In a recent article, we touched on the point that gaining weight and feeling tired are not simply a normal part of ageing. We so often see patients in clinic who attribute their symptoms simply to the passage of time. Whether it’s their weight gain, energy levels, thinning hair (women – not men!), rising blood pressure, increasing insulin or weakening bones, there are so many examples of situations and symptoms that we as a society attribute to ageing. So often it is not ageing that causes these issues – there is in fact so much we can do to reclaim our health and feel great again. It’s time to get sexy back!
Blaming everything on ageing means we are ignoring the important role our choices play in shaping our health and in determining our risk of diseases like heart disease and osteoporosis. Whilst it is true the risk of certain diseases does increase with age, it’s important to remember that correlation does not equal causation, so whilst age may be a factor to account for, it certainly does not yield the final verdict – We all know people who are in magnificent health in their 40s, 50s, 60s, 70s and beyond. It’s not just good luck; there is so much you can do to age well! In this article today, we’ll look at a few examples, but I encourage you to think about what aspects of your health you might be attributing to your age, and to consider whether there are things that can be done about it.
Increasing Blood Pressure and Cholesterol
Often with age, it’s expected that our blood pressure, cholesterol, triglycerides or other markers of cardiovascular risk will start to climb. Not only does this increase the risk of heart disease and heart attacks, it also leads to complacency. This is a sad reality, as diet (not age!) is perhaps the largest and more significant risk factor for heart disease, meaning we make the choice everyday with our dietary habits as to whether we help or harm our cardiovascular health. There are many modifiable risk factors that can be used to lessen your risk. This includes things like weight management, dietary choices, your level of physical activity, whether or not you smoke and your sleeping habits. By taking control of these factors and implementing healthier routines and habits, high blood pressure and high cholesterol do not have to be an unavoidable consequence of ageing. If your blood pressure or your cholesterol is starting to creep up, do something about it and don’t just expect to end up on medication. Being proactive now pays enormous rewards in the future.
To use an American expression, many young adults blame their weight gain on the “Freshman 15”; the fifteen pounds (or 6-7 kg) gained during the first year of university. For older men and women, they might call it “the middle-aged spread”. Both of these are classic examples of individuals attributing weight gain simply to their stage of life, without acknowledging that so many other factors are at play. We do not need to pile on the pounds just because we have moved to London, started university or entered our 40s.
When patients come in for weight loss, one of the first things we do is determine why weight gain has occurred, whether it be due to dietary reasons, lifestyle factors, stress, inflammation, autoimmune disease, blood sugar dysregulation, or more likely, a combination of these. By identifying the cause, we then have the power to change the circumstances that lead to weight gain in the first place, establish healthier routines, correct underlying nutritional deficiencies and ensure a healthy and sustainable road to better weight management. The ‘freshman-15’ or ‘middle-aged spread’ are not inevitable consequences of ageing, and everyday we work with patients who have been able to avoid or reverse this ‘age-associated’ weight gain.
Poor Bone Density
Declining bone density and full blown osteoporosis are two of the most common conditions we see in elderly men and women, but as relatively ‘silent’ conditions, these patients often come in seeking help for something else. As healthcare practitioners, it is so important we educate our patients on why declining bone density is not an inevitable consequence of ageing, the importance of addressing it early, and how they can be more proactive in maintaining and promoting healthy bones. Whilst they may have only recently been diagnosed with osteoporosis, when we look at their past blood tests, we can often see a 10 or 15 year history of blood markers that reveal excessive bone turnover, meaning had someone picked up on the warning signs earlier, they may not have ended up with osteoporosis.
Interestingly, one of the most useful markers of bone turnover is a liver enzyme called alkaline phosphatase, or ALP. Whilst ALP is found in the liver, it is also found in the bones. When the bones are breaking down too quickly, ALP can become raised, meaning it serves as a useful marker of bone breakdown. As practitioners, ALP is just one of the markers that tells us bone density may be at risk, allowing us to put in place holistic strategies to prevent further bone density loss and increase mineral deposition into the bones.
Osteoporosis does not occur overnight. In most people, it takes years and years of gradual bone density loss to occur before it is diagnosed. What this means is that when we see patients in their 20s, 30s, 40s, 50s and 60s with blood markers suggesting increased risk of bone density loss, we take steps to address it promptly and proactively. In addition to the basics (calcium and vitamin D), we also look at factors such as exercise, acidity, nutrient absorption, inflammation, thyroid function, silica, vitamin K2 and other nutritional deficiencies that lead to increased bone density loss. After all, it is much easier to prevent osteoporosis with good dietary and lifestyle habits, than to correct it retrospectively.
Low energy levels and persistent fatigue are some of the most common symptoms we see at PHF, in both men and women, across the lifespan. In older adults, we increasingly see patients attribute persistent fatigue to “getting older”. This is a real shame as it can be highly disempowering to believe that low energy levels are inevitable simply due to your age.
When patients come in describing low energy and fatigue, we look at numerous factors that could be playing a role, regardless of their age. For example, some of the potential causes and contributing factors could include:
- Nutritional deficiencies (e.g. iron, B-vitamins, zinc, magnesium etc)
- Poor dietary choices
- Poor blood sugar regulation
- Thyroid disorders (e.g. hypothyroidism)
- Poor sleeping habits or compromised sleep quality (e.g. sleep apnoea)
- Genetic conditions or variations
- Mental health disorders (such as anxiety and depression)
- Adrenal dysregulation
- Medication side effects
- Chronic fatigue syndrome
- Post-viral fatigue
- Lack of physical activity (or excessive physical activity)
- Hormonal imbalance (e.g. reduced testosterone, elevated insulin etc)
- Certain medical conditions
- And the list goes on!
This list is by no means complete, but gives you an idea of the wide range of factors that can give rise to low energy levels. Often, through case-taking, investigation and pathology interpretation, we find it’s a combination of these factors at play, and we then put in place strategies to address the underlying cause(s). We have yet to have encountered a patient whose low energy was attributable to age alone, so if you’ve been attributing a decline in energy to your age, it may be worth popping in for a visit, so we help identify (and address) the real cause.
The Take Home Message
At PHF, we embrace a proactive, preventative and personalised approach to healthcare. One of the most important ways individuals can be proactive about their health is to recognise the huge role their choices play in shaping their well-being and in determining their risk of ill health. Ill health is not an inevitable consequence of age. Whilst there is no way of making yourself 100% resistant to disease, there are numerous ways in which you can improve your health everyday, to improve your ageing process and help you have a wonderful, healthy life.