Strength training for aging bodies

Podcast transcript

INTRO
Welcome to Docs in a Pod presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-host Dr. Tamika Perry and Carmenn Miles will share information to improve your health and well-being. And now here are Carmenn Miles and Dr. Tamika Perry.

CARMENN MILES
Welcome, everybody. We're delighted to have you with us on the award winning Docs in a Pod presented by WellMed. I'm Carmenn Miles alongside our co-host for today, Dr. Tamika Perry. You can find Docs in a Pod on any music podcast listening platform. You can also find us on the radio and several Texas and Florida markets. Each week we take some time to the huddle up and to discuss health and wellness topics, especially those that impact our senior community. Our goal each week is really just to share practical information on how we all can live healthier, happier lives and to help us better manage some of those pesky chronic conditions. We're super excited to have you listening in today. Thank you again for joining us. As I mentioned, our co-host today is none other than Dr. Tamika Perry. Dr. Perry is an associate medical director at WellMed, and she's in the Dallas-Fort Worth area. In that area, she oversees several large clinics in the Optum Care North Texas region. She's board certified in both family medicine and osteopathic treatment. Dr. Perry earned a Master of Public Health from the University of North Texas Health Science Center, and she says she was inspired to enter a career in medicine to help provide quality health care to the disenfranchised. So, she enjoys working with families and communities as a whole and building those relationships with her patients. Outside of medicine, she traveled a bit as a child in military family, from what I understand, and she continues to enjoy traveling today. Dr. Perry, this may be a tough question for you, as I know how much you love the Dallas area and what an intrinsic role you play in that community there. But if you could take the community with you and take your team with you along with your patients, if you could go anywhere in the world, where would you go to practice medicine?

DR. TAMIKA PERRY
There are so many places, but I really like Cape Town, South Africa. I love Amsterdam and probably one of my favorite places in the whole wide world is Paris. I like shopping, but it's just an awesome city. I'm more interested in what our guest has to say in her path.

CARMENN MILES
Yes. We need to welcome our guest. Dr. Sagarika Ranga is a board eligible internal medicine physician with specialized training in psychiatry and addiction medicine. So, she earned her Doctor of Osteopathic Medicine degree from the New York Institute of Technology College of Osteopathic Medicine and completed her internal medicine residency at Largo Medical Center in Florida and White River Medical Center in Arkansas. She went on to complete a primary care psychiatry fellowship at the University of California in Irvine, and she's currently pursuing an additional fellowship in primary care addiction medicine. Dr. Ranga practices in a geriatrics Medicare Advantage focused outpatient setting with Optum/WellMed in the Newport Richey, Florida area. She's passionate about integrating medical health and addiction care into primary care in order to provide whole person treatment for patients. I love that. She's multilingual. Fluent in English, Hindi, Urdu and Telugu. Dr. Ranga is dedicated to serving diverse communities with culturally sensitive and compassionate care. Welcome to the show, Dr. Ranga. How are you?

DR. SAGARIKA RANGA
Thank you very much. I'm doing great. Thank you for such a great introduction. I appreciate it.

CARMENN MILES
Absolutely. Thank you again for joining us today. Today we're talking about something that might just be the closest thing we have to what I call an anti-aging tool. It's not a pill, and it's not a topical ointment upset. We're talking about strength training.

DR. SAGARIKA RANGA
Yes, exactly.

CARMENN MILES
If you've ever thought, I'm too old to lift weights, or maybe you have some concerns about hurting yourself, this episode is for you. We're going to cover why strength training matters as we age, and what actually changes in our bodies, and how to approach strength training safely as a senior. You want to help us with that today, Dr. Ranga?

DR. SAGARIKA RANGA
Yes. Of course. I'm actually looking forward to discussing this with all my interested, curious, listeners. If you think about strength training, what comes to your mind first? Do you think that that's only for athletes? Do you think that it's way too late? I cannot start doing it in my 60s or 70s. The answer is no to both. I want you to look at skeletal muscle, not just as a vehicle for movement, but I want you to see skeletal muscle primarily as an organ of longevity.

CARMENN MILES
Absolutely. Before you get any deeper, we just want to take a moment to welcome those who may have just joined us. You're listening to the award winning Docs in a Pod presented by WellMed. I'm Carmenn Miles alongside co-host Dr. Tamika Perry and our guest for todayÕs show, Dr. Sagarika Ranga. Our podcast is available wherever you listen to podcasts, and you can also find us on the radio in several Texas and Florida markets. Today, Dr. Ranga has already jumped in, and we're discussing the benefits of strength training as we age and how strength training differs from an exercise routine. I think that's where you were going. Go ahead, Dr. Ranga.

DR. SAGARIKA RANGA
If there is one message that my listeners could take away from this podcast would be, the name of the game is to play the game and stay in the game forever. The game is strength training. The goal of strength training is to minimize injury and burnout. It's not about the quantity or the duration, but it's about consistency. Consistency is the key. Being able to do a little bit of your part every day without skipping any sessions, without any excuses, you will see in a few months that your stamina, your energy levels, your mood, your stability, everything improves just by compound interest. Einstein once said, compound interest is like the eighth wonder of the world. I believe that strength training is equivalent to compound interest. When you look at exercise in financial terms, it's never too late to start saving money. It's never too late to start exercising.

CARMENN MILES
Just as you said, aging is inevitable for us. Research definitely shows us that resistance training, which is what you're getting into, can really slow and sometimes reverse or decline some of those issues that we're having in life. Dr. Perry, do you want to add onto that?

DR. TAMIKA PERRY
Well, I was going to ask you to repeat what she said earlier. She said the musculoskeletal system is an organ of what? Longevity.

DR. SAGARIKA RANGA
Organ of longevity.

DR. TAMIKA PERRY
Longevity. I absolutely love it. I 100% agree that if you start exercising in your fourth and fifth degree life, you can add on almost a decade of good years to the end of your life. If you start exercising early, you're going to live longer, but quality years longer. I'm sure Dr. Ranga would agree. Once again, it's never too late. It's about your capacity. Dr. Ranga will get into the exercises, but Rome wasn't built in a day, so you don't have to start all out in the beginning. As long as it's a progressive effort towards our goals and those goals may become consistent at some point.

DR. SAGARIKA RANGA
Yes.

CARMENN MILES
You mentioned that it's not so much about the duration or the time. It's more about consistency. Do you want to share more on that Dr. Ranga?

DR. SAGARIKA RANGA
Yes, of course. When I talk about building the muscle and building the strength and building endurance, I'm not talking about vanity or athletics. We are talking about independence, fall prevention, brain health and quality of the last decade of life. The muscle mass usually builds from the time we are born up to age 25. Afterwards, there is a gradual decline. Although it's not that noticeable, it is maintained and there's a plateau, and there's a gradual decline until around 65 to 75. After 75, there's a steep decline. After 40, nearly 1% of muscle mass is lost per year, which is equal to 2 to 4% of strength loss and 8 to 10% of power loss annually. So, the types of exercises that I would like to discuss are aerobic exercises. It could be as simple as walking. When I say walking, I have some patients who use a cane or a walker with severe osteoarthritis in the knees. Some have replaced knee joints, artificial joints, and various other issues. I say if you cannot do 30 minutes at a time, you can always split it. 10 minutes in the morning, 10 in the afternoon, and 10 in the evening. If you cannot do that, at least let us start with 10 minutes a day.

CARMENN MILES
Consistency helps with the with the movement, right? So, it's not so much like you said about the quantity, it's more about the quality of what you're committed to. When you say every day, what time of type time commitment are we talking about? Are we talking 10 minutes, 20 minutes, 30 minutes? What's a good workout in terms of strength training and how does strength training different from exercising? A lot of people get that confused.

DR. SAGARIKA RANGA
Yeah. That's a very good question. Me being trained in internal medicine and being a doctor and also being trained in primary care psychiatry, what I tell my patients is exercising in the morning when there is sunlight. Avoid the heat of the sun but get the benefits of the light of the sun. So, exercising in the morning on an empty stomach if possible. Otherwise after breakfast. Walking in the sunlight and getting fresh air will release endorphins in the body. It will regularize their circadian rhythm and they will sleep better. They will also be able to get sunlight and make vitamin D, and that will help in better calcium absorption and strengthening their bones. So, walking earlier in the day is better.

CARMENN MILES
Very good. We need to take just a quick break, but please, everybody stay with us as we continue this great discussion on why it's important to incorporate strength training in your exercise regimen and how to maintain it. You're listening to Docs in a Pod presented by WellMed. We'll be right back.

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CARMENN MILES
We're back on Docs in a Pod, and I'm your host, Carmenn Miles, co-hosting alongside Dr. Tamika Perry and our great guest today, Dr. Ranga, who is sharing with us the importance of strength training as we age. Before we left, you were talking about the different options, whether it's a treadmill or walking outside, but the importance of getting vitamin D as well. If you would just continue communicating with us about the different options that are available as we age. How do we keep our strength intact?

DR. SAGARIKA RANGA
There are different kinds of exercises for different people. Our goal as we age is not to participate in Olympics, but to be able to do our activities of daily living independently as much as possible for as long as possible and trying to do activities that we enjoy the most. For that, what I recommend is you will find an exercise that you love doing and you enjoy doing. When I say doing exercises consistently for a few months, after three months or six months, when you look back, I want you to look at it as something that you enjoy. If you truly enjoy doing it, you're going to stick to it and there are chances that you will continue doing it. Is it swimming that you enjoy doing? Is it biking? Is it walking? Is it a mix of all? A couple days you walk, a couple days you swim, a couple of days you bike. Sometimes you can also do yoga, tai chi, meditation, breathing exercises, especially for my COPD patients and those who have mobility issues, even if they cannot get out of the chair, they can still do meditation. They can still do breathing exercises. They can still do chair yoga and stuff like that. So, it's all about being motivated to actually improve your health.

CARMENN MILES
Mobility is so important. What did I read, Dr. Perry? Is it 90% of emergency room visits from seniors from an orthopedic standpoint are due to falls?

DR. TAMIKA PERRY
Yes. That has to do with frailty, which Dr. Ranga will get into. When you're frail, outside stressors, whether it's physical or even psychological, tend to attack you more. You have these stressors because your body doesn't have a defense against it. One of the main defenses against falling is strength. Do you have good core strength? For clarity, there's a difference between aerobic exercise and strength training. Aerobic exercise are things like running, walking, swimming. Your heart rate is up and you're burning calories. Think about strength training as you're strengthening your muscles. An exercise where your muscles contract like lifting weights, Pilates, band resistance. That's great for boosting metabolism and for burning fat. So, you want a combination of the two. Dr. Ranga spoke about 30 minutes a day. Where she gets that from is the World Health Organization recommends that everybody exercises 150 minutes a week of cardiovascular aerobic intertwined with strength training. ThatÕs what she's talking about right now, which is about 30 minutes a day. But we definitely don't want you guys to be discouraged if you can't do your 30 minutes a day. We want, like Dr. Ranga said, you to do what you can do in what increments you can do and build up to it. So, if you can only do five minutes three times a day. Cool. Next week let's work on six minutes three times a day, five days a week, and then seven. Before you know it, even if you're 85, you will be able to do your exercises at 30 minutes without feeling like 9-1-1 needs to be called great. Trust me when I say this. Even if you have lower body issues like hips and knee issues, you can always work on upper body strength training. You can work on upper body aerobics like moving your arms up and down. You want movement of your body. It should not be still. Not like whenever we were telling our kids to be still and be quiet. No, we don't want you to be still.

CARMENN MILES
This is not the time. Dr. Ranga, can you explain more about frailty?

DR. SAGARIKA RANGA
Yes, of course. First, Dr. Perry, thank you so much. You summarized what I was saying really well. Sarcopenia is muscle mass loss as one ages, and a lot of people think that sarcopenia is their destiny, but it is not. Sarcopenia is largely a disease of inactivity and under nutrition. Doing resistance exercises daily consistently for 12 weeks has shown that you can reverse sarcopenia and start building your muscle mass and muscle strength. Frailty comes from not only your ability to need help with basic activities of living, like using a cane or a walker for walking, but it also comes from chronic pain from advanced osteoarthritis affecting your gait and balance. It comes from polypharmacy medications. Different medicines interacting together, causing dizziness or hypotension. It could be vestibular changes and with aging it could be decreased vision, decreased hearing, all affecting frailty. Frailty drives the fall severity. It is not just a probability, but it actually drives the fall severity. When a person in their 20s falls, they bounce back quickly. But when a person in their 70s falls and most likely breaks a hip and gets bedridden, it is time away from the exercise. It's the time to de-condition, and they take much longer to actually bounce back. In fact, studies have shown that 1 in 4 people above 74 years of age who fall down and break a hip, they never bounce back to their baseline. So, what we can do here is, first of all, I urge everyone above 50 years of age to try and get a Dexa scan, which is a bone density scan. We should also get a Dexa scan where the test reports the T scores in different levels of the bones. If it shows any number less than negative one, it indicates osteopenia. That means the bones are getting weaker, but they're not brittle yet. That is when we can do interventions like calcium, vitamin D, strength training and for postmenopausal females, hormone replacement, estrogen and all of that to help these bones get stronger so when they do end up having a fall, it could be an accidental fall. However, we can prevent or minimize the number of falls. When they do have the fall, if the bones are strong, they'll be able to bounce back quicker. So, my suggestion is lift more. Exercise more. Consistency is the key word. Diet is very important. Sleep is very important.

CARMENN MILES
What do you to say to the seniors that don't really want to leave their homes, and they don't want to go to a gym or to the YMCA. How can they easily accomplish some of these strengthening goals from home? Are there videos out there? What type of equipment should they acquire?

DR. SAGARIKA RANGA
Thanks to the social media and tons of videos online, whatever social media platform they follow, Twitter, Instagram, YouTube, Facebook, whatever they like. There are tons of videos. You can select a teacher that you like, and you can do exercises right from the comfort of your home at a time that is most convenient for you. Being disciplined and doing it every day is the most important thing. It's the key. Watching what you eat is also important. Increase protein intake. At least 1.6g of protein per kilogram of body mass is necessary for you to maintain good muscle volume and strength. Just by ingesting the protein, you can build muscle mass, and by exercising, you can increase the amount of muscle mass. You have to provide the building blocks for your muscles, which is protein. When you eat good protein and a good amount of protein, it will keep you full for a longer time and it will give you energy for a longer time. It will allow you to exercise and it will also help in losing weight or maintaining a good body weight.

CARMENN MILES
Dr. Perry, did you want to add to that?

DR. TAMIKA PERRY
Yeah, just a couple of things on there. She's 110% correct. A lot of my seniors are concerned about finances because they're on a pretty fixed income. It cost you minimal extra to do strength training exercises. You can use your own body. There are Pilates that you can do. Most certainly Pilates comes with machines too, but there are places you can do just on the mat. Yoga moves you can do to strengthen up your core, which is particularly important in terms of falling. You have things in your house you donÕt even realize. Even if you're sitting down watching your favorite program, you have you a couple cans of green beans in your hand, and if your knees and hips hurt, you can extend your arms up and down, back and forth. I usually tell the patient, do it during your program, rest during the commercial because the program is going to be 30 minutes to an hour long. If that's too tiring for you, start off with exercising during the commercial and resting during the program. But by week 2 or 3, we need to flip it around because your endurance is built up by this point. ItÕs very important. The other great point that she made is about sarcopenia and how it is a combination of nutrition and lack of nutrition, lack of activity. It's important to realize you can be obese sarcopenic. So, you can have more body fat than lean muscle mass, which is a little on the dangerous side because you're masking not having the lean muscle mass. Dr. Ranga, you don't know how much I learned during this session.

DR. SAGARIKA RANGA
I am so glad.

CARMENN MILES
I've learned so much as well. With that said, we're out of time. Believe it or not, it flies by. If there's one message I can take away from today, it's that strength training is really not an option as we age. It's foundational. Whether we're 45 or 85, muscles respond to being used. So, start where you are, even if it's at ground zero. Progress slowly and remember that every repetition is an investment in your future and your safety from falls and other predicaments. That's all for todayÕs episode of Docs in a Pod presented by WellMed. Thank you for joining us as we explore ways to live healthier lives. Until next time, stay well.

OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.

DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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