Older women’s health in 2022 – the takeaways

This is a summary of key points from the posts of 2022.

Bones

A 25-year Finnish study on bone density in women, concluded that — for Finnish women at least — a loss of .4 percent per year was normal, and that using hormone replacement and having adequate vitamin D and calcium helped limit bone loss.

Most women don’t use hormone replacement, but it’s a reminder that calcium and vitamin D matter. And that if your scans show a loss of less than .4 percent per year, you’re doing better than most.

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Dairy is a good source of calcium if it suits us… a two-year study on people in their 80s in aged care in Victoria showed that those who were given extra dairy (milk, yoghurt and cheese) had substantially fewer falls and fractures.

The increased dairy brought their calcium intake to 1100mg per day and their protein intake to 1.1 gms per kg of body weight, which is close to recommended levels. Most older women don’t manage that.

It’s thought that this helped slow bone loss. While the research on milk for bone health isn’t convincing, the probiotic nature of cheese and yoghurt seems to support gut health which in turn supports bone health.

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Hearts

Malcom Kendrick, who works as a doctor in England, argued in his new book The Clot Thickens that anything that harms or inflames the lining of our arteries encourages blood clotting. And, he says, it’s clotting — not saturated fat and cholesterol — that triggers a heart attack or stroke. He’s not just any doctor; he’s been studying this forever.

Clots form like scabs over the damaged area. The arterial lining then grows over the clot, merging it into the tissue of the artery wall. Plaque is a build-up of clots, and these can protrude into the inside of the artery.

Sources of arterial damage (and therefore clots) include high blood sugar, high blood pressure, smoking, pollution, fat around our middle, prolonged stress, inflammatory conditions such as lupus or rheumatoid arthritis, and long-term use of some medications intended to be taken short-term (e.g. PPIs such as Nexium or anti-inflammatories such as Voltaren or Nurofen).

Menopause and ageing increase our risk of clotting because they slow our arteries’ ability to repair themselves, making us more susceptible to clots.

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But there’s good news too. Increasing nitric oxide levels improves our heart health. NO is an anti-inflammatory gas that relaxes and opens the arteries, reducing blood pressure.

It also stimulates the production of new cells in the lining of our arteries and prevents anything — like blood clots — sticking to them. In addition, NO helps lower blood sugar and insulin levels.

How to boost it? Get some sun, take a few slow deep breaths, drink enough water (dehydration isn’t good for blood and arteries) and include plenty of NO-rich foods in your diet. These include beetroot, leafy greens, garlic, citrus, nuts and seeds, watermelon, meat and dark chocolate.

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An international team of researchers reviewed 21 studies to investigate the relationship between lowering ‘bad’ cholesterol with statins and reducing deaths from heart attacks and strokes. Their conclusion: there isn’t one. Statins are of most value to high-risk patients who’ve had a previous heart attack.

This team also demonstrated that statistics have been used to inflate the benefits of statins and downplay their side-effects.

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Finally, atrial fibrillation. It’s a condition in which the heart flutters instead of pumping properly. We’re more at risk of this with age, but lifestyle is a big factor.

Our heart is more likely to produce this erratic rhythm if its walls have become too weak, stiff or thick — all of which affect its electrical signaling.

This change in the walls of the heart can be caused by, for example, obesity, high blood pressure, sleep apnea, type 2 diabetes, excess alcohol, smoking or inactivity.

The first sign of AF is often feeling faint or dizzy. Anyone who falls and doesn’t know what happened should be checked for AF.

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Food

As always, a big topic. This year it included glucose, the Mediterranean diet, the overlap between mental health and gut health, and processed food.

Biochemist Jessie Inchauspé noted in her book Glucose Revolution that high blood glucose is implicated in every inflammatory condition from arthritis, depression, high cholesterol and blood pressure to fatty liver, Alzheimer’s, cancer and type 2 diabetes. It’s also bad news for our weight.

What primarily raises blood sugar is sugar and flour, i.e. sweet and starchy foods. (Not all metabolisms are equal though and some people’s blood sugar will spike in response to more complex carbs such as oats or ‘good’ bread.)

Here are three of Inchauspé’s tips for stabilising blood sugar.

1. Eat sweet and starchy foods last, i.e. after salad and vegies, protein and fat.
2. Do some exercise (e.g. a 15 minute walk or three lots of 10 squats) within 70 minutes of eating carbs to reduce the increase in your blood glucose.
3. Have a tablespoon of apple cider vinegar in a glass of water a few minutes before eating sweet and starchy foods.

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We’d have to have spent the last couple of years in a cave to not know that mental health issues have been on the rise.

Conditions such as depression and anxiety were increasing anyway, but covid restrictions escalated them.

Australia ranks highly as a user of anti-depressants, but diet might also have a role to play in mental health. People with depression tend to have less diversity in their gut bugs.

Professor Tim Spector from King’s College London specialises in gut research. He argues that a varied Mediterranean diet including fermented foods keeps gut bugs thriving and diversifying. Those bugs produce healthy chemicals that boost our mood. Processed food does the opposite.

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The most read post of the year was on what people really eat in the Mediterranean.

A UK nutrition researcher believes there are three reasons that Mediterranean style eating is healthy.

One, people don’t eat between meals.

Two, they don’t eat cake, biscuits, sweets, potato crisps or takeaways like burgers and chips.

Three, they eat real food — meat, fish, eggs, dairy, vegetables, salad, fruit, bread, butter, cream and other full-fat dairy, and olive oil.

As a result, they eat very little sugar. Their bread doesn’t contain sugar. And while they eat desserts, having something sweet after a healthy (real food) meal means their blood sugar stays stable and they’re less likely to overeat.

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In Magda Szubanki’s three-part ABC TV series last month, she pointed to the lengths food manufacturers go to create products we become addicted to. ‘Snack foods’ have become a feature of the way we eat today, but both snacking and these types of foods create health problems.

So read labels, shop from the outside aisles of the supermarket, avoid snacking, and look for simple, easy, healthy meals to rely on for when you don’t feel like cooking. Ideally, do as they do in the Mediterranean.

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I’ll tuck the main points from a couple of posts on alcohol here too.

First, drinking alcohol to help with sleep can backfire. What’s predictable is that we’ll fall asleep easily but as the alcohol is metabolised we’ll be in for a restless back half of the night.

Second, although many of us have grown up around alcohol and done our share of drinking, the advice from health researchers is to be mindful of the way we use it. Bottom line: stick to the guidelines.

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Exercise

Posts under this umbrella included the 10-second balance test, the importance of getting back to exercise as soon as possible after periods of inactivity, and principles of exercise when we’re older.

Our ability to stand on one leg for at least 10 seconds is a quick and easy indicator of muscle fitness. Most of us have reasonable balance until our 50s, but it can drop off substantially after that, especially if we don’t practice. And as we know, falling is a risk in our later decades. So if you can’t manage at least 10 seconds, start working on it.

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At some point we’ll all need time away from exercise, usually through illness or injury. But that can also mean a loss of muscle tissue we never get back. So as soon as its viable, start moving again.

We also need to eat enough protein to stimulate muscle growth. Muscle mass and strength are crucial to healthy ageing and the best formula for that is eating good quality protein plus doing resistance training.

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The principles of exercise when we’re older:

• Rinse and repeat. Movement is only beneficial when it’s regular and doing something always beats doing nothing.
• Like Goldilocks, aim for the ‘just right’ zone. Too little won’t stimulate the tissue (muscle, tendon, ligament, bone) enough to make a difference; too much puts us at risk of injury.
• Follow the hard-easy principle. If your body has worked hard — regardless of whether it was doing an exercise session, doing housework, carrying a toddler or even wearing heeled shoes for a night, it needs recovery time. Take it easy the next day or as long as you need.
• Be realistic about your needs. Know yourself well enough to make choices that will genuinely work for you.
• Choose what makes you feel good. It might be the delight of walking in the bush, the peace of time to yourself, the fun of being with friends, or the satisfaction of having used your body.

PS. I chose the photo (from a June post) that goes with this wrap-up because it’s a great example of older women doing what makes them feel good and having a ball.

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Energy

It’s not well understood in our culture but a central aspect of being healthy is knowing how to rest and recover. University of California psychology professor Sara Mednick refers to this as ‘activating the downstate’. Her six primary ways to do it are:

1. Getting the best sleep we can. She’s also a fan of napping and says a nap of 20-90 minutes can be just what we need to boost alertness and immunity. (And let’s ditch that sexist, ageist term ‘nanna nap’.)
2. Slow breathing. Simple but effective. She recommends a few good, slow breaths, five seconds in, five seconds out, through your nose, anytime.
3. Exercisers sleep better and have healthier brain patterns, she says.
4. Healthy eating. Avoid processed food and eating between meals or late at night. Maybe try a bigger breakfast and lunch and a smaller dinner.
5. Getting outside in nature.
6. Physical contact with another person or a pet/companion animal. It’s grounding and nourishing.

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Attitude

The second most read article for the year was last month’s post on the impact of our beliefs about age.

Yale University’s Professor Becca Levy has shown that age beliefs affect our physical function — for example, a negative view of getting older contributes to a slower walking pace, less capacity to recall information, and even a greater risk of Alzheimer’s. We think ourselves into a state of being less capable.

Since we all get to choose our view of ageing, we might as well take the glass-half-full option. According to Professor Levy it’s an important pathway to a healthier brain.

And that’s it, 2022 in a nutshell. Thanks for reading; hope it was worthwhile.

Photo Source: Kay Hannaford