Taking a Look at Physical Activity and Cardiac Health

Published in Woonsocket Call on March 8, 2020

Spring time is coming. Get out your walking shoes…

Physical exercise (that doesn’t have to be strenuous to be effective) can lead to longer, healthier lives, according to two preliminary research study findings presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic P Scientific Sessions 2020. The EPI Scientific Sessions, held March 3-6 in Phoenix, is considered to be the premier global exchange of the latest advances in population-based cardiovascular science for researchers and clinicians.

“Finding a way to physically move more in an activity that suits your capabilities and is pleasurable is extremely important for all people, and especially for older people who may have risk factors for cardiovascular diseases. Physical activities such as brisk walking can help manage high blood pressure and high cholesterol, improve glucose control among many benefits,” said Barry A. Franklin, Ph.D., past chair of both the American Heart Association’s Council on Physical Activity and Metabolism and the National Advocacy Committee, director of preventive cardiology and cardiac rehabilitation at Beaumont Health in Royal Oak, Michigan, and professor of internal medicine at Oakland University William Beaumont School of Medicine in Rochester, Michigan.

In one session, Dr. Andrea Z. LaCroix, Ph.D., of the University of California San Diego (UCSD), presented her study’s findings that showed the importance of walking, stressing that every step counts in reducing cardiovascular disease deaths among older women.

USCD’s study was supported by The National Heart, Lung, and Blood Institute of the National Institutes of Health.

According to the UCSD study’s findings, women who walked 2,100 to 4,500 steps daily reduced their risk of dying from cardiovascular diseases (including heart attacks, heart failure, and stroke) by up to 38 percent, compared to women who walked less than 2,100 daily steps. The women who walked more than 4,500 steps per day reduced their risk by 48 percent, in this study of over 6,000 women with an average age of 79.

LaCroix says that the UCSD study’s findings also indicated that the cardio-protective effect of more steps taken per day was present even after the researchers took into consideration heart disease risk factors, including obesity, elevated cholesterol, blood pressure, triglycerides and/or blood sugar levels, and was not dependent on how fast the women walked.

“Despite popular beliefs, there is little evidence that people need to aim for 10,000 steps daily to get cardiovascular benefits from walking. Our study showed that getting just over 4,500 steps per day is strongly associated with reduced risk of dying from cardiovascular disease in older women,” said LaCroix, the lead study author who serves as distinguished professor and chief of epidemiology at the UCSD. Co-authors of the study are John Bellettiere, Ph.D., mph; Chongzhi Di, Ph.D.; Michael J. Lamonte, Ph.D., M.P.H.

“Taking more steps per day, even just a few more, is achievable, and step counts are an easy-to-understand way to measure how much we are moving. There are many inexpensive wearable devices to choose from. Our research shows that older women reduce their risk of heart disease by moving more in their daily life, including light activity and taking more steps. Being up and about, instead of sitting, is good for your heart,” said LaCroix.

LaCroix’s study included more than 6,000 women enrolled in the Women’s Health Initiative with an average age of 79 who wore an accelerometer on their waist to measure their physical activity for seven days in a row; these participants were followed for up to seven years for heart disease death.

This study was prospective, and half of the participants were African-American or Hispanic, stated LaCroix, noting that the use of an accelerometer to measure movement is a strength of the study. However, the study did not include men or people younger than 60, she said, calling for future research to examine step counts and other measures of daily activity across the adult age range among both men and women.

In another session, Joowon Lee, Ph.D., a researcher at Boston University (BU) in Boston, noted that higher levels of light physical activity are associated with lower risk of death from any cause.

According to the findings of BU’s study, older adults were 67 percent less likely to die of any cause if they were moderately or vigorously physically active for at least 150 minutes per week, (a goal recommended by the American Heart Association) compared to people who exercised less.

However, the researchers observed that, among the participants with an average age of 69, physical activity doesn’t have to be strenuous to be effective. Each 30-minute interval of light-intensity physical activities – such as doing household chores or casual walking – was associated with a 20 percent lower risk of dying from any cause, they said, noting that on the other hand, every additional 30-minutes of being sedentary was related to a 32 percent higher risk of dying from any cause.

“Promoting light-intensity physical activity and reducing sedentary time may be a more practical alternative among older adults,” said Joowon.

The BU research study, supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health, evaluated physical activity levels of 1,262 participants from the ongoing Framingham Offspring Study. These participants were an average age of 69 (54 percent women), and they were instructed to wear a device that objectively measured physical activity for at least 10 hours a day, for at least four days a week between 2011 and 2014.

The researchers say that the strengths of this study include its large sample size and the use of a wearable device to objectively measure physical activity. However, the participants of the Framingham Offspring Study are white, so it is unclear if these findings would be consistent for other racial groups, they note.

Co-authors of the study are Nicole L. Spartano, Ph.D.; Ramachandran S. Vasan, M.D. and Vanessa Xanthakis Ph.D.

Earth: The Gray(ing) Planet

Published in Woonsocket Call on April 17, 2016

Last month, a National Institute of Health funded U.S. Census Bureau report was released announcing that the world’s older population is growing dramatically at an unprecedented rate. According to the newly released federal report, “An Aging World: 2015,” 8.5 percent of people worldwide (617 million) are aged 65 and over. This percentage is projected to jump to nearly 17 percent of the world’s population by 2050 (1.6 billion).

The new 165 page report, released on March 28, 2016, was commissioned by the National Institute on Aging (NIA), part of the National Institutes of Health, and produced by the U.S. Census Bureau.

“Older people are a rapidly growing proportion of the world’s population,” said NIA Director Richard J. Hodes, M.D. “People are living longer, but that does not necessarily mean that they are living healthier. The increase in our aging population presents many opportunities and also several public health challenges that we need to prepare for. NIA has partnered with Census to provide the best possible data so that we can better understand the course and implications of population aging.”

“An Aging World: 2015” is chock full of information about life expectancy, gender balance, health, mortality, disability, health care systems, labor force participation and retirement, pensions and poverty among older people around the world.

“We are seeing population aging in every country in every part of the world,” said John Haaga, Ph.D., acting director of NIA’s Division of Behavioral and Social Research. “Many countries in Europe and Asia are further along in the process, or moving more rapidly, than we are in the United States. Since population aging affects so many aspects of public life—acute and long-term health care needs; pensions, work and retirement; transportation; housing—there is a lot of potential for learning from each other’s experience.”

A Look at Some of the Details

The report noted that America’s 65-and-over population is projected to nearly double over the next three decades, from 48 million to 88 million by 2050. By 2050, global life expectancy at birth is projected to increase by almost eight years, climbing from 68.6 years in 2015 to 76.2 years in 2050.

In addition, the global population of the “oldest old”—people aged 80 and older—is expected to more than triple between 2015 and 2050, growing from 126.5 million to 446.6 million. The oldest old population in some Asian and Latin American countries is predicted to quadruple by 2050.

The researchers say that the graying of the globe is not uniform, “a feature of global population aging is its uneven speed across world regions and development levels.” The older population in developed countries have been aging for decades, some for over a century. “In 2015, 1 in 6 people in the world live in a more developed country, but more than a third of the world population aged 65 and older and over half of the world population aged 85 and older live in these countries. The older population in more developed countries,” says the report.

Meanwhile, the researchers report that in the less developed world, “Asia stands out as the population giant, given both the size of its older population (617.1 million in 2015) and its current share of the world older population (more than half).” By 2050, almost two-thirds of the world’s older people will live in this continent, primarily located in the eastern and northern hemispheres. “Even countries experiencing slower aging will see a large increase in their older populations. Africa, for instance, is projected to still have a young population in 2050 (with those at older ages projected to be less than 7 percent of the total regional population), yet the projected 150.5 million older Africans would be almost quadruple the 40.6 million in 2015, notes the report. .

The Graying of the Ocean State, Too

AARP Rhode Island State Director Kathleen Connell says that statistics gleamed from a new interactive online tool, the AARP Data Explorer, detailed by blogger Wendy Fox-Grage, a senior strategic policy advisor for AARP Policy Institute, suggests that Rhode Island for some time, has had the highest per capita 85 plus population of any state. But “Data Explorer also shows that Rhode Island was surpassed in 85 plus per capita in 2015 – second now to Florida by 1/10,000th of a percentage point. Interesting, by 1260, we are projected to rank 14th.

“Nationally, from 2010 to 2060, the 85-plus population will more than triple (260 percent), the fastest growth of any age group over that time period,” she says.

Connell says, “AARP Data Explorer clearly shows that the age 65-plus population will grow much faster than younger age groups. All three older age groups (65-74, 75-84 and 85-plus) will more than double between 2010 and 2060, while the younger age groups (0-17, 18-49, 50-64) will increase only slightly.”

“The growth of the age 85-plus population will significantly outpace all other age groups, once Boomers begin turning 85 in the 2030s,” adds Connell, noting that “This phenomenon will have significant impact on every aspect of society, ranging from our health care system to the economy.”

“People age 85-plus are the group most likely to need long-term services and supports (LTSS) to help them with everyday tasks. They not only have higher rates of disability than younger people, but they are also more likely to be living alone, without a spouse or other family member to provide them with assistance,” observes Connell.

Over the years, the Rhode Island General Assembly has enacted legislative changes in the way it delivers and funds aging services and supports for older Rhode Islanders and their family caregivers, says Connell.

According to Connell, early last year, AARP Rhode Island released, “Raising Expectations 2014: A Report Card for Rhode Island Long Term Services and Supports System Performance.” The report assessed the LTSS Scorecard and recommended policy goals.

Connell says that the results revealed that Rhode Island showed strengths. With the subsequent passage of key legislative proposals that included caregiver paid family leave and the CARE Act, the state has moved in the right direction, she says, stressing that “the policy report pointed to areas for improvement that state leaders should not ignore.”

“With the reauthorization of the Older Americans Act through 2019, and continued backing from Governor Raimondo, Rhode Island seniors and caregivers are benefitting from a host of home- and community-based programs,” says Director Charles Fogarty, of Rhode Island’s Division of Elderly Affairs. “A top priority for the agency is strengthening of those services so everyone can make it in Rhode Island. We are proud to partner with hardworking older Rhode Islanders and advocates; we are constantly listening to their suggestions which are helpful in providing direction on development of effective programming and policies,” he says.

Fogarty noted that during Governor Gina Raimondo’s first two budget cycles (FY 2016 enacted and FY 2017 proposed budgets), more than $1 million in additional general revenue funding has been allocated for programs such as Meals on Wheels, senior centers and other home and community care services. Seniors can remain in their homes with a high quality of life for as long as possible through the provision of affordable and accessible home and community-based services and living options preventing or delaying institutionalization.

Connell says a the nation’s population ages, Rhode Island now has an opportunity of showing other states, with growing age 85 plus populations what it takes to care for an aging population.

Rhode Island, too, can also teach the world community a thing or two about providing programs and services to their older citizens.

Beware of Health Scams

Published in Pawtucket Times, December 19, 2014

Like millions of older baby boomers and seniors, some nights you just can’t get to sleep. It’s very late and you begin channel surfing. Does this sound familiar? Many TV viewers may ultimately find themselves, usually from 2:00 a.m. to 6:00 a.m., watching an infomercial announcer pitch a health product or service, always claiming your health will improve, or that the aging process can be stopped or reversed, if you just purchase that bottle of dietary supplements, weight loss product, baldness remedies or sexual enhancement supplements, that home exercise machine, even register for a memory improvement course. The lists of products pitched on these paid commercials are endless.

The Vancouver, BC-based International Council on Active Aging (ICAA), a nonprofit group that supports professionals who develop wellness facilities, programs and services for adults over 50, calls on older consumers to beware of false promises and products with little health benefit. “Unfortunately, as people over 50 pursue this goal, many succumb to what one industry insider calls graywashing – claims that chip away at older adults’ retirement nest eggs with dubious promises of renewed youth and health,” says Colin Milner, CEO and founder of ICAA, who coined the term, graywashing.

There is No Fountain of Youth

According to Milner, there is no shortcut to improving your health. “Yet, people spend billions of dollars a year on products that claim there is,” he observes. “Many products also say they will turn back time,” he says, noting that the research shows these claims to be unsubstantiated.

Milner points to a statement by the National Institute on Aging (NIA), one of 27 Institutes and Centers of the National Institute of Health, which states: Despite claims about pills or treatments that lead to endless youth, no treatment has been proven to slow or reverse the aging process.” Be aware, warns Milner, as health fraud scams are abundant.

According to NIA’s Age Page, “Beware of Health Scams,” health product scams offer viable “solutions that appear to be quick and painless.”

As to dietary and weight loss supplements, American consumers spend a small fortune on potions claiming to help shed pounds, many sold over the counter. Be careful. Some supplements contain hidden illegal drugs and other chemicals that could cause serious harm.

The NIA fact sheet also claims that most dietary supplements are not fully tested by the Federal Drug Administration, a federal agency charged with protecting the public’s health. In 2014, FDA issued 63 Warning letters to companies that cited unapproved or unsubstantiated claims, tainted products or other health-fraud-related violations.

So, think carefully before you purchase that item. It is important to talk with your physician before you begin taking a supplement or using a health product remedy.

The NIA Fact Sheet notes that arthritis remedies, using Magnets, copper bracelets, chemicals, special diets and electronic devices, oftentimes unproven, can be quite expensive, potentially harmful, and unlikely to help. There is no cure for some forms of arthritis and rest, exercise, heat and some drugs, are the best ways to control the painful symptoms.

Health scams oftentimes target very sick people, especially those afflicted with cancer, in an attempt to trick people who are desperate for any remedy they can find. Buzz words to beware of include: “quick fix,” “secret ingredient” or “scientific breakthrough,” says NIA’s Fact Sheet.

Furthermore, weight loss, sexual enhancement and bodybuilding “supplements” are especially suspect, too, warns the NIA Fact Sheet. Some vitamins may help, but some supplements can harm people taking certain medicines or with some medical conditions. In particular, avoid those supplements claiming to shrink tumors, solve impotence or cure Alzheimer’s. There is no cure for Alzheimer’s Disease at this time.

Milner urges older Americans not to be swayed by personal testimonials featuring “real people,” or “doctors,” often times played by actors who claim amazing cures. These testimonials are no substitute for real scientific studies, and can tip you off to a scam. In general, never purchase or start taking a medical treatment without first talking to your healthcare professional, particularly if you already take other prescribed drugs, recommends Milner.

Don’t Become a Victim of Scam

Be knowledgeable about the health care products you buy, suggests Milner, noting that the NIA Fact Sheet recommends that a person question what he or she sees or hears in ads or online. Always ask your physician, nurse, pharmacist or other healthcare provider about products you’re thinking of buying. Most important, avoid products that “promise a quick or painless cure.” Beware of claims that a health care product is made from a “special, secret or ancient formula” or it can “only be purchased from one company.”

Also, be wary if the infomercial claims the product can cure a wide variety of medical conditions or even successfully treats a devastating disease like Alzheimer’s or chronic arthritis. Put your credit card away and hang of the phone if you are required to make an advance payment or there is a very limited supply of the product.

“Science may be getting closer to a Fountain of Youth, says Milner, but, “we’re not there yet. “The pillars of healthy aging are simple. They include a sensible diet, regular exercise, good sleep habits, meaningful relationships, and engagement in life,”

A Final Note for Rhode Island’s AG…

The Consumer Protection Unit at the Office of Attorney General receives very few consumer complaints about deceptive health and beauty products, because most of these products are regulated on the federal level. The best advice they can offer consumers is to file a complaint with the federal Consumer Financial Protection Bureau, or CFPB. Although these types of products are not regulated by individual states, and therefore the Attorney General has no jurisdiction over the sale of such products, Attorney General Peter Kilmartin reminds consumers that the age old tip applies when considering a purchase, “if it sounds too good to be true, then it probably is.”

One way consumers can protect themselves, says Kilmartin, is to “ask for medical documentation backing up the claims and to ask and understand the refund policies before making a purchase. Another way to protect yourself is to pay by credit card, not debit card. Many credit card companies will allow you to dispute payment if the product or service doesn’t match up to its claims.”

For more information about the National Council on Active Aging go to http://www.icaa.cc/.

FDA s created a new website (www.fda.gov/ForConsumers/ConsumerUpdates/ucm278980.htm) to help consumers protect themselves from fraudulent health products and schemes.

Herb Weiss, LRI ’12, is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.