Tai Chi May Work Best to Prevent Falls in Old Age

Dennis Thompson wrote . . . . . . . .

The ancient practice of tai chi may beat strength training and aerobics for preventing falls among seniors, a new trial shows.

A modified senior-centered tai chi program reduced falls nearly a third better in a head-to-head comparison with an exercise regimen that combined aerobics, strength training and balance drills, the researchers reported.

“This tai chi program better addressed the deficits that were contributing to fall risk,” said senior researcher Kerri Winters-Stone, a professor with the Oregon Health & Science University School of Nursing.

Tai chi is a centuries-old Chinese tradition that involves a graceful series of movements. People performing tai chi flow between different postures in a slow and focused manner, keeping their body in constant motion and frequently challenging their balance.

Researchers have long suspected that tai chi can help reduce risk of falling, said co-researcher Peter Harmer, a professor of exercise and health science with Willamette University in Salem, Ore.

Annually, about 28 percent of U.S. seniors report falling, and 2 out of 5 falls result in injuries leading to an ER visit, hospitalization or death, researchers said in background notes.

“Falling in adults age 65 and older is significantly associated with loss of independence, premature mortality and big health care costs,” Harmer said.

The movements of tai chi require people to move in all directions, while traditional exercise programs focus more on forward and backward motion, Winters-Stone and Harmer said.

“The reality of how falls happen tends to be quite varied and a bit unpredictable. In tai chi, the movements are in these multiple planes,” Winters-Stone said. “You’re moving your body outside of your center of gravity and then you’re pulling it back. There’s a lot of postural responses.

“If you accidentally started to fall, if you had been trained in tai chi you would probably be better at starting to counteract that movement and regain your balance,” Winters-Stone continued.

But classical tai chi can involve upwards of 100 different movements, which can be challenging for seniors to learn, Harmer said.

So, the research team for this clinical trial developed a pared-down form of tai chi that focuses on eight fundamental movements most related to fall prevention, Harmer said. The trademarked program is called Tai Ji Quan: Moving for Better Balance.

To see how well the program works, researchers tested it against both a traditional exercise program and a control group that only performed stretching exercises.

Researchers recruited 670 Oregonians with an average age of nearly 78 and assigned them to one of the three programs. “This was a more at-risk group than we’ve worked with before,” based on both their age and screening for fall risk, Harmer said.

After six months, the tai chi group was 58 percent less likely to have a fall than the stretching group, and the traditional exercise group was 40 percent less likely to fall than people who only stretched.

Compared against each other, the tai chi program outperformed traditional exercise. People taking tai chi suffered 31 percent fewer falls than those who took strength training and aerobics courses.

“Not falling is a pretty complex physiological behavior,” Harmer said, noting that you combine muscle strength with feedback from muscles and joints, eyesight and even hearing to regain your balance. “Tai chi directly challenges the integration of all those things.”

Although tai chi did work better, people following a traditional exercise program still gain a benefit, noted Nathan LeBrasseur, a physical medicine and rehabilitation researcher with the Mayo Clinic in Rochester, Minn.

“I would not discourage people who are actively participating in a strength and aerobic exercise program to throw in the towel and say, ‘Now I need to do tai chi,'” said LeBrasseur, who wasn’t involved in the study. “The real challenge is getting people to adopt and stick to an exercise program.”

Harmer said tai chi not only improves balance, but also improves confidence.

“We’ve found a major risk factor for people falling is fear of falling,” Harmer said. “People might have had a fall. They’re scared then of falling again, so they start doing fewer physical things so they don’t fall. It kind of becomes a self-fulfilling prophecy.”

The modified tai chi program requires people to push themselves out of their comfort zone, breaking the negative cycle, Harmer said.

LeBrasseur agreed that whatever the exercise, more should be asked of seniors if they want to protect their health.

“I do think we tend to hold back across multiple exercise interventions in terms of really challenging and pushing older adults with the notion it will lead to harm and injury, when in fact it probably will drive beneficial adaptations,” LeBrasseur said.

The new study was published in the journal JAMA Internal Medicine.

Source: HealthDay

Watch video at You Tube (8:32 minutes):

Tai Ji Quan: Moving for Better Balance . . . . .

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Antioxidants Don’t Relieve Muscle Soreness After Exercise

Lisa Rapaport wrote . . . . . . . . .

Consuming lots of antioxidants through foods or supplements may not reduce muscle soreness after exercise, a research review suggests.

Researchers focused on “delayed onset muscle soreness,” the type of muscle pain or tenderness that typically peaks 24 to 72 hours after a strenuous workout. Some previous research has linked antioxidants to the prevention of cellular damage that can potentially result in sore muscles, but results have been mixed.

Data for the current analysis came from 50 studies with a total of 1,089 participants, ages 16 to 55. Across all of these studies, researchers didn’t find a meaningful connection between antioxidants in foods or supplements and the amount of muscle soreness at 6, 24, 48, 72, or 96 hours after workouts.

“The findings of our study suggest that antioxidants do reduce soreness, but the effect is so small it may not be meaningful,” said study leader Mayur Ranchordas of Sheffield Hallam University in the U.K.

“People should probably avoid taking antioxidants for recovery,” Ranchordas said by email.

Antioxidant supplements are often marketed in health food stores as a workout recovery aid. The idea that they antioxidants might ease muscle soreness after intense workouts stems from their role in potentially halting or slowing the development of what’s known as oxidative stress, researchers note in the British Journal of Sports Medicine.

As the body uses oxygen, it produces by-products called free radicals that can damage cells and tissues. The damage by oxygen free radicals is known as oxidative stress.

Foods rich in antioxidants include a variety of berries like blueberries, cranberries, goji berries and elderberries as well as dark chocolate, pecans, artichokes and kidney beans.

There are several limitations in the current analysis, including the wide variety of exercise types and intensities as well as the range of different types of antioxidant exposure from foods and supplements, the authors note.

Still, the results suggest that it doesn’t make sense for athletes to spend lots of money on antioxidant supplements to help with recovery from strenuous exercise, said Troy Merry, a nutrition researcher at the University of Auckland in New Zealand who wasn’t involved in the study.

“There are certain strategies that athletes use following exercise to improve recovery such as ice baths, massage, ensuring adequate macronutrients (carbohydrate and protein) intake during and following exercise,” Merry said by email.

“However, how much these strategies actually reduce muscle soreness is debatable, and depends on the type of exercise being undertaken,” Merry added.

The approach to recovery should depend on the type of sport as well as the intensity and frequency of exercise.

“It is also important to consider what the goal of exercise you are undertaking is, as soreness is associated with important processes that cause your muscle to adapt to exercise stress and improve its function overtime,” Merry said. “So if you don’t have to perform at your absolute best in the days following an exercise session, then some soreness is probably good.”

Source: Reuters

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Lifestyle Strategies for Reversing Prediabetes

Jill Weisenberger wrote . . . . . . . . . .

It’s Not All About Weight Loss

A shocking 84 million adults in the United States are estimated to have prediabetes. Perhaps even more shocking is that a mere 12% of them have received the diagnosis.1 The other 70 million are unaware they have a disorder that places them at increased risk of developing type 2 diabetes, heart disease, stroke, and even some types of cancer. To increase awareness, the Centers for Disease Control and Prevention and other organizations are running a multimedia campaign. Dietitians can help people with prediabetes by sharing evidence-based recommendations tailored to their specific needs.

A well-known and effective type 2 diabetes prevention strategy is weight loss. Both the federally funded Diabetes Prevention Program and the Finnish Diabetes Prevention Program showed that losing weight lowered the risk of developing type 2 diabetes among people at high risk. But not everyone with prediabetes needs to lose weight, and many individuals with extra weight or obesity don’t want to focus on weight loss. Fortunately, there are additional lifestyle strategies to reduce the risk of type 2 diabetes and perhaps even reverse prediabetes.

Eating Patterns

When the emphasis is on wholesome foods, an array of eating patterns may improve glycemia among people with prediabetes, explains Tami Ross, RD, LD, CDE, MLDE, a nationally recognized speaker, book author, and past president of the American Association of Diabetes Educators, who provides nutrition counseling and diabetes self-management education and support. Personalizing the diet plan while considering individual goals, health beliefs, culture, religion, economics, and metabolic goals is critical, she says. Below are three dietary patterns that show promise for managing or reversing prediabetes.

Mediterranean-Style Diet

A large meta-analysis of more than 100,000 participants from around the world found that those whose diets most resembled a Mediterranean style were 23% less likely to develop diabetes.2 The PREDIMED study found that after four years, those participants assigned to follow a Mediterranean-style eating pattern were 52% less likely to develop type 2 diabetes than those assigned to a low-fat diet. Though the specific foods eaten in countries surrounding the Mediterranean Sea vary by locale, this dietary pattern centers around fruits, vegetables, whole grains, olive oil, nuts, and other plant foods. In addition, clients will benefit from eating fish at least twice weekly. Wine is frequently consumed with a meal, and fruit is a typical dessert.

The DASH Diet

Though the Dietary Approaches to Stop Hypertension (DASH) diet was created and studied to lower blood pressure, ongoing research finds it beneficial for those with prediabetes. A meta-analysis of prospective cohort studies found that the DASH diet reduced the risk of developing type 2 diabetes by 20%.3 In the PREMIER study, individuals with high blood pressure who followed a DASH eating plan experienced improved fasting insulin and glucose levels as well as enhanced insulin action.4 Additional research shows that the DASH eating pattern improves dyslipidemia, lowers CVD risk, and is linked to lower risk of obesity.5 Though similar in many ways to a Mediterranean-style diet, the DASH eating plan is lower in fat and richer in animal foods, promoting consumption of fruits, vegetables, poultry, fish, nuts, whole grains, and nonfat and low-fat dairy products.

Vegan and Vegetarian Diets

Epidemiologic studies support the use of vegan and vegetarian diets in the prevention of type 2 diabetes. For example, researchers from the Adventist Health Study-2 found that vegan diets protected against type 2 diabetes compared with nonvegan diets even when they accounted for other lifestyle factors and BMI. In this study, all types of vegetarian diets offered some protection compared with nonvegetarian diets.6 Possible mechanisms for this reduced risk include greater fiber and low heme iron intakes and healthier weight status.7

Individual Foods

Though the emphasis should be on an overall healthful eating pattern, the American Diabetes Association (ADA) reports there’s evidence that eating specific foods may help lower risk. Higher intakes of coffee, tea, yogurt, berries, and nuts are associated with reduced risk of type 2 diabetes.8 Other foods have been studied for their effects on insulin sensitivity and glycemic control. Several foods with potential benefit include the following:

  • Oats and barley. These whole grains contain the viscous fiber beta-glucan, which improves insulin action and lowers blood glucose levels. As a bonus, it sweeps cholesterol from the digestive tract, lowering blood cholesterol levels and reducing CVD risk.9
  • Legumes. Studies show that diets rich in beans, peas, and lentils have beneficial effects on both short-term and long-term fasting blood glucose levels.10 Possible mechanisms include their magnesium, phytonutrients, dietary fibers, and resistant starches, which resist digestion in the small intestine and are later fermented by bacteria in the colon.
  • Nuts. Though each type of nut has a unique nutrient profile, nuts are a source of unsaturated fats, magnesium, folate, fiber, and a host of phytonutrients.
  • Berries. A Finnish study found that middle-aged and older men who consumed the most berries had a 35% lower risk of developing type 2 diabetes.11
  • Yogurt. Researchers following participants in the Health Professionals Follow-Up Study, the Nurses’ Health Study, and the Nurses’ Health Study II found that an increase of one serving of yogurt per day was associated with an 18% reduced risk of developing the disease. The mechanism by which yogurt influences diabetes risk is unclear, but it may be related to its probiotics or unique nutritional profile.12
  • Coffee and tea. The habitual consumption of either beverage is associated with decreased risks of developing type 2 diabetes. Mechanisms are unclear and may be related to the unique phytonutrients present in coffee and tea.13,14 Dietitians should advise clients to avoid common high-calorie add-ins such as whipped cream, heavy creamers, and syrups.

Moreover, the ADA states that red meats and sugar-sweetened beverages are associated with a greater risk of the disorder.8 Overall, a balanced eating pattern with an emphasis on wholesome food choices rather than macronutrient distribution appears effective in decreasing the risk of developing type 2 diabetes.

Physical Activity

Even without weight loss, moving the body helps prevent type 2 diabetes.

1. Cardiovascular exercise. The ADA recommends people at risk of type 2 diabetes engage in at least 150 minutes of moderate-intensity physical activity, such as brisk walking, each week.8 Exercise improves insulin resistance for two to 48 hours, so clients should be encouraged to exercise as frequently as possible, even if they don’t make time for the full 150 minutes each week. To help resistant or hesitant clients achieve the exercise goal, Nashville-based Lindsey Joe, RDN, LDN, a DPP Lifestyle Coach, encourages them to break it up into 10-minute sessions. “It’s amazing where you can find pockets of time if you prioritize using them for activity and not scrolling on social media,” she says.

2. Lift weights. “Resistance training is probably the most important exercise of all for anyone wanting to prevent type 2 diabetes,” says Sheri Colberg, PhD, FACSM, a professor emerita at Old Dominion University in Norfolk, Virginia. “We store most of the carbohydrates we eat in our muscles.” Resistance training builds more muscle, giving us more storage capacity for blood glucose, she says.

3. Reduce sedentary time. Even regular exercisers should avoid prolonged periods of sedentary behavior. The ADA recommends breaking up periods of inactivity with at least three minutes of walking, leg lifts, standing, or other light activity every 30 minutes. These activities stimulate the muscles to use blood sugar, Colberg says.


When time is tight, many people skimp on sleep without knowing that shortened sleep or poor sleep can harm their health. In a meta-analysis of 482,502 participants, researchers observed a U-shaped dose-response relationship between sleep duration and risk of type 2 diabetes. The lowest risk of developing the disease was associated with a sleep duration of seven to eight hours per night.15 Research suggests that chronic and acute sleep deprivation impact glucose metabolism. For example, in a small study of healthy adults, one night of sleep restricted to four hours resulted in decreased insulin sensitivity of 19% to 25%.16 Dietitians can coach clients to set goals around bedtime and look for solutions to common obstacles of getting too little sleep.

Though the majority of people with prediabetes will benefit from losing weight, it isn’t the only successful strategy for diabetes prevention or delay. Even in the absence of weight loss, healthful eating, physical activity, and other lifestyle behaviors can improve health and prevent or delay the onset of type 2 diabetes.

Source: Today’s Dietitian

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Lack of Exercise Can Boost Cancer Risk

Few Americans know that inactivity can increase the risk of colon, breast and other types of cancer, a new study finds.

An analysis of survey responses from 351 people revealed that while many knew a sedentary lifestyle increased their risk of heart disease (63.5 percent) and metabolic problems such as diabetes (65.8 percent), only 3.4 percent were aware it also adds to cancer risk.

The review also found low awareness that inactivity increases the risk of respiratory diseases (3.4 percent) and gastrointestinal conditions (0.9 percent).

The study was published in the Journal of Health Communication.

“Many people know that not getting enough physical activity can increase your chances of having heart problems or getting diabetes. However, few people realize that inactivity can also raise their chances of getting other diseases,” lead author Erika Waters said in a journal news release.

Waters is an associate professor of surgery at Washington University in St. Louis.

Researchers blamed public health campaigns that emphasize the benefits of exercise on heart health and weight control without noting that inactivity increases the risk of cancer.

They called for greater public education about the link between exercise and cancer risk.

Source: HealthDay

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Study: Older Adults Engaging in Physical Activities Have Lower Heart Disease Risk

Adults in their early 60s, who spend less time sitting and more time engaged in light to vigorous physical activity, benefit with healthier levels of heart and vessel disease markers, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

The results from increased physical activity were found to be particularly good among women.

Physical inactivity is a well-known risk factor for cardiovascular disease and premature death from cardiovascular disease. Physical activity’s protective effect is likely due in part to its impact on biomarkers in the blood that help predict atherosclerosis risk.

“The 60 to 64 age range represents an important transition between work and retirement, when lifestyle behaviors tend to change,” said Ahmed Elhakeem, Ph.D., study author and senior research associate in epidemiology at Bristol Medical School, University of Bristol in the United Kingdom. “It may, therefore, be an opportunity to promote increased physical activity.

“In addition, cardiovascular disease risk is higher in older adults. It’s important to understand how activity might influence risk in this age group,” Elhakeem said. “We found it’s important to replace time spent sedentary with any intensity level of activity.”

Researchers studied more than 1,600 British volunteers, age 60 to 64, who wore heart rate and movement sensors for five days. The sensors revealed not only how much physical activity, in general, they were doing, but also how much light physical activity, such as slow walking, stretching, golfing or gardening, versus moderate-to-vigorous activity, such as brisk walking, bicycling, dancing, tennis, squash, lawn mowing or vacuuming.

Researchers analyzed participants’ blood levels for markers of cardiovascular disease, including inflammatory markers C-reactive protein and interleukin 6 (IL-6); endothelial markers, tissue-plasminogen activator (t-PA), the molecule E-Selectin (a cell adhesion molecule that plays an important part in inflammation); and cholesterol markers leptin and adiponectin.

“We focused on these atherosclerosis biomarkers as they are less studied and have been shown to predict risk of cardiovascular events and death,” Elhakeem said.

Researchers found:

  • Each additional 10-minutes spent in moderate-to-vigorous intensity activity was associated with leptin levels that were 3.7 percent lower in men and 6.6 percent lower in women.
  • Each additional 10-minutes spent sedentary was associated with 0.6 percent higher IL-6 levels in men and 1.4 percent higher IL-6 levels in women.
  • Each additional 10-minutes spent in light intensity activity was associated with around 0.8% lower t-PA levels in both men and women.
  • Less sedentary time and greater time in low-intensity activity were beneficially related to IL-6 and t-PA, regardless of time spent at higher intensity activity.
  • Those with better cardiorespiratory fitness (based on an oxygen uptake step test) also had a healthier biomarker profile, though this effect largely disappeared after controlling for related differences in body fat.
  • Total activity volume appeared related to these biomarkers independently of underlying cardiorespiratory fitness.
  • E-selectin was the only biomarker which showed no notable associations with physical activity and sedentary time (but was related to fitness levels).

Based on the study’s findings, physical activity might lower cardiovascular disease risk by improving blood vessel function. Increased sedentary time may be adversely related to endothelial function, researchers said.

The study measured activity and biomarkers at the same time and didn’t establish whether activity influenced the biomarkers, or the biomarkers influenced activity, Elhakeem said.

To improve overall cardiovascular health, the American Heart Association suggests at least 150 minutes a week of moderate intensity or 75 minutes a week of vigorous-intensity aerobic physical activity (or a combination of the two) and muscle-strengthening exercises two or more days a week.

Source: American Heart Association

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