Full text of nutritionist and exercise physiologist Dr. Stella Volpe’s talk: “Exercise and nutrition for middle-age and older individuals” at TEDxSJU conference. In this talk, Dr. Volpe points out that it is never too late to start becoming an active and healthy individual. We just need to face that fact that exercise and eating habits are the best of attaining that.
Dr. Stella Volpe – Nutritionist and exercise physiologist
Hello everyone. It’s a real honor to be here at Saint Joseph’s University as part of the TEDx conference. So today my talk is a little bit different than Dean’s but it still has to do with nutrition and exercise. And basically it’s going to focus on nutrition and exercise in the older adult.
But some of the things I’ll talk to you about will apply to everyone in this room.
So with aging… and all of us are aging, that’s one thing we can’t actually stop… is there are things that are negative and positive that occur in our bodies and both play… both nutrition and exercise play a key role in preventing some of the things that aging… you know that occur with aging.
And one thing I’d like to make sure I say is that aging is not a disease. So so often people say well I’m older now and I can’t do this or that. And I really like to say that I think it’s because maybe they got old too fast. So we shouldn’t be stopping doing things just because we’re getting older.
And I’m still a competitive athlete in several sports and I’m not up here to talk about that. But one of the newest sports I brought into my life was just four years ago and that’s playing ice hockey.
So just so you know it’s OK to keep trying new things because that gets us cognitively challenging and also physically challenging.
So some of the things I first like to talk about are the changes that happen both in fitness and the metabolic profile, before I go on to just a couple of studies that we conducted in our lab with individuals of an older age.
And so with older individuals who exercise, the good news is is that exercise can help stave off some of the negative impacts of aging. So unfortunately, at the age of 40 or so that some of the things that happen there just is called sarcopenia where we start to lose some muscle mass. But we can prevent that if we continue to exercise both in strength training as well as aerobic training.
And some of the… you know if you continue to exercise as you get older, yes you might lose about 10% of what’s called your VO2 max or that’s the measure of aerobic fitness, a maximal oxygen consumption. But you can decrease that if you continue to exercise.
Some evidence, also maintaining habitual physical activity can decrease disease. And something else just add, I’m talking about exercise here in planned exercise. But activities of daily living also count. So taking the stairs instead of the elevator is really an important part of what we can do.
As a matter of fact, couple of studies show that if they asked people in their office building just to take the stairs and asked half of them just to continue using the elevator, that’s the only thing they changed in their lives, that those who took the stairs improved their aerobic fitness significantly compared to those who did not.
So even in my office building when I go up 12 flights, people like you’re not taking the elevator, I said well as long as my legs work I will continue to use them.
So some of the things that change too with older exercisers they typically have the same type of profile as people as younger counterparts as people in their 20s and 30s. And when I say older that can be defined very differently but from about the age of 40 on.
And also blood sugar or blood glucose levels can be better maintained when people exercise and eat well and things like your lipid profile, your total cholesterol in your blood, your good cholesterol in your blood, those are better in folks who exercises versus those who don’t.
So one of the studies we did in our lab was we recruited people who were overweight and obese that they were older. And we implemented this diet and exercise program with them.
So first let me tell you that the aim of the study was we wanted to see if they would lose weight based on our exercise/diet program. And so… and we measured a bunch of things. But I’m going to just talk about a couple of the things that we measured.
But the design of the study was a pretty basic one. We recruited about 90 overweight and obese sedentary individuals. They were about 40 some or so years of age and they had a body mass index of about 31. So most of them were overweight, not so much obese.
And what we did was we randomly assigned them to either a diet group an exercise group or a diet plus exercise group. And the diet group, we didn’t put them on a special diet; we didn’t give them special foods. I just taught them about heart-healthy eating.
And the exercise group… they got these Nordic myths track ski machines which some of you are too young to know but they’re these ski machines that use your upper and lower body. And we supervised all of their exercise programs. So they came to us… they started it three days a week and built up to five days a week for 30 minutes a session.
And then after six months, those in the two exercise groups… the exercise group and the diet plus exercise group were given those Nordic tracks to take home. And so then we would follow them up to see if did they continue with that exercise.
I will tell you that a lot of them did not but from our measurements of at nine and twelve months, so we measured them 0, 3, 6, 9, and 12 months, and mind you we measure their body fat; we measure their lipid levels; we measure their dietary intake.
But this is the change in body weight in women and you can see that in women at about six months and nine months there was a significant decrease in their body weight in the diet plus exercise group; sort of what we expected, right? Diet plus exercise, you’d expect the greatest energy expenditure and intake.
But then what happened at 12 months? This thing called recidivism and they all returned back to normal, back to where they used to be. And the hardest thing for us to change as researchers are people’s behavior. And so when they left us and they didn’t have that great camaraderie and they didn’t have the supervision of exercise and diet, they went back to where they started.
And we see the same pattern in men. We only saw a significant difference for men at nine months. I don’t know why that was but they all returned back to their original body weight. And that gets frustrating for me as a researcher because I want to change the world and I want everyone to be great when they leave and everyone to be healthy. But it doesn’t always work.
So… but the one thing I do want to also tell you is is that we did improve their triglyceride levels in their blood, not in every group, with diet plus exercise group, there are a lot of data up there, but I’m just focusing on that.
And we also actually decreased the percent body fat and we measured that by something called underwater weighing which is one of the better ways to measure percent body fat.
Unfortunately, though, that didn’t carry through. Now mind you I keep doing work on different types of research. We have some research going on where we’re trying to change the environment to sort of force people to do better in their diet and exercise habits.
But today I’m focusing on these two studies which are more with older adults. So another study we did with more of a convenient samples, we actually evaluated women, all African-American women about average age of 78 years and that was pretty exciting because a lot of these women also had a lot of diseases going on.
So they weren’t these healthy women who came to us; they had heart disease; they had kidney disease, diabetes etc. And we had the facility of the living independently for elders at University of Pennsylvania where I was before at Drexel. And we wanted to see if they could increase their physical activity.
So basically the design was that… and I realized that I just told you that and I meant to tell you that a lot of older individuals decrease their physical activity as they get older. And even though people think well if someone’s getting older and they gain a little weight, so what?
One of the biggest things is if someone’s getting older and they’re decreasing their physical activity and they have hypertension or they have diabetes, if we start to have people exercising and eating well, we might actually pull some other medications off of them, which means they’ll have less side effects and that might help them feel better and then they might exercise more.
So I see everything as a really nice domino effect and certainly with how much polypharmacy we have with a lot of older adults, it would be great if we can take some medications away from them and make them healthier.
So what we did was… let me just go back to our little design and our design was a small study; it was 16 weeks and it was a convenient sample of these women in the Life Center at Penn. Basically what we did is we wanted to build them up to walking to at least three days a week.
Mind you I had individuals there who had walkers; we had some of… I called them my ladies that who were blind, some of them did not walk well; they needed assistance. So we are not talking power walking here. We’re talking getting these women up to try to exercise and build them up from doing really no exercise to about 30 minutes per session.
But in between we had to sort of rest them and do chair exercises as well, and I tell you all this: one, for the young the young students in here that research is not always easy and it’s never perfect.
Number two, that when you get people from a stage of not exercising at all who also have multiple diseases, you have to really build them up slowly, and you have to be encouraging as well.
So what did we find? Even though body weight was our major outcome, we found no changes in body weight. Okay that’s all right. But the one thing that I forgot to tell you is that in each time point at 0, 8, and 16 weeks, we recorded their dietary intake, but we also gave them these things called Actical accelerometers that we have them wear around the wrist. They wear them 24/7 for a week. They’re akin to you know some of the Fitbits that you see today but they give us a little bit more detailed information.
And so what we found from that was that at eight weeks for some reason and we think it’s because they were sort of excited to be in our program they had a significant increase in the calories they expended based on this Actical accelerometer. And we saw the same thing with moderate activity.
So this means that outside of what they were doing with us they were generally more active, which again for these women I was hoping for that that their activities of daily living were greater even when they weren’t with us. And that was an exciting piece. We didn’t find weight-loss but we found increased physical activity.
And so again we didn’t find the weight loss. Some of that could be for some of these women who had congestive heart failure or kidney disease and held on to more fluids that we weren’t finding those changes when we weighed them in. But most importantly we found increase in physical activity.
We also found from a sort of qualitative standpoint that they really did enjoy the fact that they had this camaraderie with other women. So they do continue that program at Life. Lots of flaws to this particular study; we didn’t have a control group. But the good news was we got them moving more.
So again age is no disease and we can change our lifestyle at any point in our lives. So I sort of focused on the exercise part and now I’ll end with the nutrition part.
And so how is it that we can balance out exercise no matter how old we are and eating healthily no matter how old we are?
And so kind of alluding to sort of what Dean was talking about and we really overuse our earth and we have about 3800 calories per person a day more than we actually need. So we really waste a lot of food especially in the United States. And this slide shows you, this was a study done a long time ago but it’s something we as researchers get a little frustrated with, is that when we ask people to tell us what they eat, typically what they do for their energy intake is they significantly underestimate what they take in; doesn’t surprise any of us but they typically… it’s not that they’re trying to lie; it’s just that people don’t either remember or they might not want to quite tell us what they’ve eaten.
And they also significantly overestimate how much physical activity they get in a day. So people sort of think… maybe they do thing but then they might actually do something else.
I’d like this slide, because it sort of rings a little true with… sometimes when you talk to see some of your friends or you hear people say well yeah okay, if I’ve got to get to the hole of a doughnut but I’ve got to eat that doughnut to get to the hole of the doughnut. So I mean I guess none of you think it’s that funny but thank you all right, because remember this is being taped. So I have to act laugh really loudly and so…
But what can we do? So speaking of doughnuts which some people eat in the morning, eating breakfast actually is a really great way to start your day like all of our moms have told us, right? But it’s a great way for many reasons it actually… people who eat breakfast tend to have decreased disease and they also actually tend to have a better body weight. They actually tend to maintain their body weight better than those who skip breakfast who think oh I don’t really need to eat breakfast nor do I want to because those are more calories.
And also those who eat breakfast tend to make better choices throughout the day compared to those who don’t. By the way if you do eat breakfast, you expend about 15,000 calories more per year than those who don’t, that’s because digestion and absorption take energy. So by skipping breakfast what happens is your body slows the metabolism down a little bit more and says I don’t know when they’re eating next so I better protect them and hold on to that fat a little bit more. And that really goes against what people are trying to do.
The other thing is to set goals… set goals for exercise, set goals for eating, because if you set some goals for yourself, you’ll likely go after them. But the goal shouldn’t be too lofty, because oftentimes people will come up to me and say oh you know what I really need to lose 50 pounds and they’ve been 50 pounds overweight for a number of years.
Then I’ll say okay but we sort of need to work on maybe 10 pound increments and when I say that to someone they sort of get frustrated but I really try to work with them to say let’s work on small bits at a time.
The other thing is enjoy eating. So in our country I think that we a) feel guilty about almost everything we put in our mouths; and b) we don’t tend to sit and enjoy when we eat. Growing up from two Italian immigrants where everything… I was blessed with having everything homemade from the gardens that my parents had and yeah the typical hot peppers hanging from the ceiling and the prosciutto hanging from the ceiling and my dad made homemade wine that we enjoyed eating… we always sat down together as a family, homemade spaghetti at least twice a week.
So things were just wonderful and I grew up that way so it’s really odd that we have so much processed food and how that sort of changed in our lives and we all want to eat fast like our whole society sort of moving quickly.
So even if you’re at your desk studying or doing work, even if you turn away from that computer for about ten minutes to try to actually know what you’re eating, because the old adage of it takes 15 or 20 minutes for your brain to know that you’ve actually eaten is true. So be aware of that because that’s another thing that if weight loss is what you want to do, then you want to make sure that you actually know that you’re full.
We’re all guilty of it, of eating fast, eating in the car, then you spill something and coffee on your way to work and you’re like darn it I wish I didn’t do that.
So speaking of decreased eating on the run. And we tend to… when we eat on the run also make poor choices, right? That if you’re really hungry and you haven’t eaten well, you might go to a vending machine as opposed to maybe making something or making it going someplace and making a better choice.
And preparing meals as a family, even if you’re a family of one or two it’s really important it used to take most households about 40 minutes to prepare a meal take some about 10, right now 10 minutes rather. A lot of times that’s just microwaving something and warming up.
So even if it’s just to try to make meals a little bit more… preparing them a little bit better and including healthier options, that’s just something that’s a great thing to do. And if you’re on campus and you live with several people, it’s just fun for everyone to have a job and everyone to help each other out.
And then a life work balance which is a tough one but honestly we only have one life, really just have this one now and it’s not a dress rehearsal as you’ve probably heard that quote before. So think it’s really important that we enjoy, have a good balance of… we spend lots and lots of hours at work but then enjoy what we do outside of work, enjoy whatever it is your hobbies are, spending time with my dogs or all my different workouts that I love to do.
And so just think about that and remember to take the time to do that, because it moves so fast. And as the older you get I’m looking at the young college students in the audience, the faster it goes. I don’t know how to stop it but we can’t. So unfortunately just try to balance that out and I think the younger you learn that, the better you’ll do later in life.
This is not how we want to work with stress is to bang our head here. Thanks for laughing. It should have been louder because we’re being taped, so it’s okay, that’s alright.
So this quote is you can’t help getting older but you don’t have to get old. It’s really something I think is so important. I like this person and I like this person… growing old is inevitable but growing up is optional.
And I always like to end with the picture of my two beautiful German shepherds, see and that always does that. Thank you. Sasha… Sasha’s on your right bears on your left; they are both rescue German shepherds and I’m again grateful for being invited, Rachel and Katie have done a great job.
I thank you for your attention and let’s go Hawks. All right, thank you.