Parents Are Hard To Raise S02 E59
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Announcer: [00:00:33] We know the role exercise nutrition and lifestyle choices play in our health. But what about our aging parents. Is there ever a point at which it is too late? A point where risk of injury and potential for pain outweigh the benefits? Diane’s special guest expert Bob Tygenhof, director of the Center for Active Lifestyle Medicine at the integrative medical group in Irvine, California weighs in on the topic.
Diane: [00:00:58] Welcome to Parents Are Hard to Raise… Helping families grow old together, without losing their minds. I’m eldercare expert Diane Berardi.
Diane: [00:01:20] My special guest this week Bob Tygenhof is the director of the Center for Active Lifestyle Medicine at the integrative medical group in Irvine, California. His innovative wellness programs combine traditional medical treatments with lifestyle changes, nutritional and fitness programs, to help patients regain their health and age more healthy by reducing inflammation, combating the effects of oxidative stress and correcting hormonal imbalances. He’s been so successful in promoting healthy aging and combating polycystic ovary syndrome that he was asked to present his clinical findings before the International Congress for clinicians in complementary and integrative medicine. He holds degrees from Princeton University the University of Southern California and the American College of Sports Medicine. Bob welcome to parents are hard to raise.
Bob Tygenhof: [00:02:15] Well Hello Diane how are you. Good. Thank you.
Diane: [00:02:19] So to begin with I know you’re a big believer in proper nutrition and exercise but how important is it for our aging parents to exercise?
Bob Tygenhof: [00:02:29] Well I think it’s absolutely essential. You know it’s often people will ask, “How much do I have to exercise when can I stop exercising… Things like that.” But I think we, you know, if you recognize that humans are animals that are supposed to be in motion it’s a little bit akin to saying well “when can I stop breathing? When have I eaten enough food that I don’t need to eat anymore?” You know you have to exercise your entire life.
Diane: [00:03:00] Yeah. And you know it’s true I think people we get to a certain age and we just we don’t do it and we don’t realize how vital it is and that it is like breathing. I mean we don’t. I’m kind of guilty of that myself. And I know I keep saying OK… I’m going to I’m going to do it next week. I’m going to start, I say this every week.
Bob Tygenhof: [00:03:23] It always seems like there’s something more important to do and it’s very easy to sort of delude ourselves into thinking of well I’ll make it up next week or the week after. And we just keep putting exercise off further and further and further and unfortunately when you don’t exercise everything goes into reverse and your health starts to decline and you lose it. But it’s a very slow loss. So we don’t recognize it the way you would if you fell down and you cut yourself or you broke a bone. That’s immediate. You see it. But when it’s a long term steady decline…
Bob Tygenhof: [00:04:02] And that’s unfortunately what most people get into. It’s very hard to recognize and a little bit challenging to actually do something about it.
Diane: [00:04:12] Yeah. Now with the elderly, and I even know with my mom… My dad will mow the lawn. He says that’s my exercise and he’s up and down the steps and my mom kind of just sits and everything hurts so she doesn’t move.
Diane: [00:04:31] So how do you start an older person on an exercise program?
Bob Tygenhof: [00:04:36] Well you know I think that everybody starts depending on what their base level of fitness is. So if somebody has been active then they would certainly start at a much higher level of activity than someone who is typical of the vast majority unfortunately of people who do very little in terms of exercise. We live in a in a society that celebrates convenience and convenience very often translates into doing nothing for as little as possible. And so we live we have a tendency to work our lives in very sedentary types of environments and jobs. And when we get home or we retire then we retire often into likewise very sedentary environments and existences. I’d like to get people who have become deconditioned over time back into what I’d like to think of as the original exercise. And once you get past the rolling around and crawling on the floor phase of life you begin walking and walking really is just a terrific exercise for the vast majority of people.
Diane: [00:05:56] Now what if you have a person with a walker. You know they could go outside and walk or walk inside and yeah.
Bob Tygenhof: [00:06:04] Diane my my my mother is 99 years old. We just celebrated her birthday earlier in April.
Diane: [00:06:10] Oh my gosh fantastic.
Bob Tygenhof: [00:06:15] And I faced the same problem. She has never considered herself an exerciser but she does still use the walker and I make sure that she gets out and I sort of encourage her. Annoy her is probably how she sees it, but I encourage her to get out and walk at least a little bit everyday. And I think that in her more reflective moments she’ll often say, “you know the reason that I’m still so healthy is that I do a lot of walking.” I always think, “gee I wish you would have said that to me.” And been a little bit happier about it when I was doing that. But but I think walking is just a terrific exercise. And you know the more we do it’s what we naturally do. And it’s good for virtually every system and body.
Diane: [00:07:17] Now of course being in the Northeast we have the winter so I I’ll say to to clients well you can walk around your house. We can’t get outside it’s too cold. I mean ice et cetera. Right? They can just kind of do their thing in the house.
Bob Tygenhof: [00:07:38] Yeah. I grew up in the Northeast and moved out to California. Probably about 40 years ago. But out here we do an awful lot of in the winter.. . And we really get frightened of cold cold weather when it gets down to maybe 50.
Bob Tygenhof: [00:08:03] Yeah yeah… But there’s a lot of people who go to the local malls and there at least you have a little bit of a longer more interesting walk than if I’m just walking from the bedroom to the kitchen living room. Back to the bedroom and you know to get someplace where you can actually walk for a little bit and actual you know what’s also nice about that is is you get to socialize when you get to see other people and and occasionally strike up a conversation. And that’s all part of being healthy.
Diane: [00:08:39] Well that’s a great idea. Now how about patients in a wheelchair. We try to encourage them to do something for their upper body.
Bob Tygenhof: [00:08:49] Yeah. There are specialized types of gym equipment that you can get a an upper body aerobic workout using hand grips and it looks very much like an upside down bicycle. You can you can pedal with your hands and get a fairly decent aerobic workout. Typically when I have people who are confined to wheelchairs or things like that then we have a tendency to shift a little bit more towards resistance types of exercise rather than looking at more extended aerobic type types of programs. There are unfortunately different sets of benefits that you get from aerobic exercise versus resistance. But you won’t get everything but you’ll get a lot more than you would get if you just sat there watching TV.
Diane: [00:09:50] Now could you explain the difference between aerobic and resistance?
Bob Tygenhof: [00:09:52] Oh sure. So aerobics typically is a repetitive type of exercise that gets the heart rate elevated and at a constant elevation level.
[00:10:08] And typical aerobic exercises are walking, jogging, running, swimming, there are treadmills, elliptical machines rowing machines. But you’re doing the same basic motion over and over for extended periods of time. When I’m doing resistance training, then, it’s what people typically think of in terms of lifting weights and weights can be anything from the body builder muscling this huge enormous weight, to these very tiny dumbbells that are perfectly fine depending on where you’re starting from. It’s also body weight. So things that we kind of hark back to childhood and push ups and jumping jacks and sit ups things like that. That’s resistance training. And there are there are also types of gym equipment, the heavy framed types of things and then resistance bands and things like that. Anything that really creates resistance for the muscle and the muscle has to strain against it. They’re typically short term so you don’t have that long term constant exercising of the cardiovascular system.
Diane: [00:11:31] OK. And those those bands I guess you can use them for your legs too right.
Bob Tygenhof: [00:11:38] Oh yeah… Yeah yeah yeah yeah. There’s there’s a whole set of exercises that people can do with the bands.
Diane: [00:11:48] You can learn more about Bob Tygenhof, and his work at integrative medicine group at integratedmgi.com.
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Announcer: [00:13:58] You’re listening to parents to raise. Now, thanks to you, the number one eldercare talk show on planet earth.
Diane: [00:14:21] I want to welcome a lot of new listeners this week. So let’s see. We have new listeners in Tokyo, Osaka, Liverpool, Jakarta, Sao Paolo and Pusan South Korea, Sacramento California, Omaha City, Portland Oregon, Portland Maine, Indianapolis, Fort Mill South Carolina, Jacksonville, Cape Coral and Port St. Lucie in Florida. Welcome… Welcome.
Diane: [00:14:59] And we’re back with our special guest Bob Tygenhof, the director of the Center for Active Lifestyle Medicine.
Diane: [00:15:06] So we have a lot of parents who have dementia. What kind of exercises would you suggest for people to do with them. I know we try to get them walking, etcetera, but what else could you suggest for us?
Bob Tygenhof: [00:15:24] Well I think that walking is great. Resistance is resistance training is also very beneficial. And one of the exciting things that has come out of the research recently… And this is probably over the last maybe three to five years… Is that when you do resistance training, it actually increases the prevalence of a protein in the brain that encourages the growth and the establishment of new neurons. It’s called brain derived neurotrophic factor and you get a significant elevation when you exercise. So it is one of the reasons that exercise has become an integral part of many of the longevity and the programs and the programs that fight cognitive decline.
Diane: [00:16:24] Well. That’s very interesting. That’s really very interesting.
Diane: [00:16:28] I have a lot of patients that have Parkinson’s and they’re so afraid to exercise. What would you suggest to them as well?
Diane: [00:16:44] Well actually, there is an organization called the American College of Sports Medicine that has spearheaded a movement called Exercise is medicine. They’ve done that in conjunction with the American Medical Association. And they actually have a Web site and that on the Web site and the exercise is medicine section, they have exercise recommendations for a whole variety of different impairments and diseases and Parkinson’s happens to be one of them. There’s also exercise recommendations for cardiovascular disease, for overweight obesity, for a variety of different cognitive decline issues, hypertension things like that. In a lot of these instances the recommendation of course is to be careful, to go slow. But ultimately almost in all instances it conforms long term with the recommendation that initially came out of the Surgeon General’s office in 1996 and ultimately has more or less spread around the world and it’s now the official exercise recommendation from the World Health Organization. And that is that people try to exercise aerobically at moderate intensity for about 150 minutes per week. So if you think about that five days 30 minutes a day.
Diane: [00:18:25] OK
Bob Tygenhof: [00:18:26] And then supplement that two to three times a week with a resistance training program that basically exercises all of the major muscle systems in the body and so you can probably do that by doing somewhere between eight to 12 different exercises.
Diane: [00:18:48] I know. I guess the concept… Like Curves, that used to have that the circut and all the different machinery and then in between you were doing aerobic exercises, so I guess the circuts were set up very intentionally. To give you that rounded total body workout, so that you were exercising all of the major muscle groups by the time you finished the circuit.
Bob Tygenhof: [00:19:19] Absolutely right.
Diane: [00:19:21] I know I can’t I don’t think there’s any open any more in our area. I don’t know. I love that place but…
Bob Tygenhof: [00:19:28] And then of course they probably still sell franchises. You know you can do that in my spare time.
Diane: [00:19:38] Oh my gosh. (laughing)
Diane: [00:19:39] So now. How about a diet? Nutrition… What can you tell us about that?
Bob Tygenhof: [00:19:50] OK well, the issue that I find coming up time and time again is as people try to and begin to adopt healthy lifestyles, they of course will attempt to go into a diet that typically is going to be a little bit more plant based than perhaps the diet they’ve been taking all along. And so they’ve typically had the Western diet lots and lots of animal protein lots of grains often wheat and corn based and then lots and lots of dairy. As they move away from that. One of the things that they find is that there aren’t that many protein sources in the plant based world. And so a lot of times the people that I see at any rate are starting to become protein deficient. And if you’re if you are beginning a workout program an exercise program and you’re cutting back intentionally or unintentionally on your protein you make it very very difficult for the body to respond properly. So one of the things you really have to try and do is maintain adequate protein levels. Now part of the problem with that is that as we age unfortunately we become less efficient at digesting our foods and absorbing them. So the amount of protein that I needed when I was 20, 25 to begin what’s called muscle protein synthesis, so rebuilding the muscle that I broke down during exercise… I really only needed about 20 grams of protein in order to do that.
Bob Tygenhof: [00:21:37] As you pass age 65 and beyond. You’re really looking more at 25 to 30 grams of protein. Now if that’s going up at the same time I’m trying to institute a plant based healthier diet and my protein is going down, then I get into this gap where I’m not supplying my body with enough protein to rebuild this muscle structures that I’m that I’m wearing down. So you really have to give a little bit of extra thought and attention to getting adequate amounts of protein. And by the way that 25 to 30 grams is three times a day.
Diane: [00:22:19] Really
Bob Tygenhof: [00:22:20] Yeah, it’s not just one little shot and I’m done for the day. It seems that you get the best muscle growth and regeneration response when you spread it out over three meals.
Diane: [00:22:39] How about those protein bars? I see everybody eatring them and I’m like… I don’t know.
Bob Tygenhof: [00:22:48] Oh yeah. In a pinch they can do. There are some manufacturers who make protein powders that you can do shakes out of that are very very specifically geared to an older population. And they will typically have the specific amino acid and all protein is made up of 20 amino acids just strung together like a chain of pearls, a string of pearls. And they do a very scientific formula of those protein of those amino acids that seem to be key in initiating this whole muscle protein synthesis. So those are available and we like those a lot because certainly it makes a really convenient quick and easy breakfast for example. And people can put together a smoothie. You slice up a banana. Put it in a plastic bag throw it in the freezer and next morning you put your protein powder in with som… I like almond milk. Not everybody does but I do. And throw in the frozen bananas and you have sort of like ice cream for breakfast, but all healthy.
Diane: [00:24:21] Yeah. That sounds good.
Bob Tygenhof: [00:24:24] Not bad.
Diane: [00:24:27] Do you know any of the brand names of those products and where people can buy them?
Bob Tygenhof: [00:24:32] Yeah. As a matter of fact, Metagenics and I have absolutely no connection with them. They’re the manufacturer. It’s a product called advanced formula and it comes in vanilla and chocolate and they are, as opposed to the protein shakes of 10 and 15 years ago, that you sort of held your nose and right through down the back of your throat as fast as you can, these taste terrific. And there’s really nothing bad in them. So it’s a good option.
Diane: [00:25:11] Yeah. I didn’t even realize that. I know because I think of I do everything wrong. I know… listening, first of all. I know I have to exercise. I’ll say to my husband OK next week just salads..just eat Salads. I do this the whole thing and then he says, here there’s protein bars and I’m eating them and some of them are great and I’m thinking I don’t know if this is filling me up is this all I can eat? So…
[00:25:39] Yeah. You know you get into looking at the label and then you have crossed the line into… Oh my god what’s in this?
[00:25:49] Right. And the calories. I look at the calories I’m like oh my gosh! This little bars so…
Bob Tygenhof: [00:26:00] 230 calories. Boy, that went fast.
Diane: [00:26:04] I know I’m like… This is a meal. This can’t be. Of course, you know if you listen to the show with my mother then you’ll know that can’t just be a meal listening to my mom. You know so much.
Bob Tygenhof: [00:26:21] Mangia, mangia, mangia!
Diane: [00:26:21] Exactly. You know I tell the story of my dad being in the emergency room and you know and my husband and I went up there and we’re taking her home and I think it’s like 2:00 o’clock in the morning and she’s like … “I have to stop for bread.” I’m like, “Bread?” Why do you have to stop for bread?” I know she has bread… “in case you want a sandwich.” I’m like. I don’t think so.
Bob Tygenhof: [00:26:46] It’s only two o’clock in the morning…
Diane: [00:26:48] It’s like, “Well you have to eat.” Oh my gosh.
[00:26:54] We try to encourage people, children with their parents. How important is it for children of aging parents to join in the fun and exercise too?
Bob Tygenhof: [00:27:08] Oh I think if you’re the caregiver you hopefully have to keep up with your elderly parents, you know. But you can’t really take care of somebody else if you’re sick and you’re not capable of doing it.
[00:27:24] So, one of the things that I do… We have a little Man-Made Lake near where I live and every Saturday I get my mother. And now that’s not a distance it’s about a mile and a half around the lake. So it’s not something that she can do behind her walker. So I put her in the wheelchair. And we go down and we walk all the way around the lake. And it’s just a really nice time where she’s visually challenged and it’s a very beautiful place. So she just loves doing that. We get to share that time together and I get a workout. It’s not necessarily the easiest thing in the world pushing a wheelchair up and over bridges and all the other barriers and obstacle course items we have a long way. So yeah, it’s great.
Diane: [00:28:24] That’s perfect. Perfect. We so enjoy the show Bob and we so enjoyed having you as a guest. I know this episode gave insight into even you know ideas and insight for people to exercise with their parents or get their parents to start exercising or themselves like me. Bob thank you so much for being here. And remember you can learn more about Bob Tygenhof and his work at integrative medical group at IntegrativeMGI.com.
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[00:29:41] Thank you so much for listening. And I look forward to reading your comments and can’t wait till we meet up again next week on the next episode of Parents Are Hard To Raise.
[00:29:50] Till then… May you forget everything you don’t want to remember and remember everything you don’t want to forget. I’m Eldercare expert, Diane Berardi. See you again next week!