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TomD's avatar

The importance of exercise cannot be overstated. At 79, I finally got back into strength training almost 4 years ago. I'm confident this has allowed me to pull thru medical problems I've had recently far easier and more quickly than had I not been in decent physical condition. But I was sidelined for over a month and I can tell you that atrophy happens. Back in the gym!

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Paul von Zielbauer's avatar

Tom, thanks for your comment. I'm a couple decades behind you but find the same dynamic: sidelined by a recent shoulder surgery, with no ability to do vigorous physical training, atrophy happens, as you say. Also, what often goes unmentioned or unnoticed, on the surface, anyway, is the mental/psych toll of suddenly not being able to physically exercise. For me, that's my most consistent form of meditation and stress relief, so if that goes away for several weeks or months...there's a consequence. I'm glad you're going strong. Keep going.

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TomD's avatar

Thanks. Hadn't thought of the stress relief provided by the regular exercise but definitely agree with your thoughts

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Lisa's avatar

Thanks Paul for this post.

I'm a nurse in Canada who has worked in both the hospital and community.

Longevity does not equate to good health. I agree that it's important to live well to age well, but we all have to die.

I think our reliance on pharmacology is misplaced. There isn't a magic bullet for this. As a society, we seem to want to do this the easy way. Taking a pill will fix this, as opposed to getting of the couch, eating well and putting away our screens. Our behaviors and ideas have to change.

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Paul von Zielbauer's avatar

Lisa, greetings to you and all AGING with STRENGTH friends from Canada. Couldn't agree more that living longer isn't ipso facto better. Living vigorously in good health is what matters, however many years that gives each of us. That said, prepare to be marketed an ever growing number of magic bullets, as you put it, that promise, for a steep price, to accomplish what exercise, sleep, friendships and eating mostly whole foods can accomplish naturally, better.

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Mark Globerson's avatar

First some questions on resistance/strength training. The definition of what this means for a given person is vague. Questions such as Intense training vs very, very light training come up. Do you need at least a minimum number of exercises per sessions or could some exercises be spread out over the day? Is yoga that has stance work vinyasas/flow, balance work, planks.etc... in addition to other parts of yoga also considering strength training and is it enough to make a difference? What about pilattes mat workouts (no machines)? In general when we talk about exercise providing benefits we don't often qualify with how long, how hard, how often to know when the benefits are better. Doing something regularly is obviously better than doing nothing. Clearly people with physical limits can't do as much and part of the answer is that you need to do what you can based on where you are physically since extremes can lead to injuries. But on the flip side, super easy, super light movement that doesn't cause some exertion probably has less benefit.

Regarding calorie restriction: Many, many people who are older are also struggling with extra weight so they will do some form of calorie restriction in an attempt to manage it. It gets complicated when you try to trade off the benefits of excess weight vs doing calorie restriction. The intermittent fasting people that use light eating (600-800 or so calories on one or two days per week) are probably not depriving themselves all that much on average. Also I wonder if calorie content was mentioned since there are people in the various camps of paleo, always healthy (a limited and tailored lower carb approach that eventually allows for whole grain and treats in small amounts but doesn't restrict calories), mediterranean diets, etc... all try to help manage weight by the content of food rather than the quantity.

I guess I need to read the book.

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Paul von Zielbauer's avatar

Mark, thanks for your thoughts and questions. There's a lot here. I'll attempt to provide some answers based on what I know directly and what I've learned from others.

Re your question of types and intensity of strength training to gain a benefit: I'm not sure yoga qualifies as strength training (thus, I'm not sure it doesn't), although if you're not used to doing a particular style of yoga, or any yoga, I imagine that would leave your muscles feeling as if they got a workout. Greater functional and neuromuscular strength accrues even with light weights. The number of reps/day or workouts/week isn't as important as 1) strength training regularly and 2) working your muscles to considerable fatique. If yoga or pilates achieves that, great! If you need to add in plyometrics (no weights needed), that's easy enough. Regularly using your muscles will make you stronger. I'll reiterate that you don't need a single piece of equipment to strength train your body. Bodyweight workouts are excellent and help avoid injuries that can come from going too hard too soon with weights.

Re calorie restriction: count me as a big believer in AVOIDING this — especially for older adults. Losing muscle mass is among the biggest physical health challenges facing anyone over 50 and certainly over 60, 70, etc. Muscles need fuel. CR restricts that fuel. Unless you're a competitive, experienced bodybuilder, you don't need to restrict calories. (Which is not good for brain health, either — another reason to AVOID it for older adults.) Rather than restrict calories, older people who want/need to lose weight should focus first on 1) eating whole foods and lean proteins, eliminating ultra-processed staples, which will reduce the empty calories that contribute to the flab weight they want to lose, and 2) moving their bodies, aka regular exercise. CR is not a remedy for losing weight.

Intermittent fasting is not the same thing as CR. I don't restrict calories but I do adhere to a fasting schedule from 7pm-11am most days. (But I'm not rigid about it; if my body is hungry, I listen to that message and give it healthy food.) That doesn't work for everyone, and I'm not advocating it for anyone else. But I find that it works for me.

To sum up: exercise in any form, even brisk walking, greatly lowers mortality risk, and getting physically stronger does not require heavy weights, onerous workout schedules or even a single dumbbell. (Check out the catalog of #WorkoutWednesday 3-minute workouts on the AGING with STRENGTH homepage, for 18 workouts that achieve neuromuscular fitness.)

I hope that's helpful.

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Mark Globerson's avatar

That's a pretty thoughtful answer. I asked about the quantity and quality of strength training because I have observed that some people say they are doing strength training and if you looked at what they do it's often a very disorganized approach that is better than nothing but is probably not achieving all that much. Most people usually need some guidance and structure in order to get a balanced balanced approach that they will do consistently and will give better results. I don't mean people have to kill themselves with high intensity that leaves them wiped out and not able to recover. However the difference between someone doing a strength training routine that consists of mainly arm curls with dumbbells and not working large muscle groups versus someone that has a more organized approach that mainly works the large muscle groups and includes some mobility is quite significant in terms of results. One thing that I know has to change for most people as they get older is that the intensity usually cannot be as high. That's where you need to be careful with strength training and not necessarily push muscles to exhaustion. This is a relative thing for each person but killer workouts take a bigger toll on joints and muscles so its easier to get injured and recovery time is slower. As they say "better to leave a little gas in the tank"

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Paul von Zielbauer's avatar

Mark, thanks for that insight. I'm trying to get a better read on how much guidance people over 50, over 60 and over 70 (each being a potentially separate cohort) need and want for functional strength and neuromuscular strength training. I may "over-assume" what people already know about workout regimens that give them what they want. Maybe a PDF or short group of functional strength videos, using weights, could be helpful....Let me know if you have thoughts.

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Tobyanne's avatar

I am in my upper 60’s and most people think I’m in my upper 50’s and that’s because I’ve stayed active in every season even though I live in the northern most US.

I disagree with the author on the drugs and vaccines. Less pharmakia, limited or no vaccines, whole food vitamins while eating a variety of sound minimally-processed foods will give best nutrients the body needs. And outdoor time-the sun is not your enemy.

It’s super important to build relationships and maintain them through positive uplifting thought, speech and action. Positive vibes.

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Paul von Zielbauer's avatar

Tobyanne, I appreciate your comment and believe in rethinking Western medicine's reliance on drugs as a primary solution to illness without first considering nutrition, time spent in nature, social habits/isolation, etc. That said, I disagree with the idea of no vaccines; many vaccines are clinically proven to prevent diseases.

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Danny L. Smith's avatar

If it’s really clinically proven.

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Paul von Zielbauer's avatar

Danny, they are quite clearly proven, unless you simply don't believe the science.

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Tobyanne's avatar

I respectfully disagree with you, Paul. Many of the childhood vaccines (70plus today) have not been thoroughly dbl blind tested and contain human genetics plus other nepharious ingredients that produce harm in the receiver. While the premise seems promising I do not believe most are necessary. Studies today in various countries show the unvaccinated healthier than those who partook,myself and my children as well.

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Paul von Zielbauer's avatar

Tobyanne, I am certainly glad that you and your children are healthy. We indeed respectfully disagree. In addition, I have to point out your assertions above that are not accurate:

"70plus childhood vaccines today" — According to CDC's 2024 childhood immunization schedule, children receive vaccines protecting against approximately 14-16 diseases, with some requiring multiple doses. The total number of individual shots (total shots, not unique vaccines) is around 25-30 by age 6, depending on the combinations used.

"Not thoroughly double-blind tested" — This is false. Vaccines go through extensive clinical trials, including randomized controlled trials, before approval. The FDA requires (at least it did up to recently) Phase I-III trials for all vaccines, with Phase III typically involving thousands of participants.

"Contain human genetics" — Some vaccines (varicella, MMR, hep A) are grown in human cell lines descended from tissue obtained decades ago. These cell lines are used for virus cultivation. The final vaccines contain only trace amounts of DNA fragments that are far below levels that could cause any effect.

"Nefarious ingredients" — Not sure what you mean here. Vaccine ingredients are publicly disclosed and include adjuvants (like aluminum salts) to boost immune response; preservatives (thimerosal has been removed from childhood vaccines except some flu vaccines); and stabilizers (like sugars and gelatin). These ingredients are present in tiny amounts and have been extensively studied for safety.

"Unvaccinated are healthier" — Large-scale, well-designed studies consistently show vaccines prevent serious diseases without causing overall health detriment. Studies claiming otherwise typically have significant methodological flaws like selection bias, lack of controlling for confounders, or inadequate sample sizes.

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Tom's avatar

I’m in my mid-70s, and I agree 100%. Nature has worked much better for me than drugs or vaccines.

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Paul von Zielbauer's avatar

Tom, I appreciate your comment. Nature is incredibly beneficial. And so are vaccines.

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Rohit Jayakar, MD's avatar

I completely agree with this methodology, and try to preach the same principles to my patients - there’s no quick fix!

The only thing I would add is that for people who are dialed in with their exercise routine, nutrition, and sleep, I do believe there’s a role for supplements for that last bit of optimization (eg protein if dietary intake doesn’t reach their target, creatine for performance and recovery, etc). While supplements alone won’t do much of anything, combined with the right lifestyle interventions, they can be beneficial

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Paul von Zielbauer's avatar

Dr. Jayakar, I appreciate your comment and I'm glad you mentioned supplements. I'm a user and a believer in some of the bedrock supplements, including magnesium and, for people who are active in resistance training, creatine. (I've also been using a couple of others, on the recommendation of a naturopathic doctor to address specific things, like high fasting glucose levels.) And I've written critically about so-called celebrity supplements that have no proven efficacy, like NAD+.

But, as you point out, supplements can be helpful as *additions* to a solid foundation of exercise, nutrition, sleep, etc., and they are called supplements for a reason.

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Rohit Jayakar, MD's avatar

Ahh yes, thanks for clarifying. 💯💯Somehow the unproven ones like NAD+ become trendy and all people ask about despite the lack of efficacy

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Paul von Zielbauer's avatar

What other trendy supplements do you find people asking for a lot that aren't proven to actually work? BPC 157 peptide is something I hear a lot about these days and some people swear by it, but there's just no proof that it actually works and there are a lot of unknowns. Are there other supplements that you find People misinformed about?

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Rohit Jayakar, MD's avatar

Yes. I specifically do nonsurgical musculoskeletal medicine so I have a ton of patients asking about unregulated peptides including BPC157. Not only is there no evidence they work (other than anecdotal stories), but there are some mechanistic concerns about possibly stimulating angiogenesis or cell growth where it’s not wanted. I do some orthobiologics like PRP but I get lots of questions about “stem cells” and people wanting to go to other countries to get them. Again totally unregulated and comes with lots of theoretical risk, who even knows what they’re actually getting. There’s some low risk ones i get asked about like glucosamine and chondroitin for osteoarthritis which have mixed data at best but at least there’s not as much risk with those so I don’t push back as much if people think it helps them. It’s also ironic when I have patients who are so against traditional medicine (medications or a steroid injection), but then they’re willing to be exposed to these unknown compounds because they saw it on Google or their friend had it 😂

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Paul von Zielbauer's avatar

Thank you for that detailed response, it confirms even further what I'm told by many other doctors and clinicians. People want fast fixes, oftentimes. And there is a lot of skepticism about medicine, obviously, coming out of the pandemic. We are in an era of major skepticism about many many things; medical science is one of them. Often to our collective detriment.

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Aging well Longevity MD files's avatar

the last thing we need is to live longer with help of medications. just a reminder that increasing health span is the priority. Stress and lack of meaningful social interactions are also important. think nursing homes are helpful?

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Paul von Zielbauer's avatar

Thanks, it's a good reminder. I'm not sure anyone's advocating living longer for its own sake. That said, it appears that the supplement companies pushing questionable "longevity" pills on people don't care about health span, so long as you buy the pills.

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Dariusz's avatar

👏👏🙏

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Paul von Zielbauer's avatar

Dariusz, I'm glad this is helpful to you. Keep going.

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Dariusz's avatar

Very helpful Paul. Many thanks again for the key take-aways from Colleen Murphy’s book. To slow aging is my top priority now and your blog and tips are of great help. As always the biggest challenge is to go from „knowing” to „doing”, however, that is within everybody’s will power. Best regards from Warsaw.

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Paul von Zielbauer's avatar

Exercise, sleep and a healthy social calendar...and you 85% of the way to optimizing health span, I'd say, given the science behind longevity, Dariusz. Dobra robota — tak trzymaj!

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Danny L. Smith's avatar

Define ‘they.’

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Paul von Zielbauer's avatar

Hi Danny. I'm not sure what exactly you're referring to. If it's my previous reply to your comment, stating, "If it’s really clinically proven." I would ask you to define "it." I had assumed "it" actually refers to vaccines, or the efficacy of clinically proven vaccines.

I hope that helps. Please define "it" in your statement, "If it's really clinically proven."

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Danny L. Smith's avatar

It is defined as ‘vaccine.’ Meaning, ‘if the vaccine is clinically proven.’ And I’ll add, under rigorous standards not compressed by scare tactics and conflicts of interests.

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Paul von Zielbauer's avatar

I'm having difficulty, over three or so fragmented comments, understanding what your point is. Are you disputing the validity of vaccines? If so, based on what evidence? Please make your point in one post and I'll be able to respond to it.

Thanks so much.

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Danny L. Smith's avatar

I simply commented to your post with about ‘many’ being clinically proven. And agree, if they, the vaccines are ‘really’ clinically proven and not ramrodded through the most current process. You post some good stuff and the summary of the book in this post is good, but the author lost some credibility with her ‘ current threats to vaccination programs "will definitely shorten lifespan.’

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Paul von Zielbauer's avatar

Danny, thanks, I believe I understand your point of view now. Why did the author lose credibility for saying that threats to current vaccines will shorten lifespan? I take it you don't find that statement credible, but why do you believe it's not, if we're seeing measles outbreaks and a potential return of polio, due to declines in herd immunity because of fewer children receiving those innoculations. I'm respectfully asking what the crux of your disagreement with that statement is.

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Danny L. Smith's avatar

Good morning Paul. To clarify, though gunshot (biased) I’m not an antivax guy, but do believe there’s been a gross misuse for whatever reason. I’m 70, ex-military, had my share of vaccines in my early years, including the polio vaccine.

Having said all that, the author’s comment - “"The reason that all of us have made it to adulthood is because of vaccines," and current threats to vaccination programs will definitely shorten lifespan.”” - is frankly absurd. She can’t possible know that, and surely she doesn’t really believe it herself but let some bias infiltrate what appears to be an otherwise strong representation of how we age.

To also clarify, I’ve only read your takeaways.

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