PHYSICAL DEVELOPMENT and HEALTH
in MIDDLE AGE

WE ONLY GET BETTER!

In studying middle age, it becomes clear that it is a distinctive life stage. Middle-agers think more in terms of how much time is left instead of their time from birth.

Both sexes perceive time differently. Women define themselves mostly in terms of relationships related to the family cycle, whereas men define themselves in terms of their work. Based on this notion, women gain a sense of freedom as their children get older and no longer need the supervision and care of earlier times. Women now have more time for themselves. Men at middle age feel job pressure or job boredom. Some men may redirect their personal career advancements towards philanthropy. Others may realize they cannot attain their goals and indulge in eating and drinking to cope with their disillusion or failure. A benefit to middle age in males is that they show less aggressiveness and less concern for power. The men have more of a present time orientation. At this period they turn towards family. They are more nurturing than in early years. At the same time though, women become more dominant. They have redirected the childrearing role and have become more concerned with personal growth. Women might find their husband's demands on their time intrusive.

Our culture stresses youthful appearances. Women's magazines target women for diet and beauty. There are too many solutions on how to have the body of a firm 25-year-old. What is not addressed, however, is the reality of the human body and the many different types of bodies. The health risks of not eating right or getting the right amount of exercise is a more realistic approach, but not one that is marketable.

During middle age men and women are in a period of self-analysis. This is critical for future development. This is the time when they ask themselves, "Where have I been and where am I going?" The body is slowing down. A major concern becomes how to counteract the affects of aging, i.e. middle age spread, bone mass deterioration, and the slowing and stopping of estrogen production in women. This is the time to salvage the years that are ahead. More than any other time in development, individiual's thoughts turn to the sense of being old rather that young. Hanging onto what was and having a preoccupation with the body is also maximized during this time. Noticing facial appearance and wrinkles is a concern for women. The fashion industry has contributed to the myths that men age gracefully and women get old.

Physical changes that take place start around the age of 30 years. There is a slow steady decline in strength. It has been stated that there is a loss of 10% over the next 30 years. This is the time to start and/or maintain an exercise regimen. It is never too late to exercise, though some are not motivated because of perceived lack of time caused by work or family obligations.

According to Prevention Magazine, getting back to a younger body takes:

• a healthy low-fat, low-calorie, high fiber, diet;
• at least 45 minutes a day of some kind of moderate aerobic activity;
• and more importantly, resistance training to build muscle mass.

Young adults have more strength and a greater reserve of muscle. As we age, this organ reserve and muscle mass declines. Unfortunately, at the same time, a more sedentary lifestyle is typical of middle age. This makes strength training very important.

PUSH-UPS	PULL-UPS	CRUNCHES	SQUATS	SUPINE FLYS	PRONE REVERSE FLYS	SEATED LATERAL RAISES	ARM & LEG RAISES	LUNGES
Two sets of 25-2-3x a week	Up to 5-10	Two sets of 25	Three sets of 12	One to three sets of 12	One to three sets of 12	One to three sets of 12	One to two sets of 10 per side	Three sets of 12

Included in the physical change for middle age women is menopause. Women are born with several hundred thousand ova, which begin to mature at puberty. Around 300-400 cycles later, ovulation becomes eratic and finally stops. Menopause is considered to have occured. When a whole year has passed without menstruation, a women is in a menopause stage. At this time, ovarian estrogen production occurs for a while but eventually will cease. Deprived of the stimulatory effects of estrogen the reproductive organs and breast begin to atrophy. The symptoms of menopause are:

• headaches
• dizziness
• joint pain
• hot flashes
• loss of bone mass
• slowly rising blood cholesterol levels

Low dose estrogen therapy is encourage for women at this time. Premarin and Provera are prescribed to many women but the risks of certain cancers and heart attacks are overlooked. One of the reasons doctors prescribe estrogen replacement is due to the connection between loss of estrogen and osteoporosis. Bones become fragile and more likely to break. An alternative to Hormone-Replacement Therapy (HRT) is exercise and diet. Calcium is needed along with vitamins. This could be obtained by following a healthy diet.

HRT is not without side affects. Negative aspects include:

What has not been mentioned is the higher risk of developing certain kinds of cancer. This should be talked over with your doctor if you do consider HRT. A family history of heart disease and breast cancer needs to be considered before proceeding with the therapy. Heart disease factors might be lowered but breast cancer risks may rise. It is a personal choice. Certainly, one needs to evaluate the risks before starting homone-replacement.

Besides HRT, diet and exercise have been associated with better experiences of menopause and its symptoms. Sometimes a lifestyle change needs to be considered. There's a stress connection and a lifestyle connection. In one study (Prevention , Aug..1994 vol.46 pg.84 ), the more stress a women reported in her life the more symptoms she had. 55% in the high-stress group reported suffering from six or more symptoms as compared to just 20% in the low-stress group. It is unclear whether more stress contributes to menopause symptoms or more symptoms contributes to stress. It has been reported that exercising helps to relieve the symptoms. Researchers at Tufts University report that weight training helps to slow bone loss, another symptom of menopause. Exercise has also been associated with a better experience of menopause.

Diet is an important consideration to people in middle age. Metabolism slows down around middle age. Fat deposits are more likely to center around the abdominal area. Middle abdomen spread has been linked to heart disease, the number one killer in the United States. While calcium-rich foods have been linked to offset the bone loss, one must be aware of the fat content of the foods that contain calcium. Many vegetables contain calcium vs the higher fat milk products. It is recommended to get at least 1200 mg. of calcium daily. A low-fat diet is advised at this stage of life.

Sedatary lifestyles are attributed to middle age persons. Be it the demands of a family or a job, middle age people are not as active as their younger counterparts.

Some people work well on protein diets but the long term success rate seems temporary. What is emphasized is eating whole grains, beans, vegetables and fruits. This is a healthy alternative to weight loss and helps maintain a healthy heart and life. The pyramid diet has become more popular over the four basic food groups of meat, cheese, and other milk products for being the sole source of getting one's dietary needs. Also, in contrast to the popular three squares a day, mini meals are a possible way to eat. When eating a meal the heart pumps extra blood to the stomach and intestines. According to the British Journal of Nutrition, vol. 71, 1974, after a 240-calorie mini meal of corn flakes and skim milk, women's hearts pumped and extra 84 quarts of blood over the next two hours as compared to eating a 720-calorie meal with added sugar and bread, the heart pumped an extra 258 quarts of blood. This increases the hearts work when there is already a higher risk factor for heart disease.

Reading up on low-fat meals is an excellent way to begin to change your eating habits. Dr. Dean Ornish suggests eating small frequent meals that do not skip breakfast. When more than four hours pass between meals, blood glucose drops, which is our bodies energy source. When more time has passed we are more likely to eat larger meal. Larger meals force the pancreas to crank out lots of insulin. Higher levels of insulin are suspected to help clog arteries, another factor in heart disease.

Here are a sample of risk factors to look for to keep the heart working as we move into our middle years.

• Family History (Heart attack or stroke before the age of 60)
• Modifiable Behaviors-Do you smoke? How many days do you engage in 30 minutes of aerobic exercises?
• Weight and Fat Distribution-Are you pear-shaped or apple-shaped? Waist/Hip Ratio.
• Cholesterol -HDL(high-density lipids) these should be high around 45 ; LDL (low-density) are recommended to be 150 vs the allotted 200 and Triglycerides at a level lower than 200.
• Blood Pressure
• These are the concerns over whether you are at a higher risk for developing heart disease and to recognize that you can make lifestyle changes to offset health problems.

While middle age people have had the opportunity to grow up and mature, some look at it as a time to reflect what they need to accomplish before old age sets in. Though there are factors that cannot be overlooked, such as a decrease in strength or the metabolism slowing down making weight gain easier, physical health can be in ones control if they do not fall into the "I don't have time" attitude. This is not just a reflection of how much time one has left, it is also a time to renew one's commitment to themselves. A major issue is health. As suggested above, an overall change in ones's health and fitness approach has great benefit.

Fitness is related to the enjoyment of our leisure time. As one gives up the turmoils of youth, it is a good time to enjoy the benefits of healthy leisure activities. Middle age is also a time to find renewed meaning in one's life. For women, it could be going back to school or starting a career. It might be a time to reevaluate personal goals. Sometimes fitness was overlooked when we were younger.

There are many opportunities to begin a fitness program that is not simply "exercise", but leisure. Besides the social aspect of some clubs there are many opportunities to find a new hobby. Below is a sample of places to look...don't just look, find one and participate. The years ahead are yours to enjoy!

Newspaper	Local Sports Good stores	City Community Brochures	Local YMCA or YWCA	Local Fitness Magazines	Schools	Churches	Neighbor Community Centers
Lists local meetings. book readings	Have maps of local area hikes	Offer classes from dance to kayaking	Swimming and exercise facilities	Shows events such as walks, runs marathons	Offer classes at night i.e. photography	Fund raisers for community	Introduces you to people in your neighborhood