We've always thought of being thin as a sign of health & worry a little bit
about people with a lot of muscle - or at least people that are heavy and have
often bunched having a lot of muscle in there as well and that may be true when
you're young I think that's still debatable however once you hit your mid
60s loss of muscle is a big big deal it's called sarcopenia Sarco means
muscle and penia means loss of I had a patient I was seeing a patient this past
week female that's been with me for years and has always done great in terms
of diet medications all of the other things associated with managing
cardiovascular risk however this patient's significantly
over 65 and has always had some concern about muscle training she reminds me of
my wife janice likes to say "oh I'm saving myself" well you know you can't
save yourself with muscle training you are save yourself by not doing muscle
training you need to do it now why is that we'll go over that in this video
and actually we'll talk about a video I mean a study which was published in
Nature magazine which actually shows that the same risk factors for heart
attack and stroke are also risk factors for loss of muscle mass as we age now
what does that mean again let's just focus a little bit more on first we talk
about the study then we'll get into the problems associated with loss of muscle
mass and they're big ones but let's go back the study was published in Nature
magazine I'll go into the title page and into some details in a few minutes
here's what they found let's go from straight to the punchline sarcopenia or
muscle loss is this independently associated with CV RBF cardiovascular
risk factors and in particular is associated with diabetes and
hypertension the prevalence of muscle loss increased streak in other words the
amount the number of people that had muscle loss increased steeply with
increasing number of cardiovascular risk factors therefore the prevention and
treatment of cardiovascular risk factors may be useful in preventing and delaying
onset of muscle loss now again where muscle loss is you know what it's
becoming a little old man or a little old lady
this guy's not got a lot of sarcopenia - but here's the issue one of many many
issues associated with loss of muscles as we get age 65 here's another way of
looking at it age 65 and above - one out of three people fall each year age 72
and above you fall every other year 80 you and above you start falling every
year and the patient I mentioned earlier has had a couple of Falls with
significant injuries already so again Falls become a bigger and bigger risk
factor for disability as we get older
now there's another issue regarding loss of muscle mass and if you haven't seen
my video on mitochondria and their central role in aging go back and look
at it I just did it recently and it's coming out as one of my more popular
videos again my wife and some others tell me don't get into don't write
something on mitochondria and nobody's gonna understand it well they don't
really understand the viewership of this channel it's again coming out as one of
the more popular videos of the group people are beginning
to understand what mitochondria are and why they're critical to aging well guess
what what what his muscle mass got to do with mitochondria everything maybe the
highest concentration of mitochondria in your body is in your heart muscle but by
far the largest amount mass of mitochondria is in your muscle tissues
yeah so muscle tissue is critical so this is another video this is an old
video I did a what almost two years ago on one on the most effective way of
maintaining mitochondrial mass it's called HIIT high-intensity interval
training and again we're talking about high-intensity interval trainings on a
treadmill on a bicycle on an indoor bike we're talking about getting those big
muscles because that's where most of your mitochondria in your body reside
now even if you're not you know you go back to that picture of the fellow that
fell on the stairs and I said well maybe he doesn't have muscle loss you know
what maybe he does this is one of the deceptive things that you see with
muscle loss as people get older especially when they're sedentary
this is a young active person and I believe this was a an MRI this is muscle
this great tissue here and that darker gray tissue is fat look at this so
you've with older people you tend to have even if we maintain our weight
unless we do significant work on resistance training and interval
training we lose our muscle mass especially as we get into our mid 60s
here's another example and again it's just the same thing age 25
much more muscle and therefore much more mitochondria much more calorie burn than
fat age 63 you see what's going on so again
our goal is to go back continue to grow that muscle mass keep it there in this
last video that I mentioned by the way I talked about the Mayo Clinic study
there's a dr. Nayar at Mayo Clinic who basically took three groups of people 20
to 30 year olds 40 50 year olds and 70 and 80 year olds put them through
different types of training cardiovascular training you know low
intensity resistance training and high intensity intervals by far the best was
high intensity intervals resistance training was very good as well and
here's the thing that 80 year olds benefited the most many of them doubled
their mitochondrial mass with high-intensity interval training so
again it's use it or lose it so here to the the study itself wait a minute
before we do I need to introduce myself real quick my name is Ford brewer
brewer i started off as an ER doc focused on emergency medicine but
then changed focus as i realized that most of the things people are bringing
into the ER are ... disability and disease is preventable I went to Johns
Hopkins to get training in it and loved it it did well ended up running the
program and for the past thirty years since then I've been working with
primary care Doc's - staffs as as large as 800 and more
doctors and with my share of patients as well helping them to focus on prevention
because prevention is a heck of a lot better than seeking a cure after the
fact just ask your anyone you know that's had a heart attack or stroke
so back to the study itself and again that's what this channel is about
increasing conversation and focus around prevention and this one today is on
improving muscle mass and associating muscle mass with some of the other risk
factors actually the interesting part of this study is they showed that the same
risk factors for insulin resistance and diabetes in the elderly are also risk
factors for loss of muscle mass or sarcopenia so this was in nature
magazine let me pull this image down just just a little bit well I don't
think it's working but as you see there let me hmm well I'm not sure I'm gonna
be able to get that image to come down it's in nature magazine August 29th of
2017 and I'll give you a link to it under the under the video the full title
is increased risks of sarcopenia or muscle loss in patients with
cardiovascular risk factors in suburban dwelling older Chinese using the AWGS
definition now you may look at that and say, " wait a minute
I'm a Caucasian female. what's this what of older Chinese suburb suburb
dwellers have to do with me?" The D H here stands for the Dirty Harry and my
favorite quote from dirty harry is, " are you feeling lucky?" the mitochondria issues
and risk factors for aging for these people is the same as it is it's a
universal issue I'll go into a couple of discussion points again prevalence of
muscle loss was significantly proportional to the number of
cardiovascular risk factor components in other words every of every next
cardiovascular risk factor you had you greatly increased your risk of having
muscle loss particularly diabetes and hypertension were significantly
associated with higher risk the these risks were independent of other
confounding factors and they've seen this before this is not new some of the
some of this is new that the fact that you get additional increase of risk with
every risk factor that's somewhat new in this in this study let me cover just
another couple of things and we will wrap up now in this study the univariate
analysis showed no correlation between muscle loss and hypertension and I'm
going to just again for those of you that want to get geeky on epidemiology
univariate means you just look at relationships and you don't look at
confounding factors you remember we talked about confounders maybe all right
there's something that's associated with the outcome and the risk factor and they
may actually change whether you see risk or not and that's what happened in this
Chinese population if you just looked overall at the Chinese population here
high blood pressure didn't appear to be associated with with muscle loss however
after you did what we called a multivariate statistical analysis it
took out the confounder's - things that were related both to hypertension
and to muscle loss like age is obviously associated with that smoking can be
associated with that diabetes itself can be associated with that so once you take
those confounders out hypertension was the second most significant feature so
what are some again well here are some of the confound errs age gender BMI
marital status educational level and smoking so once you factor all those out
in this multivariate analysis then again hypertension becomes a big big issue
that is not new there been other studies which have shown
hypertension associated with with muscle loss as well
now they talked a little bit about potential mechanisms there's not enough
information right now to understand clearly but most of the people that have
watched things on this channel have seen and understand what inflammation is they
understand the processes where mast cells cytokines TNF alpha AGE advanced
glycation products you know where glucose is bound to the proteins they
cause low-grade infection I mean not infection low-grade inflammation and
there there's a significant and strong suggestion that that inflammation
impairs blood flow damaging micro vac vascular endothelium now I'll put a
quick plug in is is you may know we have we have created a course on
cardiovascular inflammation it's about the cost of a book and if you have we're
trying to figure out how to give it away for free to if you have concerns about
paying that much for it keep your eyes open go to our website and take a look
it gets deep in terms of how to measure your own cardiovascular inflammation you
know it's one thing to sit and read about it and listen to videos it's
another to think about measuring your own and you can do that so again this is
the the image showing prevalence or the percentage of muscle loss and the number
of risk factors zero eight percent one risk factor 11 percent three risk
factors up to 22 percent I would go in this these next couple of tables show
how when you look at it from univariate focus and then go in and do the
multivariate and get rid of the confounders hypertension becomes a big
deal but we're not gonna we're getting late in terms of
the video I've I've kept you long enough thank you very much for your interest