This comprehensive and detailed NYT article by the talented and prolific journalist, Gina Kolata, examines longevity and its sources.

A common assumption is that your personal longevity is strongly related to your genes and the life spans of your parents and siblings. 

A surprising insight provided by the article is:  “How tall your parents are compared to the average height explains 80 to 90 percent of how tall you are compared to the average person,” Dr. Vaupel said. But “only 3 percent of how long you live compared to the average person can be explained by how long your parents lived.”  The article explains that Dr. James W. Vaupel directs the Laboratory of Survival and Longevity at the Max Planck Institute for Demographic Research in Rostock, Germany.

Another key indicator that the impact of genes on longevity is overrated:  on average identical twins die 10 years apart.

Factors impacting life span as reported by the article include:  genetic predispositions, disease, and nutrition, a woman’s health during pregnancy, accidents and chance events like gene mutations leading to cancer.

Some diseases, like Alzheimer’s and heart disease are more linked to family histories than others. 

Still the article reports that chronic diseases strike almost at random among the elderly, making it perhaps not so surprising that life spans themselves have such a weak genetic link

Great article but a surprising lack of emphasis on factors that are controllable by the individual and known to impact longevity:  for example, proper medical care, smoking, obesity, exercise, proper diet.

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This WSJ article recaps the familiar results.  Mississippi is the weightiest state with a whopping 29.5% of its inhabitants considered obese, a 1.1% increase over last year.  Only one state, Nevada, reported a decrease in the percentage of obese adults.  Colorado continues to be the leanest state, with 16.9% obese.

The experts in the article feel there may be a link between obesity and poverty as the fattest states are also among the poorest.  Still, in my view, with even the leanest state showing a huge number of Americans that are obese, poverty is far from the only factor at work in the obesity epidemic.

One fascinating statistic from the article is that $5.6 billion could be saved when it comes to treating heart disease if just one-tenth of Americans began a regular walking program.

The article’s results are unfortunate but not surprising.  Obesity is clearly the elephant in the health care room that may more than counterbalance the great technological advances in medicine that have up until now so dramatically increased life expectancies and quality of life.  As of yet, Americans seem unwilling or unable to address the obesity epidemic either on an individual basis or as a matter of public policy.

Here are recommendations from the article to reduce obesity:

The government should mandate routine screenings that measure the fitness of Medicaid beneficiaries, plus subsidize or reimburse them for participating in exercise and fitness programs.

 At the local level, governments should approve zoning and land use laws that give people more chances to walk or bike to the store or to work. Local governments also should set aside more funding for sidewalks

 Employers should offer their workers benefits that help them stay healthy, such as nutrition counseling and subsidized health club memberships. .

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This WSJ article details a fascinating exchange between two eminent academics, Carol Graham and Darius Lakdawalla, about the causes of obesity and related issues.

While you should read the lengthy article in its entirety for the many subtleties in their positions, here is a brief overview of their positions followed by the getfitsource.com take.

At the outset, both agree about the dramatic increases in obesity, with Dr. Lakdawalla citing a 30 pound average increase in a six foot man over the last 150 years as a relevant bench mark.

Darius Lakdawalla.  He sees increased obesity primarily as a function of two clear factors:  cheaper food and more sedentary lifestyles.  He feels that obesity is a  by product of prosperity and technological advance, much in the same way that increased traffic fatalities are a side effect of the growth of the automobile society.  He feels that we should focus on making people accountable for their weight choices.   He accepts that the poor are more obese than the rich, but that the rate of obesity is rising across the board, affecting all income groups.  He feels that a norms based approach is difficult to use successfully because of its inherent fuzziness.  Society has to focus on incentives to deal with obesity rates.

Carol Graham.  Her focus is largely on norms and how they affect social behavior and how varying norms across different professional and socio economic groups affect varying rates of obesity.  She doesn’t feel that technology and cheaper food tell the whole story because, for example, the poor are more likely to be obese than the rich and that obesity tends to be negatively correlated with upward income mobility.  Why are cities like Denver thinner than cities like San Antonio?   She feels the study of norms can play a crucial role in understanding obesity causes, for example, if there is a significant stigma against obesity in a group, such as higher status professionals, obesity will be less.  Similarly, if there is less of a stigma against obesity in a group, such as lower paid office employees, obesity will be greater.

Getfitsource.com. These two are brilliant academicians who bring somewhat clinical and sometimes esoteric views to the subject of obesity.   While their insights are exceptionally well presented and argued, one would hope to see more passion in their arguments about how to reduce the levels of obesity in America, rather than so much  focus on nuanced analysis of the state of  obesity.  One would rather see them use their considerable intellects to discuss specific and concrete plans for helping America find ways to address its obesity crisis.  There also was very little focus with respect to exercise and how it plays a role in the obesity crisis and the general health of America.  We’d like to see Dr. Lakdawalla present detailed and specific policies that utilize incentives to reduce obesity and discuss their implementation.  We’d like to see Dr. Graham cite more examples of how a norms based approach can be used to reduce the obesity epidemic across the population as a whole and in the specific socio economic groups she mentions.

Overall, we feel that focus for America has to be on greater education on the reality and perils of obesity.    Notwithstanding the bulk of evidence showing that we are facing an obesity tsunami with unprecedented negative health impacts, many Americans are in denial about their weight levels, eating habits and lack of exercise.  We need a much more heightened awareness about fighting obesity as a nation.  It should be nearer the top of the list of our national priorities.

Thanks to the WSJ for hosting the views of two such qualified commentators.

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This St. Petersburg Times article by Lisa Greene, recaps the results of two recent studies that show that being overweight clearly increases your health risks and the more overweight you are the worse your health risk   The studies were published in Thursday’s issue of the New England Journal of Medicine. 

The first study tracked 1.5 million people and adjusted for smoking and chronic disease.  The second tracked 1.2 million Koreans.  These studies were among the most comprehensive ever conducted.

“Among 50-year-old nonsmokers, the study found a 20 to 40 percent increase in risk of death among overweight people. The risk was doubled or tripled among the obese.”

The article discusses the various diseases associated with being overweight including diabetes, sleep apnea, heart disease and the general social discomfort with being too fat.

Some experts mentioned in the article feel that nothing short of a societal shift will solve the obesity epidemic. 

Our view at getfitsource.com is that we probably didn’t need any more evidence that obesity and being overweight correlate with reduced longevity and greater health problems.  But these studies are pretty definitive.  People should focus on how they can lose unnecessary pounds and not waste time trying to argue that extra weight isn’t dangerous to one’s health which some earlier studies were ambiguous about.  Exercise should play a key role in efforts to lose weight but calorie control is even more important.

The article concludes with some useful notes about losing weight which we quote below:

People who lose weight and don't regain it share some healthy habits. Among them:

- Regular physical activity, often an hour or more per day.

- Continuing to follow a low-calorie, low-fat diet.

- Following a consistently healthy diet, including weekends.

- Eating breakfast.

- Regularly weighing themselves, often daily

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Here is an animated functional exercise routine demonstrated by certified personal trainer, Randy Brandt, that utilizes simple functional fitness equipment, in this case, hand weights or dumbbells,  a stability ball, sometimes called a Swiss ball, exercise ball, fitness ball or Pilates ball, and a yoga mat.

By simply observing this animated exercise you can see the power of functional exercise.  While the emphasis is on a press type exercise which focuses on the triceps, the entire body is engaged.   The core must stay engaged for balance and is therefore strengthened.   The legs are engaged as well.   The entire body is getting a workout.  Many muscles are engaged simply because one is exercising in a non-static environment.  Functional exercise does not take any longer than exercise in stasis but is far more effective at improving your overall strength and power.  It is also helpful in term of preventing injury.

Learn more about functional fitness here.

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This Daily Mail article by Jenny Hope, among other things, discusses the state of play about using BMI or Body Mass Index, for predicting coronary problems.

The article recaps BMI classifications which are:  someone with a BMI of less than 18.5 is considered underweight, between 18.5 and 24.9 lies within the 'normal' range, and 25 to 29.9 is classified as 'overweight'. Clinical obesity is defined by a BMI of 30 or greater.

Frankly, from my perspective, it’s somewhat obvious that BMI would not be a good predictor of heart issues for all people, because it considers only two factors:  height and weight.  It does not consider the amount of muscle or the distribution of weight in the body.  A trained athlete because of his or her high muscle mass may have a high BMI, but of course, such a person would not be at greater risk for heart disease; in fact, just the opposite

Given this reality, it’s not surprising that the article indicates that “it is becoming widely recognized that the BMI can be misleading in predicting who is at risk (for heart disease) because muscle is heavier than fat. As a result fitter people will show up as overweight because they are more muscular.”

The article goes on to emphasize that many experts now want waist circumference or waist-to-hip ratio, which indicates levels of abdominal fat, adopted as a more accurate guide.

An international study in 52 countries found waist-to-hip ratio was the most reliable predictor of heart attack risk.

See our November 20, 2005 post on this same subject which indicated that waist hip ratio is a much better predictor for coronary problems.  Also, this blog post pointed out that the relationship between waist hip ratio and coronary risk correlates at all levels and does not lose this correlation,  i.e., the worse your waist hip ratio the worse your coronary risk.  A waist hip ration below 90 percent for men and below 85 percent for women is considered healthful.

The Daily Mall article also points out that experts feel that extra fat around the organs of the abdomen is more dangerous that fat found other places on the body—“such fat is 'metabolically active', releasing more of the acids that raise heart disease risk, along with factors that increase blood pressure and blood sugar.”

The article quotes Judy O'Sullivan, medical spokesperson for the British Heart Foundation (BHF) as follows:  “Body mass index (BMI) measures whether you are the best weight for your height.

“When assessing the risk of developing coronary heart disease, or dying from it, what really matters is how much fat you are carrying in your abdomen.

“BMI is related to, but is not, an absolute measurement of abdominal fat. Therefore, it is not surprising this study shows for some patients BMI does not accurately measure their risk of dying from heart disease.

“The most important thing to consider is your body shape and weight. Eating less and being more active is an effective way of controlling both and improving your heart.”

Read this article in full.  It’s clear that BMI is not the best measure for predicting coronary heart disease.  However, obesity is a clear threat to your health.

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If you’re feeling a little short on motivation today, read this feature article on Texas trick skier Kay Nichols and you’ll find a well spring of inspiration.  The article by Pamela LeBlanc published in her column Fit City of the Austin American Statesman, recounts the athletic life of Kay Nichols, who at age 54 has been water skiing competitively over a span of 47 years!  Here’s a quote from Ms. LeBlanc describing Kay Nichols’ upcoming competition, “In the California competition, Nichols will reach into a portfolio of tricks that includes winding herself up like a clock spring and uncoiling in two full revolutions, all while being dragged through the water by her foot. She'll also execute maneuvers that require her to hop over the tow rope.”  We further learn that Mrs. Nichols will be executing these feats less than a year after having been diagnosed with thyroid cancer and undergoing two surgeries and treatments this spring.  The article reports she is feeling well and has returned to a rigorous practice schedule.  Trick skiing is obviously extremely demanding physically and Mrs. Nichols credits her strength training regime and yoga for her physical fitness, saying “I don't think I could ski without it,” she says. “It strengthens your inner core.”

Mrs. Nichols, in addition to holding 11 national titles and one world title in trick skiing, is also a wife, a mother, and a grandmother.  She is truly an inspiration to athletes (and mothers and grandmothers) everywhere!  We wish her well in her upcoming competition.  

Read Pam LeBlanc’s full article (and see the pictures!)

Check out a short exercise demo to improve inner core fitness

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The weather forecast in the Cayman Islands is often the same in August:  scattered thunderstorms.  But that repetitive forecast obscures the reality of the great weather here.  While there may be some clouds in the sky and an occasional thunderstorm, the weather is for the most part, bright, clear and sunny.

Seven Mile Beach is the world famous beach in the Caymans.  The beach features continuous soft white sand abutting the azure Caribbean Sea and it covers a good chunk of the Western side of Grand Cayman Island.  It’s one of the best beaches in the world. 

With this weather and this beach, a run in the sand seemed the perfect exercise routine for today.

I awoke around seven thirty and strapped on a simple heart monitor as well as an ipod with the runner’s harness.  I was set on running bare foot and clad only in a bathing suit and tee shirt. 

I turned right out of the condo and headed north up Seven Mile Beach with the Caribbean Sea to my left and the sun rising to my right.  The beach is mostly vacant at this time of the morning, although some hardy sun worshippers are starting to turn out here and there as well as early morning walkers and joggers.  As I pass by the Hyatt Hotel, the dive boat is getting organized for the morning dive. 

I’m starting out at a gentle jog and then gradually increasing my pace.  I’m generally running just at the edge of the surf line but it’s easy to misjudge the incoming waves and I often find myself in six inches of water for a brief instant before it recedes.  The sand is obviously hard packed at water’s edge so the difficulty level is not unlike running on pavement.  One does feel a little more stress on ankles and knees due to the slanted surface, with one foot hitting the ground 4 or five inches higher than the other. 

For additional cardio, I’m occasionally running higher on the beach into the soft sand, deep and dry.  One sinks deeply into the sand here and while the terrain is flat, the level of exertion needed to keep going is dramatically increased.  Running at the same speed in this sand spikes my heart rate quickly.

I run by several notable new condominium construction projects on this iconic beach and then by the recently completed Ritz Carlton Hotel Complex, which opened recently.  Beach attendants are just starting to put out towels on the myriad of beach loungers at this super luxurious Caribbean outpost.

After passing the Westin Hotel, I continue to press on.  Unless you are a marathoner, you don’t easily run out of running room on Seven Mile Beach.  When I finally decide to head back I can see the area of cemetery reef, one of the best snorkel sites within swimming distance of a beach anywhere in the Caribbean.

Dodging only an occasional fiddler crab, I’m continuing to run at the water’s edge or in light surf.   The sand is soft and kind.  Throughout the run, I’m ramping up to higher heart rates in intervals and then throttling back to let my heart rate recover and then starting the process over again.  As long as I am getting a fairly rapid drop in heart rate when I slow, I feel comfortable.  The higher heart rates achieved with interval training  produce good endorphins and good  fat burning, while somewhat lessening the impact on joints of a constant mid level  pace.

I finish the run back at the condo and after quickly shedding my ipod, heart rate monitor and tee shirt and grabbing some simple swimming goggles, I plunge into the Caribbean  for a couple of hundred yards of  gentle crawl to wind down and cool off.    It’s a great exercise routine to start the day here in the Caribbean.

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RSI or repetitive stress injury is a huge and increasing health problem for the US.  This LAT article estimates the costs, both direct and indirect at over $100 billion annually.   That's a large number even for the ten trillion plus US economy.  Guess what, we could significantly reduce that burden by reducing RSI through increased exercise.

Improved ergonomics have largely been used to treat RSI, however it is now being realized that exercise may be  more effective.

The LAT article quotes expert Yogi Matharu, director of the USC physical therapy clinic, as follows:

“Once someone is injured, ergonomics can help, but that can't be the only treatment,” he says. “Any kind of exercise increases endurance, which prevents the breakdown of different body parts, and people don't get fatigued as easily. And targeted exercise can strengthen weakened areas.”

“Finally, exercise regularly, whether it's hiking, cycling, walking, swimming or yoga, to get in better condition, which increases energy and endurance. “This way, you'll have a higher capacity,” Matharu says, “and be better able to withstand stresses on the job.”

RSI is a painful and debilitating condition that apparently does respond well to exercise.  Let's hope that those people that are suffering from RSI or hold positions that put them at risk for RSI get this important message.  This LAT article is a great start.  Read the whole article here.

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