In This Issue:

1. Do I Have to Exercise?
2. Tips to Quit Smoking
3. Dietary Guidelines 2005
4. Want Less Risk?  Get Fit!
5. SAFE Tip:  Falls
6. Manage the Benefits and Risks of Medications
7. Mature Driver Safety Program
8. Ask Dr. Vanessa

1. Do I Have To Exercise? By Vanessa M. Dazio, OTD, OTR/L, (D) ABDA

Since my career began as an occupational therapist, I have had the great opportunity to work in some manner with thousands of individuals. Many individuals experienced a loss of strength, balance, or coordination that affected skills and abilities. Treatment programs of choice often included “exercise.” Over time, I really can’t remember too many people who said they “loved” doing exercises. In fact, I often heard people say, “Do I have to exercise?” The repetitive exercises were often the least liked and the least followed activities in the treatment program.

It often seemed to me the word “exercise” was code for “Stop, I am not listening to you any more.” Exercise was the key to developing strength, endurance, coordination and range of motion. Exercise was necessary to regain health and balance in life. Yet, so many people found repetitive exercise boring, uninteresting and avoidable.

Activity Ideas

Here are some suggestions:

• Walk around a shopping mall. (increase the number of times as able)

• Take a walk around the block with family, friends, or coworkers.

• Tai chi (join a class - a really pleasant way to improve balance, coordination, range of motion and flexibility)

• Park the car farther away from entrances to stores, movie theatres, or your home.

• Fold sheets and towels.

• Walk! Walk! Walk!

• Visit museums, the zoo, or an aquarium.

• Take a walk after dinner instead of watching TV.

• Go for a walk in the park or an arboretum.

To build endurance, it is important to find activities that make the lungs and heart work more vigorously, but in a controlled manner that does not strain the body. This is called “aerobic exercise.” Regular aerobic activity has many advantages, some are as follows:

1. controls weight by burning calories

2. reduce the risk of heart disease and stroke by strengthening heart muscle and lowering blood pressure

3. helps lower cholesterol, a type of fat in your blood

4. maintains strong bones

5. relieves tension

6. decreases stress

7. builds confidence

8. improves self-image

Here are some aerobic activities that are often done at home or in the community

• Raking leaves

• Washing the car

• Using the stairs instead of the elevator

• Increase the walking pace as able

• Washing windows or cabinets

• Sweeping the garage or basement

• Dancing (square dancing, salsa, swing, ballroom, etc)

• Jogging (Jog to the mail box, then later jog down the block. Set a goal to jog greater distances as tolerated.)

• Brisk walking

• Bicycling

• Playing basketball

For healthy exercise, it is also important to develop and maintain strength because strong muscles improve balance, support the joints, builds bone, and may even prevent bone loss. Strong muscles reduce the risk of injury. Lifting weights, using resistance bands, and doing push-ups or sit-ups are examples of strengthening exercises. Here are some daily life activities that can qualify as strengthening activities:

• Doing laundry

• Swimming

• Hanging clothes on a clothes line

• Scrubbing the floors, or bathtub

• Vacuuming the floor

• Organizing the closets, cabinets, garage, etc.

Health and Safety Through Greater Activity

You can improve your health and safety by choosing routine activities in daily life that increase your flexibility, range of motion, strength and endurance. Develop healthy plans to increase activity levels. Seek the advice of knowledgeable health care workers before starting active programs, and remember you are never too old to get active!

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2. Tips to Quit Smoking

Smoking harms nearly every organ of the body, causing many diseases and reducing the health of smokers. Quitting smoking has immediate, as well as long-term health benefits. Within 20 minutes after smoking a last cigarette, the body begins a series of positive changes that continue for years.

TIPS: To successfully quit smoking, here are some ideas:

1. See your doctor, and set a quit date!
2. Call a telephone quit line, or
3. Join a support group program to learn new skills and behaviors to deal with situations when you want to smoke.
4. Get support and encouragement from family and friends.
5. Get medication and use it correctly.

For information on how you can quit smoking visit the following web sites and resources below:

• Online Guide to Quitting Smoking at http://www.smokefree.gov/
• Locate a Quitline in your State and Speak to Smoking Cessation Counselor at http://www.smokefree.gov/usmap.html
• Additional Information on How to Quit Smoking at http://www.cdc.gov/tobacco/how2quit.htm

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3. Dietary Guidelines 2005

Poor Diet and Inactivity are Linked to Ill Health

Major causes of illness and death in the United States are related to poor diet and an inactive lifestyle. Some specific diseases linked to poor diet and physical inactivity include cardiovascular disease, type 2 diabetes, hypertension, osteoporosis, and certain cancers.

Poor diet and physical inactivity, resulting in an energy imbalance (more calories consumed than used), are the most important factors contributing to the increase in overweight and obesity in this country.  This year, take personal control of your health!

New Dietary Guidelines Just Published

The US Department of Health and Human Services and the USDA just published revised recommended dietary guidelines. These guidelines provide science-based advice to promote health and to reduce risk for major chronic diseases through diet and physical activity. The following is a summary of the key points for older adults:

 

Weight Management Before starting a weight loss plan: see your healthcare provider to develop a safe plan that considers all health conditions. To prevent gradual weight gain over time: increase physical activity and make small decreases in food and beverage calories. To maintain weight: eat the same amount of calories from foods and beverages as the calories used. To lose weight: Aim for a slow, steady weight loss by decreasing calorie intake, eating nutritious foods and increasing physical activity.

Consider This: If you eat 100  more food calories a day than you burn, you'll gain about 1 pound in a month.  That's about 10 pounds in a year.  The bottom line is that to lose weight, it's important to reduce calories and increase physical activity.

Physical Activity

• Regular physical activity promotes health, psychological well-being, and a healthy body weight.
• Participate in regular physical activity to reduce functional losses associated with aging.
• For most people, greater health benefits can be obtained by doing more vigorous intensity or longer duration physical activities.

Recommended Types of Physical Activity

Use a combination of exercises that includes the following:

• stretching exercises for flexibility
• resistance exercises or calisthenics for muscle strength and endurance.
• cardiovascular conditioning exercises to increase circulation

Exercise Intensity Recommendations

1. To reduce risk of chronic disease:   Do at least 30 minutes of moderate-intensity physical activity, above usual activity, at work or home on most days of the week.
    

2. To manage body weight: Do approximately 60 minutes of moderate - to vigorous-intensity activity on most days of the week while not exceeding caloric intake requirements.
    

3. To lose weight: Participate in at least 60 to 90 minutes of daily moderate-intensity physical activity while not exceeding caloric intake requirements. (Some people may need to consult with a healthcare provider before participating in this level of activity.)

Food Groups:  Eat a Healthy Balance

Fruits and Vegetables:  Eat a variety of fruits and vegetables: (Two cups of fruit and 2 1/2 cups of vegetables per day are recommended for a 2,000-calorie intake, with higher or lower amounts depending on the calorie level.)

• Select from all five vegetable subgroups (dark green, orange, legumes, starchy vegetables, and other vegetables) several times a week.
• Consume 3 or more ounce-equivalents of whole-grain products per day, with the rest of the recommended grains coming from enriched or whole-grain products. In general, at least half the grains should come from whole grains.
• Eat/drink 3 cups per day of fat-free or low-fat milk or equivalent milk products.

Fats: Eat less than 10 percent of calories from saturated fatty acids and less than 300 mg/day of cholesterol, and keep trans fatty acid consumption as low as possible.

• Keep total fat intake between 20 to 35 percent of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.
• Limit intake of fats and oils high in saturated and/or trans fatty acids, and choose products low in such fats and oils.
• When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free.

Carbohydrates:  Choose fiber-rich fruits, vegetables, and whole grains.

• Choose and prepare foods and beverages with little added sugars or caloric sweeteners, such as amounts suggested by the USDA Food Guide and the DASH Eating Plan. 
• Practice good oral hygiene.
• Eat/drink less sugar-and starch-containing foods and beverages.

Sodium and Potassium:

• Aim to consume no more than 1,500 mg of sodium per day,
• Eat potassium rich foods such as fruits and vegetables (recommended to get about 4,700 mg/day of potassium with food).
• Individuals with hypertension, blacks, and middle-aged and older adults. Choose and prepare foods with little salt, and eat potassium rich foods.

Vitamins:  People over age 50 should consume Vitamin B₁₂ in its crystalline form (i.e., fortified foods or supplements). Older adults, people with dark skin, and people who do not get enough sunlight should consume extra vitamin D from vitamin D-fortified foods and/or supplements.

Alcoholic Beverages

• Drink alcoholic beverages sensibly and in moderation—defined as up to one drink per day for women and up to two drinks per day for men.
• Some people should not drink any alcohol, including those who cannot restrict their alcohol intake, women of childbearing age who may become pregnant, pregnant and lactating women, children and adolescents, individuals taking medications that can interact with alcohol, and those with specific medical conditions.
• Avoid alcoholic beverages when doing activities that require attention, skill, or coordination, such as driving or operating machinery.

Food Safety

To avoid microbial foodborne illness:

• Clean hands, food contact surfaces, and fruits and vegetables. Meat and poultry should not be washed or rinsed.
• Separate raw, cooked, and ready-to-eat foods while shopping, preparing, or storing foods.
• Cook foods to a safe temperature to kill microorganisms.
• Chill (refrigerate) perishable food promptly and defrost foods properly.
• Avoid raw (unpasteurized) milk or any products made from unpasteurized milk, raw or partially cooked eggs or foods containing raw eggs, raw or undercooked meat and poultry, unpasteurized juices, and raw sprouts.

FOOD SAFETY WARNING!!!!!

FOR OLDER ADULTS AND THOSE WHO ARE IMMUNOCOMPROMISED.

• Do not eat or drink raw (unpasteurized) milk or any products made from unpasteurized milk, raw or partially cooked eggs or foods containing raw eggs, raw or undercooked meat and poultry, raw or undercooked fish or shellfish, unpasteurized juices, and raw sprouts.
• Only eat certain deli meats and frankfurters that have been reheated to steaming hot.

Dietary Guidelines for Americans is published jointly every 5 years by the Department of Health and Human Services (HHS) and the Department of Agriculture (USDA). The Guidelines provide authoritative advice for people two years and older about how good dietary habits can promote health and reduce risk for major chronic diseases. The 2005 edition of the Guidelines was released at 11 AM, January 12, 2005.

Modified by SAFE Aging, 2005. For the complete guidelines, refer to http://www.health.gov/dietaryguidelines/dga2005/document/

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4. Want Less Risk?  Get Fit!

Individuals who have a combination of risk factors including high blood pressure, elevated blood glucose levels, excess abdominal fat and abnormal cholesterol levels, are at higher risk of getting heart disease, diabetes or a stroke. This combination of risk factors is known as the “metabolic syndrome.” It is estimated 25 percent to 40 percent of American adults age 40 and older have this risky syndrome.

Last month, researchers at Johns Hopkins published an article in the American Journal of Preventive Medicine, describing their study on the role of exercise training in treating “metabolic syndrome.” They determined in people age 55 to 75, “a moderate program of physical exercise can “significantly offset” the potentially deadly mix of risk factors for heart disease and diabetes.”  

Moderate exercise was a series of exercises for 60 minutes, three times a week. The exercises were designed to work all major muscle groups, the heart and circulation. These included aerobics on a treadmill, bicycle or stepper, plus weightlifting. This interesting study clearly demonstrates “the value of exercise for managing multiple risk factors”. It also provides older adults with a very strong reason to increase physical activity levels. This study showed moderate exercise will help to reduce fat, increase fitness and reduce the risk for heart disease, strokes and diabetes.

Resource:  American Diabetes Foundation

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5. SAFE TIP:  Falls

Non-intentional injury is the fifth leading cause of death in seniors, and falls account for most of these. Falls are warning signs and should NEVER be ignored! Normal aging causes changes in the senses, reflexes, and strength that affect walking and balance. When strength, flexibility and vision decline, the opportunity for falls increases. Certain medical conditions can cause dizziness or faintness that can lead to falls. Tell your doctor if you fall, are stumbling, or have had near falls. Your doctor needs to be aware of the whole story to develop a health plan to assure your safety and health. Many times, simple changes in activities and around the home can decrease the risk of injuries due to falls.

For help in identifying risks and hazards or finding solutions, contact SAFE Aging at 866-SAFE-AGE.

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6.  Manage the Benefits and Risks of Medications

All medicines, including prescription and over-the-counter, have risks as well as benefits. Think it through and work  with your doctor, pharmacist, and other health care professionals to manage the benefits and risks of your medicines.

Speak up.
Ask questions.
Find the facts.
Evaluate your choices.
Read the label.

For more information, go to www.fda.gov/cder or call 1 (888) INFO-FDA.

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7.  Mature Driver Safety Program

The AAA has developed a mature driver safety program that begs involvement. Take a moment to check out this link. It could save your life or the life of others!

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8. Ask Dr. Vanessa

Question: I am afraid of falling. What can I do about it?

Answer:  A fear of falling means for some reason you have lost or are losing your self confidence. Fear of falling is an anxiety that often results in a person imposing limits on daily life activities. Fear of falling can seriously threaten personal independence and quality of life. It is wise to be concerned about falling, but not good to be “afraid” of falling.

You have taken the first step to controlling your fear by asking what can be done. The next important step is recognize the reasons or the risks you have that could cause falls.

To Recognize Risks

Ask why, how, and when questions.

• Why did I fall? (Was I rushing, did I not see something, was I unable to do an action?)

• How did I fall (Did I slip, trip or black out?)

• How often have I fallen?  

• When did I fall? (Do I fall when getting up to go to the bathroom, when I step out of the shower or when I get up from the toilet?)

Look internally at yourself. Are you falling because of loss of strength? Are you out of shape? Are you weak due to eating habits?  How is your balance and vision? Are you taking medications that could cause loss of balance, dizziness? Do you have pain? Are you distracted?  

Look at your surroundings. How is the lighting? Are you tripping over obstacles such as a box or basket on the floor, or loose carpets? Do you have furniture in path ways? How are your shelves organized, etc?

Control Your Risks

TAKE ACTION: DO NOT DELAY. Falls are preventable! Fear of falling must be respected and controlled. To prevent falls and reduce your anxiety, action begins with recognition. Recognize your reasons (risks). Immediately share your feelings and concerns to your health care professional. Once your risks are recognized, the best course of action for you can be chosen.

Options for Action:  Action depends on cause. To prevent falls, determine the cause. Get regular medical checkups, be physically fit, wear good supportive shoes, have a safe home, be aware of your surroundings and eat a well balanced diet.  

Most importantly, see your health care professional for help. There are so many options. You may need to have medical screenings or tests. Perhaps medications should be studied. Vision, balance or posture could be checked. You may need to get involved in fitness or therapy programs to build strength, coordination or flexibility. You might need to change your environment to improve safety or add some safety equipment. Or, it might be important to choose a combination of all of the above. Let a health care professional help you to address this fear, before you get an injury.   

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