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Published on: May 1, 2014
by Women’s Brain Health Initiative:
Our brains are just one part of our bodies, so to keep our brains healthy means considering a wider context. In this article, Dr. Vivien Brown, a family physician based in Toronto, shares some insights into how a woman can take care of her whole body, ensuring that she remains vibrant and healthy as she ages.
How would you describe a healthy older woman?
A healthy older woman is active and independent. By active, I mean being able to do the things you want like meeting your friends, going out, and working out. You don’t have any limitations based on physical issues. To me, being independent is a more cognitive aspect of health. It means you’re able to do things such as your own banking, your own housekeeping and travel without needing someone to accompany you. You can live on your own; you’re not in any kind of an institution. Active and independent are the two words that best describe a healthy older woman, both contributing to a good quality of life as she ages.
What are good indicators of health in older women?
There are several markers that are considered predictors for how well you are going to age in the next 10 years. Those include: self assessment of quality of life, Body Mass Index, ability to walk/run, ability to squat down to the floor and having a strong grip.
It is interesting that your own assessment of how you are doing is usually very accurate; studies show this.
When you go to see your doctor and say “I’m a mess,” you’re probably right. But if you’re feeling good, that’s a positive sign that you probably are in good health. The ability to grip and the ability to squat really speak to muscle strength and balance, good indicators of overall physical fitness. The ability to squat is really interesting because some women participate in exercise classes or go walking or whatever, but may not be maintaining their ability to squat as a result. Being able to squat to the floor indicates strong posture and balance; it decreases the risk of falling, and avoiding falls is critical for maintaining your health as you age.
If you fall, you’re likely to break something, and fractured hips lead to a 25 percent death rate in the first year. When you can squat, you have more core strength and a stronger pelvic floor; those stronger muscles in your lower body also help avoid incontinence issues. So that ability to squat is just a quick good measure to know how you’re doing with the lower part of your body. Having a strong grip is the upper body part; it is critical to your ability to take care of yourself. When your grip is strong you can carry groceries, work in your garden or do other things that require upper body strength and coordination.
Body Mass Index (BMI) is a measure that reflects the relationship between your weight and height. Healthy women have a BMI between 20 and 25. These women tend to do better life long, no matter what you’re looking at. Whether you are looking at sexual function, heart disease, breast cancer risk or brain health, those with healthy BMIs do better. And in terms of death rates, you do better if you’re within the normal range. We worry about people who have BMIs that are too high or too low. People with low BMIs can be extremely tiny and frail, often with lower bone
What are steps can women take to maintain a healthy BMI?
I’ll quote my daughter who is a dietician; she advises following an 80/20 rule. Eighty percent of the time, eat a healthy diet based on Canada’s food guide. Have lots of fruits and vegetables, reasonable amounts of protein and reasonable amounts of carbohydrates. Twenty percent of the time, you can relax a little bit and maybe have a piece of cake at somebody’s birthday or something.
The problem is that many people get the pattern reversed, so they’re good 20 percent of the time and they’re making excuses 80 percent of the time. Another simple rule to follow when it comes to healthy eating is to eat on a smaller plate and divide it into four portions: half of it should be vegetables, one-quarter should be carbohydrates and one-quarter should be protein. Physical activity is also important for maintaining a healthy BMI.
Is there any particular type of physical activity that you recommend for healthy aging?
You need to do strength training of some sort to keep your bones strong and your upper body strong. And you need to do some form of aerobic exercise that elevates your heart rate for about 30 minutes. You’ll know your heart rate is elevated because you’ll get a bit sweaty and be a bit short of breath. Some people say, “oh, I walk the dog every day” but if your dog stops and starts, or you go to the dog park and mostly stand around, and you’re never getting your heart rate up, then it’s not enough.
It may have benefits in terms of social connectedness but you’re not getting the aerobic workout you need. I sometimes hear women say they have a very busy lifestyle that has them running all over the place. And to those women, I say hectic is not the same as aerobic. And when busy women tell me they just don’t have the time to exercise. I say “what you are really saying to me is that it’s not your priority.” Then I share the analogy of flight attendants.
They always tell you at the beginning of a flight, if the oxygen masks comes down, be sure to put it on yourself first, before you help the person beside you. So women taking care of themselves is not being selfish, it’s being selfless. It will ensure they stay healthy and able to take care of the people in their lives. That whole concept of creating time for yourself, making yourself a priority, is important not just for you but for your whole family. You can’t always be last on the list.
Besides exercise and healthy eating, what else can women do to stay healthy as they age?
A Canadian government study showed that social connectedness is really important. However old you are, if you’re still playing bridge with your friends or going bowling, participating in your church group or whatever it is that you do, you’ll fare better than if you’re isolated at home and becoming more and more withdrawn.
If you smoke, stop. This is very straightforward. There’s not a single study out there that says smoking is OK. This is not up for discussion, this is not being investigated. We know that just one to two cigarettes a day doubles your risk of heart disease; there’s no safe amount. And so I think without question, smoking is not just not acceptable. It is a significant risk factor.
In terms of alcohol, some studies show that the tannins in red wine have an antioxidant effect which can be beneficial. Moderation is key. The typical advice for women is to consume no more than one, occasionally two, drinks per day.
Is there other advice you think it is important for women to keep in mind as they strive to stay healthy as they get older?
I like to tell people that medicine is a team sport. You and your doctor work in partnership to make good health decisions for you, along with the dieticians, physiotherapists, pharmacists and any other health care providers you’re seeing. The patient is a key part of that team. Doctors can provide guidance but it is up to patients to make the changes in their lives. For example, I can tell my patients till the cows come home to stop smoking but if they go out and smoke, I can’t fix it. The patient needs to not just follow instructions but be a fully engaged partner in their health care team.
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