Whether you're an older adult, senior fitness professional, health care worker, family caregiver -- or any combination of the above -- "Round-Up" provides you with information of interest and news you can use.

 

August 15, 2005

 

Table of Contents

  • Diabetes: Factors that Increase Exercise Participation (Research)
  • Strong Bones for a Lifetime (Health Facts)
  • Sassy Substitute (Nutrition)
  • How Does Your Garden Grow? (Wellness Tip)
  • Evaluating Step-Aerobics for Seniors (Exercise Instruction)

Diabetes: Factors that Increase Exercise Participation

Anjali D. Deshpande and colleagues identify certain factors that may encourage persons with diabetes to exercise regularly in their paper "Environmental Correlates of Physical Activity Among Individuals with Diabetes in the Rural Midwest," Diabetes Care, 28, 1012.

The researchers conducted a telephone survey during which they interviewed 278 individuals with diabetes living in rural communities of Missouri, Tennessee, and Arkansas. Nearly 37 percent of the group reported that they perform no physical activity in their leisure time, leading researchers to conclude that physical inactivity is a significant problem in the type of population studied.

Among those surveyed, the regular exercisers were more likely to enjoy better general health, normal body weight, and an absence of physical impairment.

Performing regular physical activity was positively associated with:

  • Using three or more community facilities (for example, parks and/or public swimming pools) during the previous 30 days;
  • The availability of shoulders on streets;
  • The involvement of one's physician in making a plan to increase physical exercise.

Strong Bones for a Lifetime

A recent Canadian Press report, "It's Never Too Early -- Or Late -- To Think About Good Bone Health," stresses the importance of taking care of one's skeletal system throughout one's life-span.

Experts interviewed for the article reiterated certain well-known facts that always bear repeating:

  • Osteoporosis involves a loss of bone density, leading to brittle, easily-fractured bones as well as to curvature of the spine;
  • Although osteoporosis can strike men, it is seen far more often in women;
  • Persons of any age can develop osteoporosis; however, its prevalence sharply increases in the over-fifty population segment.
  • Less widely-understood is the fact that establishing good diet and exercise habits during one's early years can help to postpone the onset of osteoporosis in later years.

The report's recommendations include ensuring that children receive sufficient calcium, vitamin D, and physical exercise. Teenagers must be discouraged from taking up cigarette smoking. Young adults should remain focused on proper diet and exercise. They need to know that extreme thinness can be seriously harmful to their bone health.

In older adults, a balanced diet including the necessary vitamins and minerals is advised in order to help slow the rate of bone loss. As people enter their sixties and seventies, exercise becomes invaluable as a means of preserving adequate bone mass. One way to be good to one's bones is to increase the performance of everyday activities such as gardening and walking the dog.


Sassy Substitute

OK, you've accepted the fact that you need to reduce your sodium intake in order to help prevent or manage hypertension. So, how do you keep your taste buds from rebelling against BDS? BDS stands for "bland diet syndrome." That's our term here at SFA for diets that are so flavorless they wind up putting health-seekers at an elevated risk for bingeing on inadvisable junk foods. The solution? Don't go around feeling deprived! When it comes to reducing salt, introduce zesty alternatives into your diet so that you won't be tempted to cast all prudence aside one day -- in a moment of weakness -- and recklessly load up on sodium-laden chips and such.

Sustain the "spice of life" by experimenting with commercially-prepared salt substitutes, fresh lemon juice, different types of vinegar, and various herbs. Executive Chef Brian Clarke, owner of the spice company Hotel-Pak Gold of New Smyrna Beach, Florida, recommends using white pepper in lieu of salt, especially on hot vegetable dishes. Another great idea comes from www.heartinfo.org. In place of salt, try seasoning with salsa!


How Does Your Garden Grow?

Gardening makes an excellent wellness activity, according to Everyday Health Tips By the Editors of Prevention Magazine Health Books, a Rodale Press publication. Growing a garden can provide great exercise, emotional rewards, and improved nutrition, too. It can also lure you into the great outdoors to commune with nature and enjoy some fresh air.

If you're new to the art, plant easy-to-grow "old reliables" like beans, carrots, cucumbers, tomatoes, broccoli, or cabbage. The carrots contain beta-carotine, a leading anti-cancer substance. The tomatoes and broccoli contain vitamin C, another cancer fighter. All provide nutritious vitamins, minerals, and fiber that will help to keep your diet healthful.


Evaluating Step-Aerobics for Seniors

We recently received a question from an SFA member regarding the use of step exercise for older adults. Specifically, she sought guidelines and exercise patterns for use in senior step-aerobics classes. We had discussed the topic quite a while back in SFA's Senior Fitness Bulletin (volume 3, number 3, 1996). At that time, due to insufficient objective data supporting its viability, we were unable to endorse conducting step-aerobics group-exercise classes for older adults. During the intervening years, we had not encountered new findings that contradicted our initial assessment. We decided to give this subject another look since it seemed possible that new information could have emerged.

First, we conducted a search of the literature to locate any new research on the topic of step training for seniors, but the search came up empty. Likewise, none of the textbooks we consulted provided detailed senior-specific step exercise instructions.

The most "encouraging" -- meaning pro senior step training -- material that we could find in an authoritative publication fell short of enthusiastically promoting the practice. In chapter 13 of Physical Activity Instruction of Older Adults (edited by C.J. Jones & D. Rose, 2005), chapter co-authors Susie Dinan, Dawn Skelton and Katie Malbut include step training in a listing of aerobic activities "assumed to be supervised groups" (page 203). Instructors are advised that "step training with inappropriate step height and inadequate support could result in unbeneficial [sic], unsafe exercise" (page 202). A reader could reasonably interpret that to mean the authors consider senior step training beneficial and safe under the right circumstances. Regarding any exercise, or form of exercise, Dinan, Skelton and Malbut encourage instructors to carefully analyze the activity in order to make certain that its risks don't exceed its potential benefits to the participant. A risk-to-benefit analysis table (page 202) provides questions to ask oneself in determining whether a particular exercise is advisable for the participant. In the opinion of SFA staff writers, when this analysis is applied to most senior fitness group-class settings, step doesn't fare very well because one must ensure that the presumptive benefits outweigh the risks for every person in the group. Our concern arises from the potential for accidental injury (i.e., from falling) if just one participant experiences an unexpected and/or undetected decline in depth perception, foot-lift height, or some other relevant variable. Alternatives suggested by SFA in the past have included using recumbent steppers or simulating step exercise by conducting low-impact aerobic dance patterns on and around chalk lines (or perfectly secured tape lines) on the floor. By the way, can you guess which mode of aerobic endurance exercise the book cited above DOES enthusiastically promote? Walking (page 200).

After conducting our print search, we contacted Reebok and another large step manufacturer to ask if they were aware of any research on the safety and benefits of step training for older adults -- and if they provide guidelines specific to senior step training. Neither representative we reached could answer the questions instantly, but both promised to get back to us. The next day a spokesperson for Reebok called, stating that Reebok knows of no research done regarding seniors and step, including benefits or guidelines. They recommend doctor's clearance. The other company hasn't gotten back to us (but if it further illuminates the issue, we will provide you with an update in Round-Up).

Because we didn't find major changes since we first explored the subject of senior step training, SFA maintains the position we adopted at that time. We don't train instructors to teach senior step-aerobics, and we caution instructors that conducting step-aerobics may be highly risky in older adult group-class settings. We have not seen research validating the safety of senior step-aerobics or supporting a good risk-to-benefit balance. Why take risks when there are so many proven methods of conducting safe and effective endurance training for older adults? In addition to the options noted above, one can choose from enjoyable activities such as swimming, aquatic exercise classes, cycling, circuit training, and even simply leading a more physically active lifestyle.


SFA's previously mentioned discussion of senior step-aerobics appeared in a Senior Fitness Bulletin "Ask the Experts" column edited by Drs. Jessie Jones and Roberta Rikli. Below, with permission of the American Senior Fitness Association, that earlier piece is reprinted for you:

Question: Is step training beneficial for older adult aerobic participants? Do special guidelines apply? (Answer provided by Laura Gladwin, M.S., an SFA National Advisory Board member)

"Research supports the use of step training as an effective mode of aerobic exercise for younger adults. Step training studies involving this age group have demonstrated an increase in VO2 max and a decrease in both resting heart rate and body fat. However, there has been a lack of research on the benefits of step training for older participants.

"According to Dr. Lorna Francis, professor at San Diego State University and coordinator of the development of Step Reebok Guidelines, step training may not be appropriate for seniors. The study of step training for older adults is impeded by the difficulty in selecting senior research subjects who would be free from any potential risk factors, such as osteoporosis. The variables associated with step training which may escalate the risk for accidental injury include platform height, choreography, and music tempo. The platform height elevates heart rate faster than exercising on a flat surface, and an elevated platform poses difficulty for individuals with balance and/or dizziness problems as well as for people with vision and perceptual motor deficits. Bifocal wearers, in particular, may have difficulty judging the height and edge of the step, thus increasing the risk for falling.

"Following choreography and keeping pace with the music tempo can be difficult while simultaneously stepping up and down from a platform, a combination which may ultimately increase the risk for falls. In settings where step training has been taught to older adults, some instructors have reported that -- unlike younger adults who may fall but suffer no fractures -- healthy active senior participants were seen to encounter falls that produced bone fractures. Instructors have also reported observing that their older clients' initial enthusiasm for step training appeared to fade quickly, resulting in a drop in attendance even when lower music tempos and steps no higher than 4 inches were used. Although there has not been any documentation regarding these compliance problems with step aerobics for older populations, one can only assume that such problems are related to fear of falling and/or to difficulty in executing movement patterns.

"Currently there are no specific guidelines for step training with older adults. And although some healthy seniors are able to safely participate in step aerobics, the instructor may find it difficult to ensure exercise safety for all participants. With both safety and liability considerations at issue, until research supports the benefits and safety of step aerobics for seniors and until specific guidelines have been developed, it is recommended that senior fitness instructors select a more conservative approach to aerobic training such as aquatic fitness, low-impact dance aerobics, walking, treadmill and stationary cycling."


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copyright 2005

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