Author: Nicolette Kavouras

By: Brad Hankins

Consult Your Primary Care Provider Before Making Changes to Your Medications, Diet or Beginning/Changing an Exercise Program

We are continuing our exploration of brain health this month by looking at cognition and how we may be able to improve our cognitive abilities in daily life.

Cognition collectively means the processes taking place in the brain, including thinking, attention, language, learning, memory and perception – in other words, everything that connects us to the world and the world to us. When we experience a change in cognition, we also experience a change in self and in how we perceive the world. I think we agree anything we can do to maintain and, perhaps, improve cognition is in our favor.  But before we enter that discussion let’s look at some of the things that can affect cognition.

Mild cognitive impairment (MCI) https://www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/symptoms-causes/syc-20354578 is described as having symptoms such as, simple (but habitual) forgetfulness, difficulty following directions and tracking conversations. There is no single cause of MCI, instead MCI is caused by a constellation of conditions to include genetics and living/working/social environments.  Aging related brain shrinking, especially in the area of the brain that controls memory, brain fluid retention and decreased blood flow are some diagnosable causes.

Some studies https://pmc.ncbi.nlm.nih.gov/articles/PMC9013315/#S16 indicate up to one third of all adults over the age of 65 have a range of cognitive issues from MCI to dementia. However, having MCI is not always a path to dementia or Alzheimer’s. In fact, in some cases, MCI can be improved by making lifestyle and environmental changes.

A medical condition https://pmc.ncbi.nlm.nih.gov/articles/PMC8090478/ getting recent attention as one of the causes of MCI is metabolic syndrome (MetS).    The combination of type 2 diabetes, hypertension (high blood pressure), hyperlipidemia (high cholesterol) and, in my opinion, chronic depression are the diagnosis’s which make up MetS.  Any of the four diagnoses’ can, over time, affect brain performance, however the four together present a greater combined risk.

Type 2 diabetes causes blood to become thicker, due to increased sugar, which blocks off tiny blood vessels in the brain. High blood pressure causes micro tears in the same tiny blood vessels leading to blood clotting in those vessels that also block blood flow.  High cholesterol increases the number, and type, of fats circulating in the blood and (you guessed it) interfere with brain blood flow to include blocking microscopic blood vessels.  Lastly, and again this is only my opinion, though it is not a metabolic condition over time chronic depression changes brain chemistry in both availably and utilization leading to areas of the brain not having the right balance of brain chemicals and/or not using brain chemicals correctly.

Reduced blood flow is not the only cause of MCI but some of the factors causing reduced blood flow are, in part, manageable. Some modifiable causes can include medications (do not stop or change the dosage of any prescription medications without consulting your medical provider), vitamin deficiencies, thyroid disorders, reducing emotional and psychological stress, sleep disorders and changes in sight and hearing. There are things under our control that may improve cognition and lessen MCI, but how do we incorporate cognitive improvements into our lives?

• The first and easiest brain friendly choice you can make is – take your medications as prescribed. If it has been a while since you reviewed your medications with a medical provider schedule an appointment to do so.
• If you have MetS, or any of its individual medical conditions, stay on the treatment plan given to you by your provider. If the treatment plan is difficult to follow, consult your provider.
• Schedule an annual eye exam, and a semi-annual hearing test.
• Stay hydrated, remember the brain is 75% fluid. Current fluid recommendations https://pmc.ncbi.nlm.nih.gov/articles/PMC7694182/ for adults over the age of 65 (with good daily nutrition) is 1.6 liters (7 cups)  a day for females and 2.0 liters (9 cups) per day for males.  When exercising these numbers should increase.
• Take charge of online information/make your own algorithm. Limit/schedule screen(s) time, modify your news feed and social media, delete/block triggering information, turn off/manage notifications, as scary as it may sound – switch off your devices for brief periods and slowly (re)learn to embrace quiet.
• Exercise regularly. Exercise at least three days per week for an hour a day, mix up types of exercise – walk/dance/swim/yoga/run/pickleball/lift weights (yes you need to lift weights), schedule exercise times, consult a trainer to help get started, and make exercise a disciplined part of your life.
• Now is the time to learn something new. Try a new sport/activity – hiking/archery/kayaking/Tai Chi/fly fishing, learn an instrument, make art, start writing/blogging, take online classes, go after a certification in something interesting, become an observer and teacher.
• Reacquaint yourself with relaxing/de-stressing. Remember when people did nothing for the simple enjoyment of it? Read books – the kind with paper pages.
• If you have a deck/porch/patio try sitting on it – in a chair, with no devices, go for a walk – just a walk, or sit and breathe and get comfortable with your own thoughts.

I would enjoy hearing about your fitness journey, please feel free to email me at hankinsb@ssymca.net.

Brad Hankins RN, CPT

 

By: Brad Hankins

Consult Your Primary Care Provider Before Making Changes to Your Medications, Diet or Beginning/Changing an Exercise Program

In the next several columns we will explore brain health and those things we can do to keep our brain healthy.  I would first like to write two words, so we don’t have to be afraid of them – dementia and Alzheimer’s.  It is extremely unfortunate when individuals and families are touched by either, and both can be frightening to consider. However, there are choices we can make to help to improve the health of our brain, regardless of age.

Let’s start with a page from the brain owner’s manual:

• Our brains weigh approx. three pounds and are about 2% of total body weight. At the same time 15% of our blood flow goes to our brain (approx. 1.5 pints per minute), and our brains consume 25-30% of our daily calories.
• Fluid makes up approx. 75% of the brain, by volume.
• There are 170 billion brain cells making up 86 billion individual neurons (nerve cells).
• Your body creates 750 to 1500 new brain cells each day (about one per minute).
• The brain is approx. 60% fat, making the brain the fattest organ of the body.
• Most brain fat is used in myelin, which insulates each nerve from the others. This is the same as insulation on electrical wire prevents the inner metal part from touching other wires.
• There are approx. 180 separate and distinct areas in each hemisphere (half) of the brain.
• You are both left brained and right brained. Each hemisphere is separate but connected to the other.  Each communicates with the other, sometimes directly and sometimes in consult.
• Our brain cells use a combination of electrical impulses and chemical reactions (dopamine, serotonin etc. – there are over 60 different brain chemicals) to communicate.
• Brain impulses travel at speeds up to 400 feet per second, or over 250 miles per hour.
• If all the blood vessels in our brain were connected end to end, they would be approx. 100,000 miles long (a distance almost halfway to the moon).
• The two main brain fuels are oxygen and sugar.

Our brains are a very complex and busy place.

This may help in a minute-a bit is the smallest unit of digital information, it is equal to answering a single question yes, or no. A byte is 8 bits of information, a gigabyte is one million bytes and an exabyte is one billion gigabytes.  

Our brains processing speed (how quickly our brain can take in, interpret and respond to information) is a maximum of 120 bits per second.  We typically reach this limit processing word recognition, interpreting speech, processing images and reading. When we are in conversation, we can usually process what the other person is saying at a rate of 60 bits per second – on a good day.  This is why when two people are speaking to us at the same time it is difficult to understand, let alone retain, what both are saying – we have exceeded our maximum 120 bit per minute processing speed. Interestingly this is the same reason when driving you instinctively turn the music down when traffic gets heavy, and it suddenly starts raining – you have hit your maximum 120 bits per second and need to reduce information input to devote all available processing speed to not becoming a hood ornament on a Kenworth.

We take in a tremendous amount of information per day, and with each passing day our exposure to information increases.  Each day we can process up to 3.4 gigabytes of information, or information equal to 100,000 words every 24 hours – though much of that information is in the form of TV, podcasts, TikTok videos, and scrolling through Facebook posts about kittens. And we live in a world of 300 exabytes (300 followed by 18 zeros) of available human-made information.  Google alone contains hundreds of billions of webpages and has well over 100,000,000 gigabytes of directly searchable information.

In 1925 newspapers were the main source of information, a daily newspaper of the day contained an average of 25,000 total words. Only 19% of American homes owned a radio and the concept of national radio stations was still developing.  Most information came from local, or regional, sources. Currently you can check the weather in Shanghai in less than a second and practically every news source on the planet is immediately available at the touch of a screen

We have the same brain function our grandparents had in 1925, with the same 120 bit maximum processing speed.  But we are processing many times that amount of information in the same 24 hours.   For those of us old enough to have lived from newspapers, radio and primitive TV to laptops, iPads and cellphones, our brains have made huge adaptations in the ability to process information. And all this information, along with the technology that supports it, adds to the difficulty of processing day-to-day activities. Like trying to open one of those thin, stuck together plastic bags every time you want to buy a tomato.

As we are limited to how much we can process, choosing what to process becomes important.  There are times we are on auto pilot (have you driven to the store but can’t remember details of how you got there), but most of the time we are aware of the increasing input/stimulation around us.  Focusing on this awareness, or at least occasionally checking in with yourself, and self-responding early to escalating input can go a long way in making your brain, and yourself much happier.

I would enjoy hearing about your fitness journey, please feel free to email me at hankinsb@ssymca.net.

Brad Hankins RN, CPT

 

By: Brad Hankins

It’s a new year!  Hope, a new start at new things as well as the opportunity to revisit old things in new ways, gives meaning to this time of year.  This annual reset also gives us pause to consider different approaches to past struggles, be they emotional, behavioral or physical.  We hope you will consider your local South Sound YMCA branch as a partner in planning and implementing your wishes and goals.

Let’s start the year with a rarely discussed part of overall fitness, stamina. The duo of Merriam and Webster define stamina as, “the bodily or mental capacity to sustain a prolonged stressful effort or activity”.  However, stamina is more than that, it is not endurance – it is that place past endurance. It is having the mental and physical reserves to meet and exceed not just challenges but blatant adversity. Stamina is the fuel of courage and resolve.

Over years of emergency room Nursing, I found two main things helped people survive the worst day of their life, an uncommon will to live and stamina. Stamina in form of deep physical and mental reserves, in other words both gas tanks were full and available to fuel the next 48 to 72 hours of incredible need.  Granted this is worst case scenario, but it gives you an idea we are not talking about something superficial. Instead, this is something that it is part of our being.

Stamina is developed over time, with awareness and purpose.  It is a combination of routinely overcoming physical limits and learning to navigate complex emotional and mental challenges, all the while remaining grateful. Time is the key; stamina does not weave its way through us over weeks or months, but years.  The time-bound process of imbedding stamina is one of many ways age is in our favor.

In another time stamina would be defined as toughness, grit, guts.  Those of us raised by depression era parents and whose mothers and fathers won World War Two understand these terms.  So, in this age of AI and same day Amazon Prime deliveries how do we connect to our parent’s strength, fortitude and willpower? Discipline.  We do it through discipline, the same way they did

Discipline is doing the right thing, for the right reason regardless the obstacles.  You find discipline going for your daily walk on a cold, windy, rainy morning because of the weather challenge, not staying in bed because the weather is challenging.   You embrace discipline when you give grace to the person who beat you to a parking space, and not succumb to self-defeating anger. And like many things, discipline weakens if not regularly exercised.

By exercising discipline you can, in turn, build stamina.  You build physical stamina by going a minute more on the treadmill than last time, pushing out an extra rep on the chest machine, or swimming a half lap more than yesterday.  Mental stamina can be incrementally improved by focusing, read a book (a whole book) and begin by keeping your reading focused for 15 minutes at a time.  Develop your emotional stamina by learning to take a breath before negative feelings overwhelm you, then learn to let one breath become two then three.

Building stamina, in any of these three areas, is not easy.  That’s the point, and the reason stamina is becoming rare in both individuals and societies. This year challenge yourself, improve yourself emotionally, physically and mentally.  And you need no other reason than a simple desire to be a better person.

I would enjoy hearing about your fitness journey, please feel free to email me at hankinsb@ssymca.net.

Brad Hankins RN, CPT

 

By: Brad Hankins

With the Holidays and a new year upon us, there is no better time for reflection and hope.  Considering our somewhat older and perhaps retired lives, it is easy to slide toward complacency and lose sight of the path we are on and where we would like that journey to take us.

I am biased toward higher levels of wellness and health being part of a full and enriched life.  My Nursing career has shown me that without a foundation of good health (as that means to you) it is difficult to reach personal potential, regardless of age.  And with age we can become comfortable with our current levels of physical, mental and emotional health, easily forgetting there are many things to explore and experience.  How do we reconnect ourselves to our lives?

Step one, become active.  In other words, do more in different ways than you currently are. The body is connected to the mind and the mind to the body – inseparable yet unique.  Both loves to be exercised, challenged and exposed to the new and unexplored.  Great joy can come from body and mind overcoming the perceived insurmountable together.  Age is not a barrier to learning and growth.

Step two, improve yourself physically.  All it takes that most rare behavior, discipline.  We all know discipline very well; we couldn’t successfully have reached our age without it.  Did you serve in the military?  If so, discipline is imbedded in your DNA.  Remember those early mornings you drug yourself out of bed to face another frustrating day of work because it was the right thing to do for your family? Then you have no shortage of discipline.  It is simply a matter of focusing the discipline you have developed over time on beginning a daily walk, going to the gym three days a week, taking a yoga class, or diving into a regular swimming practice.

Step three, exercise your mind.  Our brain becomes accustomed to patterns, both of thought and daily life. It becomes comfortable doing only expected things and gets grumpy when we ask more if it.  Ask more of your brain.  Change up your daily activities, brush your teeth with your non-dominate hand, go through the grocery store the opposite direction, put your pants on standing up.  Scroll less, read more. And when you read, challenge yourself with new authors and new topics.

Last step, be kind to yourself.  We didn’t get chronologically here without hitting a few bumps in the road – maybe a guardrail or two. Give yourself the grace to appreciate the life you have lived and the space to embrace your future.  It is easy for rumination to overwhelm us at times.  That’s okay, it happens but only visit those memories for what they were and refuse to let them describe who we are today.  In the words of Stephen Stills, “don’t let the past remind us of what we are not now”.

The improvement of emotional, mental and physical wellbeing is not restricted by age, circumstance nor perspective. Introspection is readily available to all of us and there are times even simple journeys can bring new, never before seen vistas.

Merry Christmas and I hope your new year is full of wonder and happiness!

As always, I would enjoy hearing about the challenges and successes of your fitness journey.  Please feel free to email me at hankinsb@ssymca.net .

Brad Hankins RN, CPT

 

By: Brad Hankins

Though March is national protein month it seems November, with Thanksgiving having a delightful abundance of protein, is also a good month to visit these delicious amino acids. Additionally, protein has recently been getting top billing in nutritional articles and podcasts, which can bring as many questions as answers.

First, protein is one of the three essential macronutrients along with carbohydrates and fats.  What makes essential macronutrients essential is our bodies cannot either produce them or produce enough of them.  In other words, we must eat or drink them – frequently and in adequate amounts.

Proteins are responsible for building and repairing tissue (to include our nervous system) and muscle as well as providing structure to the membranes of our cells, balancing our body’s acid levels, and are used as the building blocks of enzymes and hormones. In fact, without protein, and the right amino acids derived from it, your body is unable to create many enzymes and hormones. Protein is a big deal – regardless of age.

For those of us enjoying our 60’s, 70’s and beyond protein plays a big role in our health, strength and stamina.  Per the Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/23167-sarcopenia , age related muscle loss (sarcopenia) begins in ours 30’s and 40’s and can account for a loss of up to 8% of muscle mass per decade.  For the average person this can add up to five pounds of muscle lost every 10 years.  This loss of muscle contributes to poor balance and greater fall risk, difficulty walking and climbing stairs, and struggles with daily activities and routine home chores.

To maintain, or regain, muscle size and strength a minimum of two things are needed, 1) adequate dietary protein and 2) exercise – preferably weight training.  For both to work it takes informed decision making, a tolerable plan and discipline.   Knowing this, a good first question is how much protein is enough.

The USDA RDA for protein is 0.8 grams of protein per kilogram (one kilogram = 2.2 pounds) of body weight per day.  A common thought is for those over age 50 this base line should be increased to 1.0 grams per kilogram per day to offset both age related muscle loss and slowed digestion/nutrient uptake.  Keep in mind this is the baseline to keep you healthy, not necessarily the specific amount you should be eating if you are exercising frequently.  A general rule of thumb for those exercising is daily protein intake should be increased to 1.2 to 2.2 grams per kilogram of body weight per day to adequately support tissue repair and muscle growth.

Determining the exact amount protein needed to meet your daily and fitness needs is as much feel as science. If you are meeting your strength and muscle growth goals, and your post exercise recovery and energy levels are as expected then you are probably at the right protein place.

Regarding which protein source is best, and if you need a protein supplement, my thought is protein should first come from a dietary source that fits well with your daily diet, that you (and your digestive system) can tolerate and meets your fitness and daily activity needs.  As with most dietary exploration a good place to begin is with an honest food diary, preferably one that tracks your meals and snacks over a month.  You can use a food journal or there are lot of good apps that are click-the-box simple and will also provide great dietary data.

Once you know how much protein you are eating each day and have a baseline range of what your daily protein intake should be, you can calculate if you need a protein supplement.  The types and functions of currently available protein powders could, and have, filled volumes.  The Cleveland Clinic again weighs in with a concise, informative article on the subject, https://health.clevelandclinic.org/7-tips-choosing-best-protein-powder .  As you will see, there are protein powders available for most everyone even if they are lactose intolerant, prefer plant-based protein sources or are looking for a supplement that is gluten free.

This article lightly touches on the basics of protein nutrition and its positive effect on increasing muscle strength and size.  For more information on how much of which kind of protein is best for you and how these insights can fit into a comprehensive fitness plan please schedule a visit with a SSYMCA Personal Trainer.

As always, I would enjoy hearing about the challenges and successes of your fitness journey.  Please feel free to email me at hankinsb@ssymca.net .

Brad Hankins RN, CPT