Older, Wiser, and Healthier: Guidelines for Healthy Aging - UPMC.com

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1 Fall 2013 Older, Wiser, and Healthier: Guidelines for Healthy Aging By Ronald Glick MD, Carol Greco PhD, John Laird,ND, James Donnelly, MA of the Center for Integrative Medicine, Denise Zucker Hodes, LSW, of the Senior Care Institute, and Esther Teverovsky, MD, of the Benedum Geriatric Center When I turned 40, I went in for a general cardiovascular disease. Its high in whole depression and anxiety that rival those of check up. My doctor looked at my chest x-ray grains, legumes, fruits, vegetables, nuts, and medications and therapy. and said, Ron, your heart and lungs look olive oil, and moderate in poultry and fish. Thirty minutes per day of moderate level great but your spine is a mess. It turns out It is low in red and processed meats, dairy, aerobic activity provides a general health my father has the same spine disease. At that and sweets. A recent trial of the benefit for heart and lungs. By moderate, we time, my back looked at least 20 years older, Mediterranean diet in Spain among people mean an activity, such as walking at a brisk so now it must be pushing 80. No surprise at high risk for cardiovascular disease pace, that gets your heart pumping and allows were all aging; the older we get, the more revealed that the diet cut the risk for heart you to work up a little bit of a sweat. For likely we are to experience health problems. disease and stroke by 30 percent after five someone who is sedentary or who has heart This can slow us down, and the decreased years.2 or lung disease, it is best to start slower and activity sets us up for further problems and Guidelines for an Alzheimers prevention work up gradually, and its always a good bet declining function. diet were released recently by the to consult with your physician before starting You cant open a popular magazine without Physicians Committee for Responsible such a program. coming across sage advice on healthy aging, Medicine. Similar to the Mediterranean diet, When starting a routine, its important to preventing dementia, or a related topic. At the groups recommendations emphasize choose something that feels good physically. the risk of being repetitive, we start with the consuming legumes, whole grains, fruits, As with going on a diet, people often start Big 4 (diet, exercise, stress management, and vegetables and nuts, and minimizing the an exercise program with good intentions. the avoidance of addictive substances) intake of foods containing saturated fats Were more likely to stay with it if the activity because theyre central to a healthy lifestyle, (meat and whole fat dairy) and transfat is fun. For many people, exercise that involves disease prevention, and longevity. Beyond (hydrogenated oils). The recommendations other people, such as walking in groups or that, well touch on some basic guidelines that are in line with those of the American attending classes, helps them to stay weve seen in our practices here at the Heart Association, American Cancer motivated. When choosing a class, we need Center for Integrative Medicine, the Senior Society, and the American Diabetes to be realistic about our level of health and Care Institute at UPMC Shadyside, and the Association for the prevention of the fitness. If an aerobic or yoga program is too Benedum Geriatric Center. common causes of death and disease in the intense, a person can get injured, setting him United States.3 Eat plants: What are the nutritional keys for or her back for a week or two. Smaller healthy aging? To put it simply, a plant-based The DASH diet (Dietary Approaches to classes or programs geared for seniors, such diet. Perhaps youre familiar with author Stop Hypertension) is recommended by the as Silver Sneakers, are less likely to create a Michael Pollans well-known quote, Eat food, Joint National Committee on Prevention, problem. not too much, mostly plants, which sums up Detection, Evaluation, and Treatment of Manage your stress: We cant get rid of the simple guidelines for a plant-based diet.1 High Blood Pressure (JNC VII). The DASH stress. Stress is part of life, and challenges diet recommends consuming nine or more The Mediterranean diet has evidence to arise for everyone. But stress levels that are combined servings of fruits and vegetables support its benefit in preventing high or persistent can contribute to common per day, low fat dairy foods, moderate health problems as we age. Luckily, there are intake of fish and poultry, and cutting back many ways to cope with stress that are on the salt.4 Inside CIM Newsletter healthy for us. For example, meditation can Exercise for physical and mental reduce anxiety, distress, and pain, and has Healthy Aging, cont. 2 health: As we get older, exercise takes on even been found to improve memory.5 Set special importance. Regular exercise helps aside about 20 minutes per day, find a Child Psychiatry 3 maintain bone density and muscle strength. relatively quiet space, and allow yourself to It is useful for heart health, and studies focus gently on some aspect of your present Lectures and Classes 4 show that those with healthy cardiovascular moment experience. This can be the systems are less likely to develop dementia. sensations, of breathing, or other physical CIM Staff 4 In addition, exercise can have benefits for sensations in your body, or sounds, or even Continued on page 2

2 Healthy Aging (cont.) gazing at a photo or candle flame. When the additional stress tends to aggravate was possible. The choice is ours. mind wanders, simply turn your attention problems. Tight muscles cause poor Stay connected: Older Americans greatly back to the sensations, without judgment or posture, further loading joints, increasing value staying connected. It contributes greatly blame. By paying attention to what is here in discomfort, and leading a person to become to healthy aging and often positively reduces the present moment, and letting go of more sedentary. There are three common the risk of memory changes and physical judgment, we often notice that we feel more areas of restriction that can affect gait and decline. On the other end of the spectrum, open, more calm and relaxed. Over time, we balance in later years. These include loss of feelings of isolation and loneliness place an realize that our judgments and expectations spinal extension, tight hip flexors, and tight individual at risk for depression and could are actually the source of much of our stress. hamstrings. We use spinal extension in negatively impact all aspects of their health. Once we develop a more compassionate doing a back bend, and hip flexors lift our Staying connected becomes more difficult as attitude towards ourselves and our life hips up, as when bringing your knee to your we age, with loved ones dying, extended experiences, challenges may still be present, chest. Tightness in these areas leads a families relocating, limited finances, and but we are less reactive to them, less caught person to flex forward at the waist. The declining physical health and mobility. up. We can focus on, and truly enjoy, the hamstrings are what a ballet dancer Fortunately, with creativity and flexibility, the simple pleasures of life, such as being in stretches at the barre, and tightness of this options continue to expand. nature, and connecting with friends and family. muscle limits hip movements. To keep Engaging in these simple pleasurable activities these areas loose, a person can ask a Staying connected means something different is also a wonderful way to manage stress! physical therapist, athletic trainer, or to each person. For some, it might be sitting chiropractor for stretches to do at home. on their porch and chatting with passing Dont poison yourself: In the movie Sleeper, Participating in a class such as gentle yoga neighbors; for others, its grocery shopping after Woody Allen wakes up from 200 years or tai chi may be more fun. Other classes, with their children followed by lunch; and for of suspended animation, the doctor gives him such as general exercise or aerobics, may others its going to weekly church services or a cigarette and tells him, Its tobacco. Its also have stretching built in. the daily lunch served at the local senior one of the healthiest things for your body. center. Such activities offer people the Now go ahead. You need all the strength you Embrace your spiritual side: Yogi Berra opportunity to feel connected with family and can get. While it turns out that a little red once said, If you see a fork in the road peers and be part of a group. wine can promote health, science has yet to take it. This is a reminder of the need to find a benefit for smoking. Rather, it leads the make deliberate choices in our lives. Volunteer work allows many seniors to list, followed closely by obesity and sedentary Getting older is a fork in our lives that expand their networks and give back to their lifestyle, as a cause of premature aging and requires us to make a choice. One choice communities in a meaningful way. Book clubs raising the risk of heart disease, diabetes, and leads to bitterness and resentment; or card groups abound at senior centers and cancer. Dopamine is the brain chemical most focusing on all the things that we have lost, houses of worship; classes are offered at all associated with smoking and other addictions, believing our best days are behind us. The the universities at minimum cost; walking and its powerful. Theres a tendency to look other path leads to a richer life. Knowing clubs are popular at local malls; and AARP for medical solutions for addictions. While that we have made some mistakes in our organizes day and week-long trips. medications may help, the other guidelines in lives, we become more willing to forgive Increasingly, older adults are taking advantage this article may be helpful for habit control, others for the mistakes they have made. of the explosion of options in technology. It particularly taking steps to increase aerobic We begin to see that what other people could be as simple as getting a smart phone activity, clean up diet, and manage stress. think of us is not as important as what we with Skype, using the internet email or think of ourselves. With the awareness that participating in on-line support groups for Keep your body stretched out: An erect time is no longer unlimited, we begin asking caregivers, or joining social networks such as posture takes the load off of our back, hips, how we want to be remembered; and what Facebook and LinkedIn. One doesnt need to and knees. As we become sedentary, its is the meaning and purpose of our lives. understand the science to take advantage of automatic that muscles accommodate to a These are ultimately spiritual questions. If the technology and these gadgets and systems seated position. Our backs and hips shift to a we begin to ask these questions, the are becoming more affordable. flexed position, which leads us to be answers may surprise us. They may or may somewhat hunched over when we stand and For references, please see the electronic not fit neatly into the religious systems we walk. This puts additional stress on these version of this newsletter on our web site: were exposed to as a child. However they areas. Along with the start of arthritic changes integrativemedicine.upmc.com may give us a peace of mind and an inner many of us experience with age, this sense of contentment that we didnt know 2 Shadyside Place Suite 310 580 S. Aiken Ave 412-623-3023 integrativemedicine.upmc.com

3 Research Opportunities An Interview With Dr. Greg Thorkelson The UPMC Center for Integrative How did you get interested in deficit hyperactivity disorder (ADHD) than Medicine is dedicated to psychiatry and child psychiatry? just giving stimulants. By expanding from increasing knowledge about the I was drawn to the role of the mind in traditional pharmacologic and behavioral effectiveness and safety of approaches, theres a chance to provide human health, and Ive been particularly complementary and integrative more help and in some cases get by without interested in simple things a person can medicine approaches. Other or with lower doses of medication. There do to improve their physical and mental integrative medicine modalities have been promising studies on the benefits health. Ive always enjoyed working with may not have been subjected to of fish oil and zinc. Studies on diet or food the same level of scientific inquiry children and adolescents. Theres more of additives and ADHD have been inconclusive, as western medicine treatments. an opportunity to influence a persons life, but some children seem less hyperactive The Center for Integrative given that the brain itself continues to grow and change into the late 20s. with dietary changes; unfortunately, it is not Medicine, in concert with the yet clear exactly who will benefit and to University of Pittsburgh, is Working with kids is more rewarding for me. what degree. The bottom line is that a actively pursuing research to support the benefits of these holistic approach doesnt take the place of Of all of the approaches in traditional therapies, but it may help. This therapies. integrative medicine, what interests can particularly be the case when a child CURRENTLY RECRUITING: you the most? hasnt responded to the usual treatment, or UPMC Center for I have several interests: the role of in the case of an individual with milder Integrative Medicine symptoms who just needs a little boost. supplements, the connection between diet Research Registry and physical and mental health, and How is child psychiatry going to be The Feel My Best emerging science involving intestinal different 10 years from now? study for individuals bacteria and overall well-being. Im most Were seeing a shift to a more biomedical with Lupus excited about mind-body approaches, and approach and well certainly see more in COMING SOON: also have a personal interest in the role of terms of benefits of genetic testing and brain Non-surgical options for present moment awareness. There is a imaging. The newest entry into practice is a tremendous opportunity to help Lumbar Spinal Stenosis device that uses EEG signals to help diagnose adolescents in the community with ADHD that was just approved by the FDA. For more information call learning mindfulness and stress- On the one hand, I welcome and look 412-623-6872. management skills to prevent many of the forward to some of these developments, but problems that we see in practice. we cant neglect our clinical skills. As an Hypnosis has been around since Freuds example, even if someone had an EEG Acupuncture for Cancer Pain profile that showed signs of ADHD, if my days, but were just now learning how it If you have cancer and you are may help in treating people with health evaluation showed prominent anxiety conditions that involve inflammation, like symptoms, that would be the first thing we experiencing pain, you may be would address in treatment. There are Crohns disease. eligible for acupuncture at no similar developments coming in our Is there a natural alternative to understanding of autistic spectrum charge. stimulants for children with disorders. Its going to be an exciting time, Funded by a generous grant from the Shady- attention deficit disorders? but it will be important to balance side Hospital Foundation, the Center for technology with a human touch. Hopefully, Integrative Medicine is offering acupuncture The short answer is yes and no. Many psychiatry will always channel that intense as a method to treat cancer-related pain. pediatricians and child psychiatrists will personal connection to help people make For information call 412-623-2374 or tell you that there is more to attention positive changes in their lives. email: [email protected] Shadyside Place Suite 310 580 S. Aiken Ave 3 412-623-3023 integrativemedicine.upmc.com

4 2013 Lectures and Classes at the UPMC Center for Integrative Medicine UPMC Employees receive 75 Take a Healthy Step points for attending. All lectures and classes at CIM. August 2013 3:30 5:00 p.m. Yoga Level 2 (6 classes) Mon. 8/12 9/23 $75 Alicja Walczak, MS, CRS 6:00 7:30 p.m. Yoga Level 1 (6 classes) Wed. 8/14 9/25 5:30 7 p.m. Yoga Level 1 (6 classes) $75 Alicja Walczak, MS, CRS Thurs. 8/15 5:30 6:30 p.m. Relieving Pain with Acupuncture and Acupressure FREE Tricia Smith, LAc Thurs. 8/29 7 8 p.m. Mindfulness Meditation Orientation Session FREE Carol Greco, PhD September 2013 Thurs. 9/12 11/14 5:00 6:00 p.m. Tai Chi and QiGong (10 sessions) $100 Joseph Bozzelli, MMQ Thurs. 9/12 10/31 6:30 8:30 p.m. Mindfulness Meditation (8 sessions) $300 Carol Greco, PhD Thurs. 9/19 5:30 6:30 p.m. The Alexander Technique FREE Lisa Levinson, AmSAT Wed. 9/25 10/23 5:30 6:30 p.m. The Alexander Technique (Includes 2 free sessions) $200 Lisa Levinson, AmSAT October 2013 Wed. 10/2 11/21 12:00 1:30 p.m. Mindfulness-Based Anxiety Reduction (8 sessions) Dinnie Goldring, LCSW Thurs. 10/17 5:30 6:30 p.m. Maximizing the Benefits of Your Lymphatic System FREE Erin Simon, LMT, LLCC UPMC Center for Integrative Medicine Team Neal Ryan, MD, Director Ronald Glick, MD, Medical Director Administration Deborah Grice Conway, PhD Sharon Plank, MD Jeanette Adams Psychotherapist Integrative Medicine Physician Administrative Manager James Donnelly, MA Michael Schneider, PhD, DC Kathy Hecht Psychotherapist Administrative Assistant Asst. Prof. of Health & Rehab Science Dinnie Goldring, LCSW Gail Chalmers-Blair Psychotherapist Kate Sherman, MSCP Office Assistant Shiatsu Massage Therapist Carol Greco, PhD Rhonda Mason Assistant Professor of Psychiatry, Erin Simon, LMT, LLCC Office Assistant Meditation Instructor Massage Therapist Research John Laird, ND Greg Thorkelson, MD Christine McFarland Naturopath/Nutritionist Psychiatrist Research Coordinator Jessie V. Larson, LMT Stacy L. Simon, PhD Adam White Massage Therapist Psychotherapist Research Specialist David Lesondak, BCSI Tricia Smith, LAc, MAc Practitioners Structural Integrator Acupuncturist Joseph Bozzelli, MMO Lisa Levinson, AmSAT K.K. Teh, LAc, MAc Tai Chi, QiGong Teacher Alexander Therapist Acupuncturist Sari Cohen, ND Dan Miller, DC Alicja W. Walczak, MS, CRS Naturopathic Counselor Chiropractor Biofeedback, Yoga Instructor The Center for Integrative Medicine at UPMC Shadyside is a hospital-based center in Pittsburgh that combines natural healing practices with conventional medicine. Integrative medicine refers to the incorporation of evidence-based complementary therapies into conventional treatments for patients. Integrative medicine is meant to work in conjunction with traditional medicine, providing a more holistic approach to healing mind, body, and spirit. Shadyside Place Suite 310 580 S. Aiken Ave 4 412-623-3023 integrativemedicine.upmc.com

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