1. science
2. medicine
3. surgery

July 2015
Volume 12 • Number 7
News Briefs
■■ Two minutes of light
activity can help
offset long sitting.
■■ Drug to treat
pre-diabetes is
seldom used.
■■ Older JapaneseAmericans offer clues
for healthier living.
3
Know the Three Ds
Signs for delirium,
dementia, and depression
can be similar.
4
A New Look at
Improving Vision
Lens replacement
surgery can mean no
more glasses.
4
Picturing Stroke Risk
Routine imaging may
detect early warnings.
5
Be Optimistic About
Heart Health
Outlook on life is
linked to improved
cardiovascular health.
6
Feel the Power
of Pulses
These nutritional
powerhouses are
affordable and versatile.
8
Ask Dr. Ferrell
■■ What is the difference
between soy, coconut,
and almond milk?
■■ What could be
causing my sudden
night blindness?
■■ What is the best
way to go off antidepressants?
Swim your way towards a healthier life
A regular swim routine offers many physical and mental benefits for seniors.
Y
ou may have swum
activities, such as golfing,
only for fun in the
exercising on treadmills
past, but this sumand stationary bikes, and
mertime sport offers
calisthenics. (The researchmany year-round beners speculated that women
efits for older adults.
would benefit, too.)
First off, swimming
The reason may be that
is a low-impact activity,
swimming develops strong
which means it places
large and core muscles,
less stress on the joints
which are necessary for
compared to endeavors
good balance control and
like running and tennis.
are a major protective fac“The body feels like it
tor against falls.
weighs less in water, so
In fact, the study also
there is less body weight
noted that the swimmers
resistance for muscles
outperformed their counSwimming is easy on the joints, so it can be
enjoyed throughout your lifetime.
to work against,” says
terparts in a standing balDaniel Vigil, MD, of the
ance test, in which a person
UCLA Division of Sports Medicine. “This
stands as still as possible for 30 seconds
makes it an ideal activity for seniors who
with minimal sway or change in posture.
have lost muscle mass and strength and want
➥➥ Lower blood pressure and stroke risk:
to get their bodies back into exercise.”
A 2012 study that examined how swimIt may not look aerobic, but swimming
ming affects vascular health among
can give you a heart-pumping workout. “It
adults age 50 and older found that sysuses large muscle groups like the quads
tolic blood pressure dropped from 131
and abdominals, which requires your heart
mm/Hg to 122 after 12 weeks of swimand lungs to work hard to pump blood and
ming. The swimmers also saw a 21 perdeliver oxygen,” says Dr. Vigil.
cent increase in carotid artery compliSwimming also is a good calorie burner.
ance, which is a measure of elasticity
An average 155-pound person can burn
of the blood vessels that carry blood to
between 300 and 400 calories in 30 minutes,
the brain. “This is believed to lead to a
depending on effort. This is comparable to
decrease in risk of stroke,” says Dr. Vigil.
running at a 11.5-minute-per-mile pace or
➥➥ Promote social activity: While it may
cycling at 14 to 16 miles per hour.
look like a solitary activity as you swim
A regular routine can improve other
back and forth in a pool lane, the sport
health issues specific to seniors. For
can be quite social. “If you join a swiminstance:
ming club or training team, there are
➥➥ Reduce your risk of falls: Australian
opportunities to talk and mingle, which
researchers recently looked at 1,700
you often don’t get with other types of
men age 70 and older and compared
exercises,” says Dr. Vigil. “And do not
their choice of exercise to the likelihood
neglect the mood-boosting fun and enjoythey experienced a fall over a four-year
ment of being in the water, which can
period. They found that men who swam
help with stress reduction and fend off
were 33 percent less likely to fall comdepression.”
Continued on page 7
pared with those who did land-based
Thinkstock
2
N E W S B R I E F S Two minutes of light activity each hour may offset risk from too much sitting
CONTRIBUTING EDITORS
Dawn Bialy
Kate Brophy
Studies have shown that sitting for extended periods of time each day leads
to an increased risk of heart disease, diabetes, and early death. However,
a new study from the University of Utah School of Medicine found that
breaking up hour-long sitting with two minutes of light intensity activity
lowered the risk of dying by 33 percent among 3,243 subjects. Surprisingly, the study
found no benefit of decreasing sitting by two minutes each hour, but only when sedentary time was interrupted with an activity like casual walking, light gardening, and
house cleaning. The recommendation for weekly exercise is 2.5 hours of moderate activity, which expels about 600 kilocalories (kcal) of energy. The researchers pointed out
that two minutes of light activity every hour during an average 16-hour awake period
equals 400 kcal each week. Light activity should not replace moderate exercise, the
study noted, as it strengthens the heart, muscles, and bones better than lighter intensity
exercise. Yet, adopting the two-minute per hour approach can help meet your weekly
goal of 2.5 hours of moderate exercise. “Even small changes in behavior can have a big
impact,” according to lead researcher Tom Greene, PhD.
ADVISORY BOARD
Drug effective in treating pre-diabetes often not prescribed by doctors
EDITOR-IN-CHIEF
Bruce A. Ferrell, MD
UCLA Division of Geriatrics
EXECUTIVE EDITOR
Matthew Solan
GROUP DIRECTOR
Jay Roland
Randall Espinoza, MD, MPH;
Arash Naeim, MD;
Michelle Eslami, MD;
John FitzGerald, MD;
Ellen Wilson, PT
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2
July 2015
Few doctors prescribe a low-cost drug called metformin that has been proven effective
in preventing the onset of diabetes, according to a new UCLA study. The research published in the Annals of Internal Medicine found that only 3.7 percent of adults with prediabetes were given the drug over a recent three-year period. (Metformin also goes by
the brand names Glucophage, Glumetza, Glucophage XR, and Fortamet.) The reasons
for its underuse are not clear, says lead researcher Tannaz Moin, MD, of the David Geffen School of Medicine at UCLA. One opinion is reluctance by patients and doctors to
rely on medication to treat pre-diabetes. Metformin is used in conjunction with lifestyle
changes like weight loss to help treat pre-diabetes, says Dr. Moin. Metformin works to
restore your body’s healthy response to insulin. It also decreases the amount of sugar
your liver produces, which your stomach and intestines must absorb. It is not clear how
long someone would have to take metformin, as it depends on the individual. According to the Centers for Disease Control and Prevention, about one-half of adults age 65
and older have pre-diabetes, which is marked by higher-than-normal blood sugar levels.
On average, about 15 to 50 percent of this group will develop diabetes within five years.
Most people do not show the symptoms, which include unusual thirst, bouts of extreme
fatigue, and/or blurred vision. You are also at high risk if you have a family history of
diabetes, are overweight, or have high cholesterol. A blood test from your doctor can
confirm a diagnosis. “If you test positive for pre-diabetes, consult with your doctor about
all treatment options for diabetes prevention, lifestyle, and/or metformin, to determine
the best option,” says Dr. Moin.
Elderly Japanese-Americans could offer clues to longer, healthier lives
UCLA researchers believe older Japanese-Americans may hold the key to healthy aging.
Nearly one in four Japanese-Americans are age 65 or older—about twice the proportion
of seniors in the overall U.S. population. The facts that they are more likely to live
longer than other Americans and are healthier as they age could provide valuable
insight about how all Americans can age better, according to a recent study from the
UCLA Center for Health Policy Research. The research highlighted specific behavior
that may explain this group’s longevity and well-being. Using data from the California
Healthy Interview Survey from 2003 to 2012, the study found that elderly JapaneseAmericans have lower risks for nine of 15 health indicators compared with other racial
and ethnic groups, including obesity, psychological distress, and falls. More research is
needed, but these initial findings suggest that many older Japanese-American lifestyle
habits, such as diets high in fish and fresh produce, avoiding fast foods, eating meals
in moderation, and paying more attention to preventative care, like getting seasonal
flu shots, can be a model for all older Americans to follow, suggests lead researcher
Ying‑Ying Meng, PhD.
M I N D A N D M E M O R Y Know the three Ds: delirium,
dementia, and depression
Recognize their early signs in order to get immediate treatment.
Thinkstock
T
he three Ds are the most common
diagnoses in geriatric psychiatry, but often the most difficult to
identify because they have overlapping symptoms. “They can occur at
home as well as during certain situations, like during hospital stays or
returning home after a hospitalization,” says Pauline Wu, DO, assistant
clinical professor of health sciences
at UCLA. “Knowing the difference
between them can help you get early
treatment or take steps to avoid the
conditions.”
DELIRIUM Delirium is an acute
disorder marked by inattention and
confusion. It is quite common among
older hospitalized patients, and the
condition is associated with prolonged
hospital stays.
People often describe those with
delirum as being “out of it” or “not
acting like themselves.” Episodes
have an onset within hours or days,
which sets the confusion apart from
dementia, which typically seeps in
over months or even years. “Delirium
is considered a major medical emergency,” says Dr. Wu. “If not treated,
mortality rates can be from 10 to 20
percent.”
Delirium can be caused by infection, dehydration, electrolyte imbalance, a fall or head injury, a reaction
to too much medication, substance
abuse, or any combination. “In many
elderly patients, and in individuals
with cognitive impairment, delirium
also can be the initial manifestation of
a new serious disease,” says Dr. Wu.
Treatment involves addressing
the underlying medical cause. “This
could vary from using antibiotics to
treat an infection, adjusting existing
medication, and/or ensuring the person stays properly hydrated,” says Dr.
Wu. “Early diagnosis and treatment
The three Ds share many symptoms, which can
make diagnosis a constant challenge.
leads to better outcome.” Delirium
symptoms can take time to resolve.
About 50 percent of patients have the
underlying cause treated within three
months of a diagnosis, yet symptoms
can linger for up to six months.
DEMENTIA Dementia is a progressive
syndrome best known for short-term
memory impairment, but also may
include a problem in at least one of
the following areas:
➥➥ Language: difficulty with expression or comprehension
➥➥ Motor memory: unable to perform
a learned skill like driving
➥➥ Sensory memory: failure to process information stimulated by one
of the five senses
➥➥ Executive thinking: the inability to
create and execute plans
In addition to these cognitive symptoms, patients with dementia often
experience neuropsychiatric ones,
such as depression, agitation, apathy
(lack of interest and enthusiasm), and
psychosis (losing contact with reality).
“About one-half of people with dementia will have these symptoms at some
point,” says Dr. Wu.
With advanced dementia, people have problems completing daily
life tasks and become more isolated
as social interactions grow difficult.
There is no single test for demen-
tia—it is determined through clinical examination, behavior analysis, and cognitive assessments. Age,
family history, high blood pressure,
untreated depression, and uncontrolled diabetes increase your risk.
“While some of these factors you
can’t control, others you can by managing your lifestyle,” says Dr. Wu.
DEPRESSION Depression has many
forms, but telltale signs include low
mood, loss of interest in activities you
once enjoyed, difficulty with sleep
and appetite, low energy and concentration, and/or a growing sense of
worthlessness. You need to experience
symptoms for at least two weeks and
have them affect your social or work
life in order to be diagnosed with clinical depression.
Seniors often will not admit or
recognize their declining emotional
state. Instead, early depression may
show itself in other ways, like complaining more about physical conditions that bother them.
“People think depression is normal when you get older, but that’s
completely false,” says Dr. Wu.
“Seniors often encounter life events
that can trigger sadness, including loss and complex medical problems. However, reactive sadness
and clinical depression are not the
same. Depression is not normal and
in fact is treatable.” Treatment optiions include recognizing symptoms,
providing support, limiting isolation,
and medication.
Seek help from others
If you live with someone, you can
each try to be more mindful of early
warnings signs. However, if you live
alone, this can be difficult, so you
should create a support group to monitor any changes in your behavior.
“Ask close friends or family members to be attentive to the symptoms,” says Dr. Wu. “The three Ds
become more relevant as you age.
But by increasing your education,
you may catch them early and seek
appropriate care and treatment before
they get worse.”
July 2015
3
V I S I O N A new look at improving vision
Lens replacement surgery corrects eyesight so you don’t need glasses.
I
lar lens (IOL) implant, patients can
see distance, intermediate, and near
without glasses.”
LRS can also protect you from
future cataracts, adds Dr. Hamilton,
since the natural lens is replaced
with a synthetic implant that will
remain stable for the rest of your life,
and never cloud up.
Laser precision
LRS is an outpatient procedure that
takes only about 15 to 20 minutes
per eye. Eyes are often treated about
two weeks apart. Here is how the
surgery works:
➥➥ After numbing the eye, the surgeon uses a laser to make precise
incisions in the cornea. The laser
allows greater accuracy in terms
of depth and length of the incisions compared with a traditional
blade. “Every eye has a cornea
that is unique in terms of thickness and curvature,” says Dr.
Hamilton. “The laser uses realtime image guidance, which customizes the incisions to match
the unique dimensions of the
cornea.”
A new approach by UCLA neurologists has found that medical
imaging, like dental x-rays, MRIs, and CT scans, can detect
narrowing of arteries to the brain or vascular disease that may be an early warning sign of a stroke.
The ongoing research, led by David S. Liebeskind, MD, of the UCLA Stroke Center, can help broaden the
view of preventative medicine. “Imaging can tell all kinds of information beyond the procedure’s original
intent,” he says. “You just have to look closer.”While imaging can pick up warnings for other neurological
conditions, it can be especially helpful for stroke prevention since strokes are so common among older
adults. Besides highlighting narrowing arteries, imaging can detect calcified plaque in blood vessels
outside the brain, which an American Heart Association report found increases the risk of stroke and
dementia. Dr. Liebeskind does not advocate undergoing extra imaging unless otherwise indicated, but
instead to share any past or future imaging with your primary doctor. “The information stays relevant
for years and can track a progression of your health,” he says. “In this way, it can offer novel insight to
help identify potential problems before they become life threatening.”
July 2015
Replacing an aging lens with a multifocal
intraocular lens implant can help you see clearly.
➥➥ In the second step, the surgeon
uses a laser to make a precise, circular opening in the capsule containing the lens.
➥➥ Next the surgeon uses the laser to
soften the lens and break it into
segments for easier removal.
➥➥ Then an ultrasonic probe is
used to remove the lens material through the small incision in
the cornea.
➥➥ The final step is the implantation
of the new replacement lens into
the capsule.
➥➥ The incisions are self-sealing.
Patients see out of the eye immediately after the surgery, and the
eye feels essentially normal the
day after, says Dr. Hamilton.
Who is a candidate?
Lens replacement works best for
seniors with cataracts and those
without cataracts who are farsighted
and wish to function without glasses.
However, LRS may not be
appropriate for those who are only
nearsighted and/or have worn
glasses most of their adult lives.
“A nearsighted eye has a thinner
and more delicate retina, which can
more easily tear or become detached
during or after surgery,” says Dr.
Hamilton.
Thinkstock
Routine imaging offers
clues about stroke risk
4
Thinkstock
n the past, LASIK was the go-to
procedure to eliminate the need
for glasses. “While LASIK continues to be the procedure of choice for
younger people, lens replacement
surgery (LRS) using laser technology
may make the most sense for older
adults,” says Rex Hamilton, MD,
medical director of the UCLA Laser
Refractive Center.
As you age, your lens loses its
flexibility. This process, called presbyopia, leads to the need for reading
glasses or bifocal/progressive spectacles as you reach middle age.
Over the years, the lens also can
become progressively cloudy, a condition known as cataracts, which
causes blurred vision to worsen and
cannot be corrected with just a stronger eyeglass prescription.
“While LASIK treats the clear
window on the front of the eye
called the cornea, it does not address
the main problem in seniors,” says
Dr. Hamilton. “As one ages, it is the
lens inside the eye that causes vision
to decline. LRS directly treats this.
By replacing the lens of the eye with
a high-tech, multifocal intraocu-
V I S I O N Lens replacement surgery
is offered at a growing number of eye surgery centers. But
be mindful that LRS in an eye
without a cataract is considered cosmetic and rarely covered by insurance.
Costs can range from
$1,500 to more than $5,000 per
eye depending on the situation
and which technologies are
used. (Even if you have a cataract there is often some outout-of-pocket expense. Check
with your insurance company
about your coverage.)
Still, for many seniors the
procedure may be worth the
price in order to increase quality of life.
“Patients should consider
that they are investing in a
treatment that will benefit them
every waking hour of every day
for the rest of their lives,” says
Dr. Hamilton. (For more information on the procedure, visit
www.uclaser.com.)
WHAT YOU SHOULD KNOW
Three types of IOLs are available to replace your natural lens, depending on your vision. Your doctor will make a recommendation:
➢➢ Monofocal fixed-focus IOLs provide clear vision at
distance, intermediate, or near ranges—but not all three at
once. Toric IOLs to correct astigmatism also are classified as
monofocal IOLs.
➢➢ Multifocal IOLs provide clear vision at multiple distances.
➢➢ Accommodating IOLs enable focus at multiple distances
by shifting their position in the eye.
H E A R T H E A L T H Thinkstock
Be more optimistic about your cardiovascular health
Regular exercise and proper diet are the
levels than those with less optimism. They
standard formula for heart health, but there
also were more active, had lower body mass
is another way: Improve your outlook on life.
indexes, and were less likely to smoke.
“The body and mind work together in a
“Optimistic people also are more likely to
continuous cycle,” says Gary Small, MD, director
see their doctor regularly and follow his or her
of the UCLA Longevity Center and co-author
advice,” says Dr. Small.
of 2 Weeks to a Younger Brain. “If you are happier,
Of course, it is easier to say, “be more
your heart is healthier, and when your heart is
optimistic” than to do it, especially for older
strong, your mindset will benefit.”
adults who confront more challenging issues
A 2015 study in Health Behavior and Policy
like illness, decreased mobility, and personal
Review found a link between optimism and
losses than younger people. “Still, you can
heart health in more than 5,100 adults age 45
learn to be more optimistic,” says Dr. Small.
to 84. Their cardiovascular health was assessed
Here are some tips:
using seven metrics from the American Heart
■ Be flexible: If you experience physical
Association to measure optimal heart health:
decline, focus on what you still can do.
blood pressure, body mass index, fasting
“You can’t run anymore? Try walking
plasma glucose levels, serum cholesterol
instead. You can’t walk as far as you once
levels, dietary intake, physical activity, and Optimism can be a learned behavior
did? Change your goal to just walking on
that creates stronger health habits.
tobacco use.
a regular basis,” says Dr. Small.
Each subject was given zero, one, or two
points for each category representing poor, intermediate, and ■ Be grateful: Keep a daily journal and list the things that make
you feel good or thankful, even if they seem minor, like a
ideal scores. Total health scores ranged from zero to 14. People
compliment about something you did for someone.
also completed surveys to assess their current mental health,
levels of optimism, and physical health.
■ Be aware of negative attitudes: It is not always easy, but each
The researchers found that total health scores increased
time you find yourself thinking that something won’t work
in tandem with perceived levels of optimism. People who
out, take a breath, and ask how you can look at the situation
were the most optimistic were twice as likely to have ideal
in a positive light. “Often you can find an upside if you try,”
cardiovascular health.
says Dr. Small.
Even the smallest changes in outlook can have a significant
■ Be social: Isolation fuels negative thinking. If it is difficult to
impact. Another study that used the same seven-metric
drive, or you can no longer drive, rely on taxis or ask a friend
parameters found that just a one-point increase in total health
to transport you to social activities.
score lowered a person’s risk of stroke by eight percent.
How does a positive outlook affect heart health? For the ■ Seek out uplifting people: “Optimism is contagious,” says Dr.
Small. “Surround yourself with people who see the glass
most part, optimists tend to take better care of themselves. The
half full and you will, too.”
study found they had better blood sugar and total cholesterol
July 2015
5
N U T R I T I O N Feel the power of pulses
Dried beans and peas, chickpeas, and lentils are low in fat, high in protein,
and can protect you from many health problems.
P
ulses are some of the most inexpensive, versatile, and healthy
foods around, and seniors
should be eating more.
“They are nutrition powerhouses
full of nutrients, such as folate,
potassium, calcium, and fiber to help
seniors avoid heart disease, osteoporosis, obesity, high blood pressure,
and diabetes,” says Elana M. Sussman, RD, with UCLA Health.
“Pulses also are a great option for
individuals who follow vegetarian,
gluten-free, or heart-healthy diets.”
Buying, cooking, and storing
Pulses are part of the legume family and refer only to the dried seed.
Dried peas and beans, lentils, and
chickpeas are the most common.
Most pulses are bought in one of
two forms: canned or dried. Canned
pulses have already been soaked
and cooked, but make sure to choose
low- or no-sodium brands, or rinse
them to reduce the sodium content.
Dried pulses tend to be cheaper
than canned (average cost of 1 cup of
cooked dried beans is 25 cents compared to 60 cents for canned). However, there is more labor involved, as
they must be soaked before cooking.
There are three methods of soaking: quick, traditional, and hot. Soaking time ranges from one to 24 hours
depending on the method (check the
package for suggestions).
The benefits of soaking are twofold: It decreases flatulence associated with eating beans and reduces
cooking time.
“Once beans are soaked, they can
take anywhere from 45 to 120 minutes to cook depending on the type
of bean,” says Sussman.
If you aren’t going to eat cooked
dried pulses immediately, then
quickly cool them, cover them, and
place them in the fridge or freezer.
“As with all cooked foods, don’t
leave cooked pulses at room
temperature for more than
one to two hours because this
allows bacteria to multiply,”
says Sussman. “If you keep
cooked pulses in the fridge,
eat them within two days.”
What is inside?
(1 CUP SERVING, DRIED AND COOKED)
Chickpeas
Beans
CALORIES
FIBER
PROTEIN
(g*)
IRON
(mg*)
269
12.5g
14.5g
4.7mg
230-240 8-12g
14-16g
4mg
(g*)
Lentils
230
15.6g
18g
6.6mg
Peas
231
16.3g
16.4g
2.5mg
*g = grams; mg = milligrams
Source: National Nutrient Database for Standard Reference
6
July 2015
How to include more pulses in your daily diet:
➢➢ Substitute pinto, black or kidney beans
for meat in chili, stews, and soups.
➢➢ Toss chickpeas or lentils to salads.
➢➢ Create a pesto with navy beans, basil,
spinach, olive oil, and herbs, and pour
over your favorite pasta dish.
➢➢ Mash up beans to use as a dip for a
healthy midday snack with sliced carrots,
cucumbers, or celery.
➢➢ Place cooked peas in a blender with
some olive oil and seasonings of choice
to create an alternative spread to
mayonnaise or cream cheese.
➢➢ Add any variety of pulses to omelettes.
of protein (see chart, left), which is
comparable to a 4-ounce serving of
fish (22 g) or lean beef (22 g), and
much higher than 1 cup of milk (8 g)
or a large egg (6 g).
Other benefits of pulses include:
➥ Better weight management: Because
pulses are high in fiber (1 cup has
about half the total daily amount
recommended for adults), they can
increase fullness and help with
weight control, says a 2014 study.
The research found that people felt
31 percent fuller after eating an average of 150 g, or ¾ cup, of pulses
compared with a control group.
Pulses are complex carbohydrates
and have a low glycemic index. This
means they break down slowly and
can make you feel fuller for a longer period compared to mediumand high-glycemic-index foods
like bread, snack foods, white rice,
cereal, and orange juice.
“Controlling hunger can prevent
cravings and binge eating that leads
to weight gain,” says Sussman.
➥ Reduce cholesterol: A recent study
from the University of Toronto found
that eating one daily serving of
beans, peas, chickpeas, or lentils can
shrink levels of LDL (bad) cholesterol by five percent and reduce your
Thinkstock
NUTRITIONAL PROFILE OF PULSES
Pulses are a rich source of
protein, which seniors need
to strengthen their immune
system and help build and
maintain muscle mass.
Other high-protein foods
include meat and dairy products, but these also can be
high in cholesterol and saturated fat. “In comparison,
pulses are a cholesterol-free
plant protein,” says Sussman.
A single cup can contain
between 14 and 18 grams (g)
WHAT YOU CAN DO
NUTRITION
risk of cardiovascular disease by five
to six percent.
➥ Fight deficiencies: Many older adults
are deficient in micronutrients, such as
zinc, iron, manganese, magnesium,
Swimming—cont. from page 1
Testing the waters
There are many ways to dive into
swimming. Besides local pool centers
and YMCAs, most adult community
centers and fitness centers offer basic
swim classes, many of which are
designed for seniors.
“If you are new to swimming or
have been away from it for a while,
entry level classes can help you learn
basic stro ke techniques so you can
maximize your workouts and reduce
risk of injury,” says Dr. Vigil. “Once
you are familiar with different strokes
and workouts you can do them on
your own.” Another upside to swimming is that it does not require much
time. Thirty minutes of pool time easily satisfies the American Heart Association’s guideline for 30 daily minutes of brisk exercise.
Mix it up
Swimming can put you at risk for
repetitive-use injuries like shoulder rotator cuff injury, which is why
potassium, copper, and selenium. Iron
deficiency is the most common, followed by zinc. In fact, 40 percent of
those age 65 and older do not consume
enough zinc, according to a 2015 study.
you should always vary your routines during every workout.
“Devoting several minutes or
a certain number of laps to backstroke, freestyle, and breaststroke
can avoid excess stress on certain
parts of the body and ensure you
engage in an all-around workout,”
says Dr. Vigil.
Using paddle boards and fins—
which most pools offer, although you
may want to invest in your own—
can further balance your workouts.
Boards can help you focus more
on your lower body and give your
arms and shoulders a rest. Fins
enhance buoyancy and speed so you
can focus on your stroke technique.
Swimming does have its limitations, adds Dr. Vigil. Since it is not a
weight-bearing workout, you should
complement it with resistance exercises like weight training or walking
to keep bones strong.
“Swimming is one of those unique
exercises that has no limits,” adds Dr.
Vigil. “You can do some form of it for
almost your entire life.”
Thinkstock
DIFFERENT
STROKES
The most common swimming strokes are freestyle,
breaststroke, backstroke, and sidestroke.
Freestyle: The preferred stroke of swimmers. You kick
hard with a flutter kick, while you bring your arms over
However, a 100-gram serving (3.5
ounces) of pulses can provide most
of the recommended daily allowance of all these important micro­
nutrients, says Sussman.
WHAT YOU SHOULD KNOW
Swimming tips for beginners:
➢➢ Warm up with five to 10 minutes
of easy laps or range-of-motion
exercises that mimic swimming, like
shoulder rotations, body twists, and
neck rotations.
➢➢ Keep a water bottle within easy
grasp and drink regularly during your
workout to avoid dehydration.
➢➢ Wear goggles to protect your eyes
from chlorine and a swim cap to keep
water out of your ears.
➢➢ Enlist a friend if you feel anxious
about joining a class. It is always
easier to overcome fear if someone is
there for emotional support.
➢➢ Begin with water aerobic classes,
which are done in waist- to chesthigh water, if you are uncomfortable
in the water.
your head and into the water one at a time. You usually
breathe to the side with each alternating stroke.
Breaststroke: Both arms execute half-circular arm
movements at the same time underwater in front of your
body. The arm recovery also occurs underwater. The legs
simultaneously execute a frog-style kick where you bend
your knees and kick your legs out beneath the water.
Backstroke: As its name suggests, backstroke is swum
on the back and uses alternating circular arm movements.
The legs execute a flutter kick like freestyle.
Sidestroke: You swim on one side using a scissor kick
while one arm does a reach and sweep movement
underwater like picking an apple and placing it in a basket.
July 2015
7
A S K T H E D O C T O R Q
A
Editor-in-Chief
Bruce A. Ferrell,
MD, Professor of
Medicine and
Geriatrics
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