Our World is Aging

What is aging? Is it about the number that’s written on your ID? Is it the number of candles on your cake? Is it the number of lines on your face? Is it the number of beats your heart has beaten all these years?

When we talk about age, we should think of the physical as well as the mental and emotional aspect. Although in many cases, the different aspects of age are more or less synchronized, though there is not always the case. Some people may look young on the outside but feel old and weary deep inside. There are also those who feel “young at heart” even in their 80s.

Aging is a natural process and there is no way we can fully stop it, unless we have the mythical elixir of life. However, recent medical advances may be able to delay aging. There are many ways to Battle Aging. Cosmetic surgery such as facelifting and botox can remove the lines from a face and thus temporarily stop physical aging. Some people, however, choose to “age gracefully” by accepting the wrinkles but keeping the body young and fit by leading a healthy lifestyle. And then there are those whose body may be old and broken by disease but whose heart and spirit are still young and whole.

In Battling Aging, we will tackle all the different aspects of aging.

What is aging? Is it about the number that’s written on your ID? Is it the number of candles on your cake? Ist it the number of lines on your face? Is it the number of beats your heart has beaten all these years?

To start off, I’d like to bring you some figures about the age of the world population expressed in years. Here are some statistics from a recent report entitled “An Aging World: 2008” International Programs Center in the Population Division of the Census Bureau and commissioned by the US National Institute on Aging:

• In 2008, there were 506 million people worldwide aged 65 and older.
• In 2040, the 65 and above generation will reach 1.3 billion.
• In just over 30 years, the proportion of older people will double from 7 to 14%
• In 10 years, there will be more people aged 65 and older than children under 5 in the world.

Here are some highlights from the report:

While developed nations have relatively high proportions of people aged 65 and older, the most rapid increases in the older population are in the developing world. The current rate of growth of the older population in developing countries is more than double that in developed countries, and is also double that of the total world population.

As of 2008, 62 percent (313 million) of the world’s people aged 65 and older lived in developing countries. By 2040, today’s developing countries are likely to be home to more than 1 billion people aged 65 and over, 76 percent of the projected world total.

The oldest old, people aged 80 and older, are the fastest growing portion of the total population in many countries. Globally, the oldest old population is projected to increase 233 percent between 2008 and 2040, compared with 160 percent for the population aged 65 and over and 33 percent for the total population of all ages.

The 65-and-older population in China and India alone numbered 166 million in 2008, nearly one-third of the world’s total. Issues related to population aging in the world’s two most populous nations will be accentuated in the coming decades as the absolute number climbs to 551 million in 2040 (329 million in China and 222 million in India).

Childlessness among European and U.S. women aged 65 in 2005 ranged from less than 8 percent in the Czech Republic to 15 percent in Austria and Italy. Twenty percent of women aged 40–44 in the United States in 2006 had no biologic children. These data raise questions about the provision of care when this cohort reaches advanced ages.

Older people provide support to as well as receive support from their children. In countries with well-established pension and social security programs, many older adults provide shelter and financial assistance to their adult children and grandchildren. Older people in developing countries, although less likely to provide financial help to children, make substantial contributions to family well-being through such activities as household maintenance and grandchild care.

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AHA report update 2009

As the year comes to a close, reports from health authorities and advocacy groups are slowly coming. The American Heart Association’s Heart Disease and Stroke Statistics 2009 Update has just been released – with data from 2005 to 2006. The report gives some good and not-so-good news. On the one hand, US mortalities due to heart disease and stroke are down On the other hand, the risk factors for cardiovascular disease are still on the rise.

Some figures to think about:

• Mortalities due to CHD have gone down by 30.7%.
• Deaths by stroke have gone down by 29.2%.
• One out of 2.9 deaths in the US was due to cardiovascular disease.
• Coronary heart disease (CHD) was responsible for one out of five deaths in the year 2005
• Stroke accounted for about one out of ever 18 deaths.
• Heart failure was a factor in one out of 8 deaths in 2005.

“It’s really gratifying to see that coronary heart disease and stroke deaths are continuing to decline, and they have been declining since 1968,” first author on the report, Dr Donald Lloyd-Jones of Northwestern University, told heartwire. “Since 1999, our most recent benchmark, we have seen essentially a 30% reduction in those death rates, which from AHA’s perspective is particularly nice to see because we’ve already exceeded the goal set for 2010. So that’s fantastic, and it comes from a number of different things. But there’s also an important asterisk beside those figures, and that is, if you really drill down in the data, there are some concerning trends to suggest that among younger adults-and we see this best in women ages 35 to 54-there actually appears to be a slight uptick in CVD and stroke death rates, which may well be attributable to the obesity epidemic and subsequent increases in diabetes finally working their way through. So there is cause for celebration, but real cause for concern that we’re going to give back some of the substantial gains that we’ve made, because obesity and the aftereffects are going to start to come to the fore, and we’re going to be paying the price.”

The risks factors that triggered these concerns are as follows:

• Mean serums levels of total cholesterol were declining in older people (men 40 and above, women 60 and above) but not in younger adults.
• More that 66% of adults surveyed lacked exercise and did not meet the minimum 10 minute daily recommended vigorous exercise.
• Incidence of childhood obesity was up by 4% (children aged 6 to 11 years old) in 2003 to 2006.

Although the figures showed some improvement, it seems that AHA and other heart health groups have so much more to do before we can beat the monsters heart disease and stroke.

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Resource Article for June: Heart and Stroke Statistics

Today, let’s have a look at figures and statistics on heart and stroke that we can ponder upon:

United States

According the Centers for Disease Prevention and Control (CDC), heart disease is the number one killer in the US [1].

• 28 % of all American deaths in 2002 were due to heart disease. More than half of those who died were women. The age-adjusted rate was 241 deaths per 100,000 population.
• Heart disease doesn`t recognize ethnic differences. Your ethnicity doesn`t count. It is the top killer among whites, African Americans, Hispanics, and American Indians and second among Asians and Pacific Islanders.
• The main type of heart disease that kills people is coronary heart disease, which accounts for 71 % of all deaths.
• In 2006, health care cost projection for heart disease was $258 billion, which includes costs for health care services, drugs, and lost productivity.
• From 1979 to 2005, there was a 484 % increase in the number of inpatient cardiovascular procedures and interventions.

There are differences in prevalence of heart diseases between states and territories. According to a survey [2] by the Behavioral Risk Factor Surveillance System (BRFFS) in 2005, the prevalence of myocardial infarction (heart attack) and angina pectoris (chest pains) were highest in West Virginia and Puerto Rico and lowest in the US Virgin Islands and Colorado. The figure [2] shows the

Self-reported prevalence of history of myocardial infarction or angina/coronary heart disdesease among adults aged ≥ 18 years – Behavioral Risk Factor Surveillance System, United States, 2005.

Europe

According to the European Heart Network 2008 cardiovascular disease statistics [3]:

• Cardiovascular diseases cause over 2 million deaths in the European Union and 4.3 million deaths all over Europe. This accounts for almost half (48 %) of deaths in the continent.
• More women die from cardiovascular diseases than men. Cardiovascular diseases could account for 45 % of female deaths and 38 % of all deaths in men in Europe.
• Cardiovascular diseases are the main cause of deaths among females in all countries in Europe. It is also the main cause of deaths among men except in France, the Netherlands, and Spain.
• Death rates from coronary heart disease are highest in Central and Eastern Europe than other parts of the continent; so are death rates from stroke. The incidence of cardiovascular diseases continues to rise in these regions.
• The overall cost of cardiovascular diseases to the European Union economy is estimated at €192 billion each year.

Worldwide

Worldwide, heart diseases and stroke are also found to be the leading causes of death. It is estimated that 7.1 million people worldwide die of heart disease each year. Researchers at the University of Queensland in Brisbane, Australia did an extensive study [4] on mortalities worldwide. About 56 million people died in 2001. Sadly, 10.6 of these were children in low- and middle-income countries.

The researchers found that although causes of death varied depending on the countries` economic status, ischemic heart disease and cardiovascular disease were the top killers in all countries regardless of income. In low- and middle-income countries, 11.8 % and 9.5 % of mortalities were due to heart and cardiovascular diseases, respectively. The figures were slightly higher for high-income countries – 17.3 % died of heart disease and 9.9 % died of cardiovascular diseases [4].

In a commentary in the Lancet, Kim Eagle writes [5]:

“While the mortality associated with cardiovascular disease seems to be declining in western Europe and North America, the burden of cardiovascular diseases in developing countries continues to rise and is expected to be a major cause of death in adults from low-income and middle-income countries worldwide.”

In particular, South Asia is of major concern. A recent BBC report warns about increasing rates of heart diseases in India. Based on a study by Canadian and Indian researchers and published in the journal Lancet [6], it is estimated that India will account for 60 % of cases of heart diseases worldwide in the next two years.

“South Asians have a greater prevalence of coronary risk factors than the rest of the world, and coronary artery disease often manifests at an early age which creates unusual pressure on society and the economy.”

 References:

[1] CDC fact sheet on heart disease in the US

[2] Neyer JR, et al. Prevalence of heart disease-United States, 2005. Mortality and Morbidity Weekly Report 2007; 56:113-118..

[3]European Heart Network. European Cardiovascular Disease Statistics 2008

[4] Lopez, A. et al. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. The Lancet, May 27, 2006; vol 367: pp 1747-1757

[5] Eagle, K. Coronary artery disease in India: challenges and opportunities. The Lancet April 2008; 371:1394-1395.

[6] Xavier et al. Treatment and outcomes of acute coronary syndromes in India (CREATE): a prospective analysis of registry data. The Lancet April 2008; 371:1435-1442.

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You Are NOT What You Eat!

By Craig Ballantyne

It’s almost impossible to avoid everyday evidence of the obesity epidemic. Walk down the street, look around at work, or even take note at the gym and you will find that the prevalence of obesity is remarkable.

Just recently, while seated in the top-level seats at a Utah Jazz basketball game, it was painfully obvious that the future health care system in the USA is going to be dramatically overburdened by a generation of obese adults, if it isn’t happening already. Admittedly, to get to the top row of seats in the arena it was a tough climb up 19 rows of steep steps, however it is a sad commentary when one man, perhaps 45 years of age and visibly obese remarked that, “that’s enough exercise for the entire week”.

Actually it’s not fair to single out North Americans, as even Hungarians, Danish, Russian, Turkish, and Dutch researchers are identifying obesity as a huge problem. All around the world scientists are attempting to find pharmaceutical and nutritional interventions to combat the problem of obesity. Even the Chinese are getting fat, likely due to the “McDonald’s disease” (the introduction of fast food restaurants and a sedentary lifestyle into their culture). Type 2 diabetes, high blood pressure, and abnormal blood lipid levels are now common in Hong Kong Chinese and this is closely associated with the increase in obesity.

More importantly, is that these countries are also observing increased obesity incidence in their youth, so it’s not just a reflection of the “American” culture, but rather the sedentary lifestyle seen across a generation, in combination with very poor nutritional choices. However, remember that there have been a number of reasons proposed as a cause of obesity (hormonal, genetic, societal, physiological, psychological, neurotransmitter), and of course some of these overlap. According to the World Health Organization, the prevalence of obesity has increased so rapidly in many populations that the changes cannot be attributed to changes in genetic inheritance alone.

GRIM STATISTICS

* Americans (and many other modern countries) are suffering from a “fat” epidemic.

* 55% of American adults are overweight or obese (Women = 50.7% & men = 59.4%).

* More specifically, 22% of US adults are obese (Women = 25% & Men = 19%).

* The economic costs of obesity are staggering. Researchers estimate that the financial drain from obesity and physical inactivity is over $90 billion a year, representing 15% of the American national health care expenditure.

* Americans spend $33 billion per year on products and services to help them lose weight (this includes gym memberships, diet soda, low-cal foods, and dietary supplements).

* Dietary supplements sales were $16.8 billion in 2000. Ten years ago sales were only $3.3 billion. The fastest growing segment is diet aids.

* The United States spent $1.2 trillion on healthcare in 1999 and this will increase to $2.6 trillion by 2010, likely because prescription drugs costs will grow by 12.6% per year.

Both rich and poor North Americans have equal opportunity to become overweight in these days of $5 fast food feasts. Body fat is simply the storage of excess energy intake from a positive energy balance. Energy balance can be best expressed as the calories (energy) consumed in comparison to the energy (calories) you burn off each day. Food energy is measured as a calorie, and so is the work that you do during exercise. Therefore, this basic energy equation (calories in vs. calories out) determines whether you gain, lose, or maintain your weight.

You expend energy every minute of the day, although the final amount is obviously determined by your activity level, not to mention your muscle mass (more muscle results in more energy being expended at rest). Diet-induced thermogenesis (DIT) also contributes to energy expenditure and obese adults often show lowered DIT compared to lean adults. DIT is the amount of energy that your body expends during the digestion, absorption, and utilization of food energy.

Obese adults that have a low DIT have a more efficient utilization of calories and greater ease of fat accumulation. In less technical terms, this simply means that “naturally thin” individuals (also referred to as individuals with “fast metabolism”) use up more energy during these processes and as a result have less energy to store as body fat.

Chronic overfeeding (regardless of whether it is carbohydrate or fat) is associated with obesity, insulin resistance, and elevated blood insulin levels. Insulin is an anabolic hormone with both good and bad connotations. Fortunately, it can prevent muscle breakdown after exercise and it helps the muscle store glycogen (a fuel for high intensity exercise), however it can also increase the storage of blood free fatty acids in fat cells. It also limits fat mobilization (the release of fat from fat cells to be used for energy production). So even if you are consuming a low-calorie diet but still consuming a diet that promotes high insulin levels (i.e. lots of high-glycemic carbohydrates), you may have difficulty losing body fat.

There is evidence that “high-glycemic” carbohydrates are best avoided by those seeking to lose weight. High-glycemic carbohydrates are refined foods such as processed cereals, cookies, pasta, white rice, cakes and other processed goods high in sugar. The term high-glycemic refers to the rapid increase in blood sugar that these foods cause after ingestion because they are rapidly absorbed. In a recent study in the American Journal of Clinical Nutrition (71: 901-907, 2000), researchers found that after only 6 days, subjects eating low-glycemic foods lost more body fat than subjects eating high-glycemic foods. Also, the group eating the low-glycemic foods had a higher metabolic rate and a lower rate of snacking on sugary foods.

From 1994-96 Americans consumed the equivalent of 82 grams of high-glycemic carbohydrates per day from added sweeteners, which was about 16% of total calories. Adolescents had the highest intake, about 20% of calories, with soft drinks accounting for a third (!) and table sugar, syrups and sweets, sweetened grains, and milk products providing the rest. That translates into almost 330 calories of sugar per day! Eliminate this from your diet and you have the potential to lose 1 pound of fat (generally considered to be 3500 calories) in 10 days.

While the prevalence of obesity continues to rise controversy remains as to the specific causes of this trend. What about the phenomenon of winter fat? Roberts et al. (2000) determined that the weight gain during the 6-week winter period from American Thanksgiving through New Year averaged only 0.8 lbs. However, weight gain was greater among individuals who were overweight or obese, and 14% gained more than 5 lbs over this time period. Among the entire population, weight gain during the 6-week holiday season explained 51% of annual weight gain.

So it appears that most weight gain does occur during the holiday period and by early March their was a recorded net weight gain of approximately 1-1.5 lbs (Robert et al., 2000). If you do that every year you can see how “the pounds creep up on you”. In another study, Yanovski et al. (2000) found a similar trend and therefore American adults should expect to see a net weight gain (winter fat!). In conclusion, it looks like holiday weight gain really is the important contributor to the rising prevalence of obesity that many people often make it out to be, even though absolute values for weight gain in this study were less than anticipated.

Craig Ballantyne is a Certified Strength & Conditioning Specialist and writes for Men’s Health, Men’s Fitness, Maximum Fitness, Muscle and Fitness Hers, and Oxygen magazines. His trademarked Turbulence Training fat loss workouts have been featured multiple times in Men’s Fitness and Maximum Fitness magazines, and have helped thousands of men and women around the world lose fat, gain muscle, and get lean in less than 45 minutes three times per week. For more information on the Turbulence Training workouts that will help you burn fat without long, slow cardio sessions or fancy equipment, visit www.TurbulenceTraining.com

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