. As these changes occur, these structures become more brittle, less resilient and more likely to suffer injury, such as, strains and sprains. And because these structures don’t have a very good blood supply to start with, repair and recovery is typically slow, and slower as we get older. Other important soft tissue structures, such as the intervertebral discs between the vertebrae bones of the spine, and cushions, such as the meniscus in the knees and the labrum in the hip and shoulder joints, also suffer the same changes and the same potential for injury and degeneration. 

The skeleton, which is made up of over 200 bones, also undergoes changes as we age. Most commonly, the joint surfaces between the mobile joints can suffer wear and tear over a lifetime of use. The connective tissue barrier known as cartilage that coats the ends of each bone to make it slippery and cushioned can gradually thin out and leave the underlying bone exposed and sensitive to inflammation. This is commonly referred to as osteoarthritis (see Yoga for Osteoarthritis), an extremely common aging-related problem that can actually start at about any age, especially in those who use their bodies intensely for sports and work activities. 

Finally, the bones can begin to thin and lose density as we age, making them more vulnerable to fractures, which can then be slower to heal due to the abnormally thin bones. Thinning of the bones (osteoporosis) is extremely common in women over 65, with up to 50% developing it, and surprisingly common in men as well over 65, at 25% incidence. The bones of the thoracic spine (your mid spine) are at greatest risk for fracture, followed by the wrist bones and the femur bone (thigh bone) of the hip joint. Fractures from osteoporosis can lead to ongoing chronic pain, physical disability and, particularly with hip fractures, premature death. 

These factors and others, such the connection between the muscles and the neurologic system, can also lead to changes in posture and balance, which can also increase the chances of injury over time. An increase in general stiffness and pain can also arise with combinations of the above changes. 

On a brighter note, it has been noted in aging athletes, specifically long distance runners and cyclists, who maintain good cardio-vascular and respiratory function may see improved endurance in their sports compared to when they were younger! Here is a case where long term participation in physical activity pays off in improved function, not decline. This speaks directly to what we can do with regards to our lifestyle choices that can positively influence these changes of aging: stay active!  Regular exercise, modified to accommodate body changes such as arthritic joints or thinning bones, can help to slow, stall and even reverse many of these conditions. And for our purposes here, yoga can be an ideal standalone practice for some conditions, such as sarcopenia, and great in combination with other health practices for others, such as with osteoporosis or arthritis (which might also require medications and mineral supplements, for example). Eating a healthy diet and drinking adequate amounts of water to fuel and hydrate the body, and by extension these parts of the musculo-skeletal system, is another wise choice. 

For further information, check out these posts from our archives:

• Yoga for Strength: An Overview 
• Yoga and Flexibility: An Overview
• Healthy Bones for Men and Women Alike
• What is Osteopenia? How Can Yoga Help?
• Yoga for Osteoarthritis

—Baxter

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What is Aging, Anyway?

by Nina

Death and Life by Gustav Klimt

We all experience aging as we move through time, from that first gray hair to the need for reading glasses or a twinge of arthritis to more dramatic changes. Eventually our bodies just don’t work as well as they did when we were young. (A formal definition of aging is “the process of a system’s deterioration over time.”) But have you ever wondered what causes aging? Or why human beings have the life span that they do? After all, a worm lives for only 10 days, a mouse for one or two years, and a dog typically over 10 years. Some kind of clockwork causes all living things to gradually age—yes, even worms get wrinkly when they get “elderly”— according to an apparent built-in schedule. But why does this all happen? And is there anything we can do about it?

When Dr. Bradford Gibson first joined the Buck Institute for Research on Aging, he was looking forward to finding the answers to those questions. Much to his surprise, he discovered that there are many different and often conflicting theories of aging. He had somewhat naively assumed that there must be some general consensus on the basic questions of how and why we age. But, he says:

“As I examined theories such as the free radical theory of aging to antagonistic pleiotrophy, it became readily apparent that this was still early days of this discipline. While many of the processes described in these competing theories seemed plausible, they couldn’t all be correct. So working in this field was going to be much more confusing— and interesting — than I had originally imagined.”

Since you might have read about telomere shortening or caloric restriction in the news, here’s a list of some of the theories of aging that Dr. Gibson confronted when he first joined the Buck Institute (with the ones he currently thinks most likely to be important in bold).

• Wear and Tear theory
• Error and Repair theory
• Neuroendoncrine theory
• Redundant DNA theory
• Genetic Control theory
• Free Radical theory
• Caloric Restriction/Nutrition
• Cross-Linking
• Waste Accumulation
• Gene Mutation
• Limited No. of Cell Divisions/Telomere Shortening
• Rate of Living
• Hayflick’s Limit theory
• Order to Disorder (entropy)
• Death Hormone
• Thymic-stimulatory theory
• Mitochondrial theory
• Autoimmune theory
• Antagonistic Pleiotrophy

That’s quite a list, isn’t it? But that’s not all; newer data have emerged in the last few years that have shown the importance of stem cell maintenance, modifications to your DNA (epigenetics), and senescence-associated inflammation as playing key roles in the aging process. I’m sharing all this with you for a couple of reasons. First of all, if someone out there tells you they can “stop” or even “reverse” aging—I've heard both claims myself—you should be very skeptical. Because right now with so much unknown about aging, there is no proof that any of these anti-aging solutions are effective (and, in some cases, like overuse of certain supplements or human growth hormones, they could actually harm you). And, second, I want to set your expectations. This blog has always been about healthy aging, never about stopping or reversing aging.


I’m going to be defining “healthy aging” and writing more about what it means in future posts, but, for now, you can check out my post Longevity vs. Morbidity (Ill Health). 

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