Osteopath and Lifestyle Medicine Coach Ed Paget shares his expertise on how to avoid – or reverse – the midlife health slump and weight gain. I'm now firmly in middle age.From the little hair I still have, I can see it's gray; there are a few wrinkles around my eyes, but I'm the same weight as I was when I was 21, maybe even a little lighter. The same is different for my friend group. The 'spare tire' seems to get bigger yearly, and the health complaints keep mounting. Most think it is an inevitable part of aging, but, as I'll explain below, it isn't inevitable; it isn't due to genes, falling testosterone levels or getting older.
What happens as we get older?
From a physiological point of view, our ability to gain muscle decreases as we age.If we don't actively seek to keep them, our muscles will tend to waste, and the scientific term for this is sarcopenia. Decreased muscle mass means we need less energy, which can also change our body's ability to handle sugar. Muscles are a great way to use sugar quickly; less of it means excess sugar will be converted to fat. We will gain weight if we don't match our caloric intake with our caloric needs. As we discover, extra fat can produce hormones, and the added stress of middle-aged responsibilities can dysregulate our normal hormonal rhythms. These are the confluence of factors that lead to the "dad bod." Simply put: Decreased muscle from inactivity plus no change or increased calories consumed equals more fat storage.Add to this the stresses of middle age, and we have hormonal dysregulation, high blood pressure, decreased mental well-being, and a host of other physical and psychological problems that affect men in their 40s, 50s, and 60s.But there is good news—these five tips have been well-proven to reverse these physical and mental changes; we need to follow them.
1. Get Moving and Stay Active
A sedentary lifestyle significantly contributes to weight gain even when we don't lose muscle. Put bluntly, the World Health Organization (WHO) estimates that physical inactivity is responsible for around two million deaths annually. It warns it could be among the top ten leading causes of death and disability worldwide. Regular physical activity reduces the risk of cardiovascular diseases, diabetes, obesity, and mental health disorders.Actionable Tip: Start with small, achievable goals to incorporate more movement into your daily routine. Simple actions like doing one press-up or squat a day or taking a five-minute run to build a habit of regular activity. The 19th-century athlete Walter George spent long hours working as a pharmacist and, as a result, couldn't train. Instead, he started running on the spot between customers. He attributed this training method to his success. He held the world record for running the quickest mile, which wasn't beaten for 30 years!
2. Embrace Strength Training
To counteract muscle loss, we need to do something involving resistance. That means moving something that isn't easily moved, like a weight or band. Not only does it help with weight management, but it also improves balance and coordination and keeps the hormones running just fine. Compared to men in their 20s, only a tiny percentage of middle-aged men meet the recommended guidelines for muscle-strengthening activities. This can be due to the busyness of work and family commitments. However, I always questioned people about how busy they were, and after 20 years of coaching, I usually found a time that people could exercise. Actionable Tips:
Incorporate strength training into your daily routine without needing a gym.
Keep weights around your home and lift them during phone calls or whenever you pass by.
Lift your children or someone else's…ok, maybe not, but you get the idea.
Simple exercises like squats and lunges can also be done at home; make it a habit. Strength training just twice a week can significantly improve muscle mass and overall health.
3. Moderate Your Alcohol Consumption
Many middle-aged men shift from binge drinking in their youth to more consistent, daily alcohol consumption. In a recent interview on my podcast, Your Lifestyle Is Your Medicine, I interviewed Kevin Smith (45), who was drinking five days a week and feeling the spread of middle age. He had an epiphany about two years ago when he realized his groggy mornings were why he was seeking out bad food and not going to the gym. Once he cut back and stopped drinking, he had the energy to change his diet and go to the gym. He joined a Cross Fit gym, and he's been there ever since. Now, he's the strongest he's ever been while rocking the body of a 20-year-old. Actionable Tip: What Kevin did is not for everybody. Many people believe that giving up alcohol may seem like social suicide, but the group "One Year No Beer" advocates a more moderate approach, limiting your alcohol intake to special occasions and avoiding making it a daily habit. They are also an excellent resource for those wanting to re-examine their relationship with alcohol. Also, with the advent of decent-tasting non-alcoholic options, not drinking doesn't mean not socializing.
4. Pay Attention to Food Labels
Like my old science teacher told me, this is boring but important. The modern food environment is filled with ultra-processed foods (UPFs) high in fat, sugar, and salt. These foods might lie at the core of our current obesity and heart disease epidemics. Our brain is wired to seek sugar, salt, and fat. When we were evolving, these foods were in short supply but provided essential calories and nutrients for survival. We still have the legacy of our more primitive brain coupled with our ingenious ability to satisfy it…and turn a profit at the same time. Unfortunately, these highly addictive foods are marketed aggressively and can contribute to weight gain and other health issues.Actionable Tip: Make a habit of reading food labels and choosing whole, minimally processed foods. Prepare meals at home using fresh ingredients, and be cautious of foods with long ingredient lists or those high in additives. Prioritizing nutrient-dense foods over convenience options can significantly improve your diet. It might sound a little preachy, but finding time to cook with fresh food is one of the best things you can do for your body. If you genuinely have no time, there are some great resources to become more efficient, with companies like 'Hello Fresh' in the UK, delivering fresh food to your house or 'Dashing Dishes' offering meal kits for pick up in Canada.
5. Maintain Mental and Social Health
A study in the British Medical Journal found that cognitive decline can begin as early as 45, meaning that we have to keep our brains active as we age. Interestingly, the better we are at something, the less we use our brains. For example, a 2003 study in NeuroImage agreed with other studies when it showed that professional musicians used a smaller area of their brain than amateur musicians to play music. This means the mental effort it takes to learn music or even a language is more significant than playing or speaking when you are fluent. The act of leaning stimulates the brain. Actionable Tip: Engaging in mentally stimulating activities like puzzles and board games will help but as Dr Tommy Wood, associate professor of Neurology at Washington University, recently said on my podcast, it doesn't compare to learning something new like a language or dance. Along with training the brain, we should maintain social connections by scheduling regular meetups with friends or joining clubs and community groups. Activities that combine physical and mental engagement, such as playing sports or attending classes, are particularly beneficial. I've noticed a massive uptake in a game called Pickleball in my community. I've seen people who had a myriad of health complaints, from high blood pressure and reflux to high cholesterol, get the medical all-clear by losing 10lbs and running around a bit. Middle age doesn't have to mean inevitable weight gain and physical decline. By staying active, incorporating strength training, moderating alcohol consumption, making mindful food choices, and maintaining mental and social health, men can defy the myth of unavoidable middle age spread and enjoy a healthier, more vibrant life. Remember, the key is consistency and making sustainable lifestyle changes.References
World Health Organization. "Physical Inactivity: A Global Public Health Problem." WHO.
Britton, Annie, and Steven Bell. "Alcohol Consumption and Health Outcomes: Evidence from the UK." University College London, 2023.
Singh-Manoux, Archana, et al. "Timing of Onset of Cognitive Decline: Results from Whitehall II Prospective Cohort Study." British Medical Journal, 2012.
Kleber, B., Birbaumer, N., Veit, R., Trevorrow, T., & Lotze, M. (2003). The musician's brain: Functional imaging of amateurs and professionals during performance and imagery. NeuroImage, 20(3), 1817-1829
Podcast: your Lifestyle Is Your Medicine
Unlock the Power of Walking: Heal Back Pain and Improve Scoliosis
Are you tired of dealing with the fatigue that comes with persistent back pain or struggling with scoliosis? A solution may be as simple as changing the way you walk. This comprehensive guide will explore how incorporating specific walking techniques can alleviate discomfort and improve your overall spinal health.
The Key to Efficient Walking
Most people with back pain find walking tiring quickly, indicating that their walking technique could be more efficient. The reason for this is how our bodies are designed to move. Proper walking is all about getting the right joints to move in the right order and at the right time.
The Importance of Hip Mobility
One of the most significant joints in the body is the hip. If the hips aren't working well, the rest of the body struggles to compensate, pushing movement up into the lower back and putting strain on the upper back. This transference of movement particularly affects the L5-S1 joint, as it is the smallest joint that is close to the hip. By focusing on improving hip mobility, we can unlock the key to more efficient and pain-free walking while taking pressure off your lower back.
Rediscover the Natural Sway of Your Hips
When we walk, our hips are meant to have a natural sway, a movement that is often understated in many cultures. This means that wiggling your hips is usually frowned on. However, this way is essential for maintaining good foot, knee, and hip health. The body naturally stops hip movement if you are injured or have joint pain, like arthritis, but this comes at a cost. When this natural sway may be absent, it can lead to a stiff, rigid walking pattern, which is inefficient and leads people to fatigue more quickly.
Unleash the Wiggle in Your Hips
To restore the natural sway in your hips, try this simple exercise:
Start by stepping forward with one leg (like taking a first step) and then putting the opposite hand forward. For example, step your left leg forward and put your right arm forward. This is the basic set-up for walking.
Push your hip down on the side of the rear leg, hiking up on the other. This will create a lateral tilt to your pelvis, along with a slight rotation and extension.
Take the next step forward and repeat the movement, alternating sides as you walk. Imagine you are a catwalk model, and you have to move your hips. Keep your head up and chin tucked in. If that doesn't work for you, google Olympic Speed walking, and you'll get an idea of the hip movement I'm talking about.
I show exactly how to do it in this video:
Perform this exercise for 10 meters, then return to your regular walking pattern. Repeat this sequence several times during your walk. Over time, you'll notice your walking becoming more fluid, and you may experience reduced back pain and scoliosis-related discomfort as your hips loosen up.
Consistency is Key
Incorporating these walking techniques into your daily routine can profoundly impact your spinal health. Commit to practicing the hip sway exercise for 4-6 weeks, and you should notice a decrease in fatigue while walking, increased mobility in your hips, and potentially less pain in your knees or ankles.
Work with me
If you have specific concerns or would like personalized guidance on managing your back pain or scoliosis, I invite you to send me a message via the Contact Us page or connect with me directly via email, Instagram, or Facebook. We can create a tailored plan to help you achieve your goals and live a healthier, pain-free life.
Remember, small changes in your walking habits can significantly improve your overall well-being. Embrace the power of proper walking techniques and take the first step towards a healthier, more energetic you.
Preventing Falls and Fractures in Older Adults: A Whole Person Approach
On a recent visit to see my elderly mother, I began to think about her risk of falling. Falls and fractures are significant health concerns for older adults, particularly those with osteoporosis. I’m sure you have heard stories, as I have, about an otherwise fit and healthy elderly person falling, losing their independence, and never quite recovering again.One of my mentors once said that aging can be seen as a series of accidents or events, like torn muscles and fractures, that reduce function and which is never gained back. However, the right strategies can significantly reduce the risk of falls and subsequent fractures. Here, I discuss effective measures based on best practices in geriatric care.
Understanding the Risk
Osteoporosis is a major contributor to fractures among older adults. According to the Bone Health and Osteoporosis Foundation, about 10 million Americans have osteoporosis, and 44 million have low bone density. This makes bones more fragile and susceptible to fractures, even from minor falls. Women and men are both affected, with one in two women and one in four men experiencing an osteoporosis-related fracture in their lifetime.When someone finds out they have osteoporosis, they are usually told to exercise a little more with some resistance or weight and given medication. Common medications include bisphosphonates and denosumab, but these have risks, which include bone fracture and bone death, which is not really what you want from a medication that is meant to make bones stronger.
How about focusing on falls rather than bones?
I don’t know if my mother has osteoporosis, given her age (86). She probably does, but the NHS in the UK isn’t an easy system to navigate, and we will not find out anytime soon.However, balance is a trainable skill, and better balance can help prevent falls. How do we put that into practice?
Practical Steps to Prevent Falls and Fractures
1. Comprehensive Mobility Assessment:We start with a thorough assessment of an older adult’s mobility, including evaluating gait and balance. This is where allied health professionals such as osteopaths, physios, chiros, and PTs play a crucial role. We can assess, identify deficits, and prescribe simple balance and mobility exercises to help a person improve. These can be as easy as repeatedly getting someone to step forward and backward with one leg. This pivot-type movement involves strengthening and mobilizing the standing leg while challenging balance. One, this is easy for older adults. Different head or arm movements can be introduced to challenge more of the ‘kinetic chain’ and other proprioception. 2. Home Environment Modifications:Simple changes at home can prevent falls:
Install grab bars in bathrooms.
Remove loose rugs and other trip hazards.
Ensure adequate lighting in all rooms and stairways.
Use non-slip mats in the shower and bathtub.
3. Use of Assistive Devices:Encouraging the use of walking aids, such as canes or walkers, can significantly reduce fall risk and provide a quick visual cue for others to watch out for. Education is critical, as some older adults may initially resist using these aids, feeling they signify a loss of independence. However, understanding that these devices can prevent falls and maintain mobility is crucial, and using an aid in unfamiliar environments can be very beneficial.4. Medication Management:Not only do we have to look critically at the medications for osteoporosis, but certain other medications can affect balance and coordination. It is essential to review all prescriptions, especially psychotropic drugs, with healthcare providers to adjust dosages or find alternatives that pose less risk.5. Vision Care:Regular eye exams and proper vision correction can help prevent falls. Poor vision can lead to missteps and accidents, so it's critical to address any vision problems promptly. Lack of lighting and not wearing glasses can also be significant problems.6. Addressing Medical Conditions:Conditions such as postural hypotension (a drop in blood pressure when standing up), heart rate irregularities, and other chronic illnesses should be managed carefully. These conditions can contribute to dizziness and falls, so regular check-ups and tailored treatments are necessary.7. Education and Awareness:Educating older adults about fall risks and prevention strategies is vital. This includes understanding the unpredictability of falls and the importance of precautions like modifying environments, lighting, and the judicial use of aids.
Conclusion
Preventing falls and fractures in older adults requires a holistic approach that addresses physical, environmental, and medical factors. By following this simple framework and implementing practical measures such as mobility assessments, home modifications, and medication management, we can significantly reduce the risk of falls and enhance the quality of life for older adults. If you have elderly family members, make sure you work with them to keep them independent as they age.
Unlocking the Key to Thyroid Health: Beating Hashimoto’s and Thyroid Disorders
Dr Stone and I sat down to talk about everything thyroid. You can watch the video here or listen to the podcast hereThis is what I learned:The thyroid is a small, butterfly-shaped gland at the neck's base. This gland plays a crucial role in our overall health and well-being. It produces hormones that regulate our energy levels, metabolism, and even our mood. When the thyroid functions properly, we feel energized, maintain a healthy weight, and experience a sense of emotional balance. However, when the thyroid is not working as it should, it can lead to troubling symptoms.
Hypothyroidism: When the Thyroid Underperforms
Hypothyroidism, or an underactive thyroid, is a common condition that affects millions of people, particularly women. When the thyroid gland doesn't produce enough of the essential hormones T4 and T3, it can result in a range of symptoms, including low energy, weight gain, anxiety, depression, constipation, and hair thinning. Traditionally, the medical approach to hypothyroidism has been to prescribe synthetic thyroid replacement medication, such as levothyroxine or Synthroid, to supplement the body's natural thyroid hormone production.
The Limitations of the Traditional Approach
While thyroid replacement medication can be helpful in some cases, it often fails to address the underlying causes of hypothyroidism. Many patients find that even after taking these medications, their symptoms persist or worsen over time. This is because the root of the problem may lie in an autoimmune condition called Hashimoto's thyroiditis, which is responsible for up to 98% of hypothyroidism cases.
Hashimoto's Thyroiditis: The Autoimmune Connection
Hashimoto's thyroiditis is an autoimmune disorder in which the body's immune system mistakenly attacks and damages the thyroid gland. This ongoing assault on the thyroid can lead to a gradual decline in its ability to produce sufficient hormones, resulting in hypothyroidism. Interestingly, Hashimoto's is often accompanied by other autoimmune conditions, such as lupus, Sjögren's syndrome, or rheumatoid arthritis.
Addressing the Root Causes
To effectively manage Hashimoto's and hypothyroidism, it's crucial to address the underlying factors that are driving the autoimmune response. This requires a more comprehensive, functional medicine approach that looks beyond just the thyroid and considers the whole body. Some of the key factors that can contribute to Hashimoto's and hypothyroidism include:
Insulin Resistance and Blood Sugar Imbalances: this is because chronic high glucose and insulin levels can trigger the immune system and exacerbate autoimmune conditions. (1)
Adrenal Dysfunction: Chronic stress and burnout can impair the adrenal glands, leading to hormonal imbalances that impact the thyroid. (2)
Gut Health Issues: Leaky gut, dysbiosis, and other gastrointestinal problems can contribute to developing autoimmune disorders. (3)
Environmental Toxins: Exposure to heavy metals, mold, and other toxins can trigger an autoimmune response and disrupt thyroid function. (4)
Food Sensitivities: Certain foods, such as gluten, dairy, or soy, can cause inflammation and further aggravate the immune system in those with Hashimoto's.(5)
A Personalized Approach to Thyroid Health
A personalized, holistic approach is essential to effectively managing Hashimoto's and hypothyroidism. This involves comprehensive testing to identify the underlying triggers, followed by a customized treatment plan that addresses each individual's unique needs. The plan may include dietary changes, targeted supplements, stress management techniques, and other lifestyle modifications to support the body's natural healing processes.
The Power of Lifestyle Interventions
While medication may play a role in managing thyroid dysfunction, the real key to long-term health and wellness lies in addressing the root causes through lifestyle interventions. This is a key piller of my philosophy by using "You Lifestyle As Your Medicine". By optimizing factors like blood sugar levels, adrenal health, gut function, and environmental exposures, many individuals with Hashimoto's and hypothyroidism have been able to significantly improve their symptoms and even achieve remission of their autoimmune condition.
Embracing a Holistic Approach to Thyroid Health
The journey to optimal thyroid health is not a quick fix but a lifelong commitment to self-care and wellness. It will involve experimentation and persistence, but by understanding the complex interplay between the thyroid, the immune system, and the body's various systems, we can empower ourselves to take control of our health and find lasting solutions to even the most stubborn thyroid problems. With the proper support and guidance, it is possible to overcome the challenges of Hashimoto's and hypothyroidism and reclaim a vibrant, healthy life.I hope you found this information helpful. If you want my help to see if we can use specific exercises and lifestyle medicine to help you recover from pain, injury, or illness please reach out to me via ed@edpaget.com
"Oh My Gosh- I am ALREADY feeling relief after a few days! I used to wake up 2-3 times a night with shooting pain that anti inflammatories couldn't touch. Now I have been waking up just because I want to notice what it feels like to lay in bed pain free- THANK YOU!."
Sue Plumtree
"When I first started with your program I was experience a lot of pain. Walking was difficult. I had to stop and catch my breath every few minutes and lean against a wall for support. Now when I walk with my husband we go for over an hour. I never had to sit down and stop...and, hardly any pain!!! 😊😊 I can’t thank you enough."
