Physical. There is no doubt that exercise can benefit the body in “aging well”. Minimally, one must maintain a high level of daily physical activity—something that is becoming increasingly “difficult” in our digital age. I was born in 1963. Since my birth, I can think quickly of countless technological advances that have made my life increasingly less active—cable (now Internet streaming) television, the television remote, video games, computers, smart phone, Amazon,…. As well, box stores and suburbanization have us driving more than walking. There are, however, no excuses. One’s activity level is a matter of choice. If anything, these modern conveniences should offer more time for exercise (albeit less for physical activity). So, as our lives become increasingly sedentary, our need for exercise increases.
It is never too late to begin (or restart) an exercise program. Shortly before I started my doctoral program, I was working as a personal trainer. Harry, who had just turned 84, decided to gift himself with personal training. He had read of a study by Tufts University that examined the effects of resistance exercise in nursing home patients. He read that the training resulted in decreased dependence on assistance devices (e.g., canes and walkers). Harry was determined to stop using a cane. Initially, Harry’s gait was much like the Tim Conway character on the Carol Burnett Show (and if you remember this, you are already concerned about the effects of aging). He shuffled in short, choppy steps. Over the course of several months, Harry—who had never lifted weights in his life—was walking without his cane and with longer, more confident, strides. I would like to have worked with Harry longer to see what he might have accomplished.
It is unfortunate that exercise for older adults is driven by fear or what they “can’t” do or “shouldn’t” do rather that what than the basic principles of overload and exercise progression. There is a fear of injury that is unwarranted. Certainly, any one which health risks (and age is considered a risk) that are contraindicating to exercise should consult his or her physician and exercise under the instruction of a qualified professional, but there is always a starting place. In other words, don’t listen to anyone who would say “you shouldn’t be doing ____ at your age”. This includes physicians. (Sadly, I have seen physicians counsel against exercise or limit exercise when it wasn’t warranted.) Start where you can and safely progress.
The loss of physical abilities with age have much more to do with physical inactivity than with the aging process. Thus, the degree to which we “age” is largely a matter of choice.
Cardiorespiratory exercise—particularly low-to-moderate-intensity steady-state aerobic exercise (e.g., walking)—often becomes the go-to exercise for older adults. This generally results in little to no progression—and often a regression—in intensity.
Resistance training is often limited, as well. If performed, resistance exercise with older adults tends to emphasize machines. Machines can be fine in the initial strength program, as stability and motor control may be issues, but it is ideal to progress the level of complexity and instability of the exercise.
What should one be doing to age well in the gym? Well, pretty much anything one is capable of doing. This is pretty broad, but there is no reason to think that the physiological responses to exercise change dramatically as one ages. It is true that the magnitude of the response and recoverability diminishes, but the nature of the exercise need not change. Resistance training—particularly hypertrophy and strength training techniques—should be a priority. Maintaining (or gaining) muscle mass as we age will greatly benefit our ability to perform activities of daily living as we age. Cardiorespiratory performance, while important, will be diminished over time if muscle function is not maintained. One should focus first on technique and building stabilizer strength (e.g., core muscles, hips, and rotator cuff) and progress to free-weight exercise, if available. I strongly recommend a base of the “basic 5” (squat, deadlift, bench, row, and press) for all ages, as a minimal strength training program. Lift in the 8-12 repetition range (preferably lower, e.g. 5-10) and progress the weight, as proper technique permits.
Cardio should be of moderate-high to high-intensity to stimulate mitochondrial function and involve all muscle. High-intensity interval training (HIIT) should be preferred over low- or moderate-intensity steady-state (LISS or MISS) aerobic exercise. It is not only time-effective, it is most effective in improving VO2max.
High-intensity interval resistance training (HIIRT) is a great catch-all. While it won’t dramatically affect cardiorespiratory endurance or muscle strength, it can be effective in improving body composition and cellular function, as well as motor skill-related fitness. It can accomplish much in a short exercise session. The complexity and progression of the intensity of the movements can be individualized and modified according to need and opportunity.
Ideally, for aging well, one should strike a balance among the aforementioned training components (and include regular flexibility training). Minimally, I would recommend six sessions of exercise per week (2 cardio, 2 strength, and 2 HIIRT) with an addition recreationally active day. More sessions per week is preferred. If possible, limit the session to one training modality. In other words, try not to do cardio and strength in the same session, if possible.
Physically, we also need to consider diet. Simply point: eat healthy to age healthy. Limit sweets and processed foods, but don’t omit foods you enjoy (after all, if we are going to live longer we might as well enjoy it.) Fill your plate first with vegetables and then with healthy proteins. Eat “premium” carbs in proportion to your activity. And don’t cut out healthy fats.
Dawn Jackson Blatner (The Superfood Swap Diet) recommended to her client on “My Diet’s Better Than Yours” that she only have dessert away from the house. Rather than have tempting sweets in the home, indulge on occasion where the serving is restricted. We all know that if there are cookies or cake in the house, we will eat it! To satisfy that sweet tooth, acquire a taste for dark chocolate (the high the cacao content the better). This also has some great health benefits. As well, allow fruit to become the indulgent “sweet” in your diet.
Ultimately, weight management is about how much you eat (i.e., caloric balance) more than what you eat. Nevertheless, what you eat is important. Limiting sugar, alcohol, and unhealthy fats are essential to aging well, but, if I have to completely cut out the things I love, “shoot me now, ‘cause life ain’t worth living” (Dennis Miller). The key is balance and eating to perform.
Be your best today; be better tomorrow.
Carpe momento!