Episode 45: Exercise for Health with guest Juliette Norman
About Juliette Norman
Juliette Norman has a strong passion for physical activity and health.
She completed a Bachelor of Science in Biology – followed by a Master's in Physical Activity/Exercise and Health Exeter University. After learning how physical activity can help prevent chronic disease, she applied to do a Ph.D. in Liverpool. She has also completed a one-year further Master's on musculoskeletal ageing (the biology of aging). She is currently finishing her Ph.D. at the University of Liverpool in the United Kingdom. She has a passion for promoting physical activity to improve health and prevent chronic disease. Her research focuses on investigating aging, physical inactivity, as well as musculoskeletal and metabolic health. She also works as an Exercise for Health instructor within a Liverpool City Council fitness centre.
What is Musculoskeletal Health?
Your musculoskeletal system (essential for movement and keeping all of your structure and form) is composed of:
Muscles
Bones
Joints
Connective tissue (e.g., ligaments and tendons)
Keeping your musculoskeletal system healthy is very important for your ability to be active and functional.
As you age, the health of your musculoskeletal system gradually declines, which can cause pain, stiffness and weakness in muscles and bone. Muscle loss can lead to frailty and a reduced ability to perform everyday activities. As such, maintaining a healthy musculoskeletal system is important for keeping you independent for longer periods of time.
Link between musculoskeletal health and sarcopenia
Sarcopenia is age-related loss of muscle size and strength. Although many people have heard of other age-related chronic conditions such as:
Osteoporosis - when bones become weaker or less dense and more prone to fractures
Osteoarthritis – damage to joints and is associated with pain and inflammation
Even though sarcopenia is less known, it is just as important. It is very common with aging. It is estimated that after the age of 50 years old, we lose about 1-2% of muscle each year [check audio], which also coincides with an estimated annual loss of strength at about 3% a year. Although this might seem like small amounts, it can have a hugely detrimental impact by the time you reach 70 years old.
How can you prevent or slow down age-related muscle loss?
Physical activity plays a huge role in helping to reduce age-related loss in muscle mass and strength. You don't have to go to the gym and lift heavy weights. There are options. You can incorporate strength exercises at home or just in your everyday life.
Going to the shops and lifting the bags
Carrying things
Doing small exercises at home
Going to a local class
Go swimming - you've got that buoyancy of the water, but you've also got the resistance of the water, which can help improve muscle size or at least muscle strength. But without that fear of falling over, and it can be enjoyable.
Short-term Inactivity, Health & Aging
Being physically inactive can accelerate the onset of these chronic musculoskeletal conditions, including other areas of our health, such as increased risk of obesity, cardiovascular disease and other metabolic disorders such as type 2 diabetes.
In this current day and age, humans are becoming increasingly inactive and spending more time sitting and engaging in other areas of sedentary behaviour.
Sedentary behaviour refers to different forms of sitting behaviours, where you are not using very much energy to move around.
Causes for short-term periods of inactivity:
Weather (e.g., icy conditions)
Sickness
Recovering from an operation
Social isolation – when people don't want to leave the house, it can cause people to become more inactive
Holidays – e.g., over the Christmas period where you lounge around for a couple of weeks
The accumulation of these small bouts of inactivity can have a massive impact on your musculoskeletal health and other areas of your health as well.
Being busy does NOT equal physical activity
A lot of people tell Juliette that they are very active because they are busy all day. For some, being "busy" makes them feel that they are being physically active. But, oftentimes people are busy doing a lot of tasks around the house that don't involve doing too much movement; so, they're not actually using that much energy. Rather, think about how much energy you're using and how many actual steps you're taking.
The benefits of breaking up prolonged periods of inactivity
It's important for your health to avoid long periods of maintaining one position – e.g., being seated. This fact is particularly important for your metabolic health, as long periods of sitting can cause problems with how you regulate your blood sugar levels.
In her role as an exercise for health instructor, Juliette commonly gets referrals for people who have been diagnosed with prediabetes (they haven't yet developed type 2 diabetes, but they are on their way.) Their blood sugar levels suggest that if they carry on the way that they are, they will develop type 2 diabetes. During their first meeting with Juliette, they talk about how they can increase their activity and not necessarily using the gym. It's often walking and breaking up the time that they are spending sitting. Just by moving their bodies more, many people have managed to reverse their prediabetes diagnosis. They have managed to take back control of their blood sugar level regulation.
Moving can be as simple as getting up and going for a walk. The key is to break up any prolonged inactivity. In fact, your body can become quite inflamed if you remain sedentary for a long time. Whereas if you move a bit more - using your muscles and joints actually helps reduce general inflammation in the body. This information is beneficial because if you have a lot of inflammation in the body, it can be a causal factor in a lot of health conditions.
How exercise improves your glycemic control?
Say you've had a bowl of porridge for breakfast. There are carbohydrates in your porridge. So, that will increase the amount of sugar that's in your blood. After eating the bowl of porridge, your pancreas senses rising blood sugar levels and releases the hormone insulin. Insulin helps sugar enter your cells, so your body can use it as energy. If you are quite active or if you maintain your movement patterns, your muscles will need to use that sugar in your blood for energy; so, insulin becomes very helpful in this regard. What’s more is that any type of physical activity has the potential to make your insulin work better. But, if you are not very active, and consume carbohydrates and sugar (glucose), your insulin levels will go up (in response to what you’ve eaten) and stay up (because your muscles don’t need to use the glucose as energy). The outcome of this abundance of insulin is that - eventually - your cells stop listening to insulin, and don't take up the sugar from your blood as much; so, you pump out more insulin. You will ultimately end up breaking your insulin system by over working it. This is the state where you become insulin resistant - and you're not able to control those blood sugar levels as well.
Being inactive is a big risk factor for this.
Full-blown diabetes is when the cells that produce insulin stops working properly (don't produce insulin), and that's when you need to go on medication.
The good news is that prediabetes can be reversed. When you've got poor glycemic control and an insulin resistance state - by increasing your activity, you can get back control and stimulate your body to regulate its metabolic health.
Don't worry – you don't need to do extreme forms of exercise (e.g., running) to see the benefits. Just increasing the moving and being physically active is sufficient:
Walking
Swimming
Your glycemic control system originally evolved in humans because there was a time when humans didn't know when their next meal was going to be. Humans had to endure long periods of time without food, and we also had to expend quite a lot of energy in one go (searching for food, running away from predators, etc.). Your glycemic control system is actually your body's way of reserving energy. But, in current day, we have easy access to plenty of food. Present-day humans don't need to have that reserve anymore. Holding sugar in our blood is your body's way of preserving energy. It's kind of like an evolutionary maladaptation because the current human lifestyle does not require that we hold sugar in our blood as a way to preserve energy. There's no famine. We're not starving. We're not seeking food for days on end where we would where this would be useful. In this way, you have to change your lifestyle and adapt your behaviours to match how your body functions and accommodate this pre-existing biological function. It is your responsibility to move your body and make use of the sugar in your blood.
Juliette’s PhD Research on Inactivity and Health
Juliette's research explored whether older adults are more at risk of the effects of sedentary behaviour or physical inactivity as compared to younger adults. Juliette's research is funded by a research body called CIMA (Centre for Integrated Research into Musculoskeletal Aging.)
Participants
All together they recruited 26 younger and 21 older adults. The younger adults were aged 18 to 45 and the older adults were aged 50 to 70.
Juliette was looking for research participants who were deemed physically active – took at least 10,000 steps a day). The 10,000 steps count had to occur in their everyday life – e.g., walking to the shops or walking to work or just going for walks in the park and things like that.). None of the research participants were exercises (none of them went to the gym or did cardio, e.g., running).
Intervention
Participants were asked to reduce the number of steps they took for two weeks from 10,000 to 1500 per day.
What did the researchers measure?
Muscle size, strength and power
Bone density
Metabolic health
Glycemic control
Cholesterol
Results
Just two weeks of inactivity caused significant changes in many of the health measures:
Muscles mass and muscle size and strength was significantly decreased
Significant gains in overall body fat (particularly around the waist.)
Bone density decreased
Cardiorespiratory fitness (how you utilize oxygen during movements) declined
Mitochondrial function (how you produce energy) declined
People with low cardiorespiratory fitness and low mitochondrial function are at risk for numerous cardiovascular and metabolic diseases and other health conditions.
Interestingly, they found that both age groups experienced similar changes after two weeks of inactivity (except for cardiorespiratory fitness and mitochondrial function.) What was different is all of the measures (e.g., muscle mass, strength, body fat), they were all different in the older people to start with:
Older adults lower muscle mass and reduced strength
Older adults had higher levels of body fat
Older adults had lower bone mass
All of the things you'd expect during aging.
However, Juliette and her team found that inactivity caused similar changes in younger and older adults. Their results suggest that inactivity has a greater impact on the health of older adults, as compared to the young because they are starting from different places.
This research highlights the impact that even a short amount of inactivity can have on your health.
Tips for being more active on a daily basis
Make gradual changes - If you're not currently exercising three times a week, don't stat there. Start where you are at and make small changes.
Make small little improvements - small changes can have a big impact
Go for a short walk
Walk to work or the shops
Take up a hobby that's active
Join a local class
Park farther away from the entrance to the shop
You don't have to do vast amounts of exercising to gain benefits. Doing a little bit CONSISTENTLY can have a tremendous impact on your health.
Small incremental changes are extraordinarily helpful.
You don't have to get a gym membership and spend hours in the gym. Just move your body.
Adding little bits of movement to your everyday life can be powerful. Make a conscious effort to be attuned to how much you are moving your body and strive to be active – in some way – every day. Be realistic about what you can do and start there – e.g., "I'm going to give myself three minutes of walking." Put on your favourite song, podcast, or Audiobook and just give yourself three minutes. At the end of the three minutes, if you want to do a couple more minutes – go for it!
Conclusion
Even small amounts of exercise can have a tremendous impact on your overall health and wellness, so get moving! Being physically inactive can accelerate the onset of chronic musculoskeletal conditions and metabolic disorders, such as increased risk of obesity, cardiovascular disease and type 2 diabetes. Even short bouts inactivity can have a surprisingly negative impact on your health. Given this, be sure to prioritize moving your body - in a safe way - every single day. Your overall health depends on it!