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It’s taken a bit longer than I had anticipated to get this new episode out. Just when I was about to start writing episode 9 - about exercise and bone health - I had something happen to me that I thought would be worth sharing.

For context, now that I’m in my 50s - 53, to be precise - I have an annual blood test done to check things like my cholesterol, fasting blood sugar level, triglycerides and prostate specific antigen. A couple of the other values tested are creatine kinase and liver function. Creatine kinase is an enzyme that can be present in the bloodstream after muscle damage occurs - in the context of this test, it is the enzyme CK-MB, which is a marker of damage to the heart muscle. The liver function test looks for certain proteins and enzymes in the blood that signal damage to the liver.

These basic but essential tests cover the main pathologies that tend to affect men my age, namely, cardiovascular disease (including heart disease), prostate cancer, and liver disease. This test also checks for specific markers in the blood that may signal as to whether or not other cancers may be present in the system. In Australia, this test is free (with the exception of the PSA test, which is $50), and along with the annual bowel cancer test available to all Australians over the age of 45 (another excellent initiative), it is paid for by the Commonwealth. Just a quick comment - I think it’s pretty outrageous that men have to pay for the PSA test here in Australia, while women get free breast screens and pap smears. It makes no sense whatsoever that the system has such a bias. Prostate cancer is the second-most prevalent cancer in Australian men, and has the second highest rate of mortality. I suppose $50 is not a lot in the scheme of things, but there is a definite asymmetry in health policy here. Anyway…

Further reading:

Heart Research Institute (NSW, Australia): https://www.hri.org.au/health/learn/risk-factors/what-do-lipids-tell-us-in-a-blood-test?campaignid=22288393601&adgroupid=180837024652&adid=735050693981&gad_source=1&gad_campaignid=22288393601&gbraid=0AAAAADkaM0K5LODBZQStuqnPi8wxpBU2F&gclid=Cj0KCQjw097CBhDIARIsAJ3-nxe5tnz-YEr2x0cvfS7nx4fI48JDj5rC1zfqSf-1haAVVD__kupZVAkaAq9AEALw_wcB

Lemieux I, Lamarche B, Couillard C, et al. Total Cholesterol/HDL Cholesterol Ratio vs LDL Cholesterol/HDL Cholesterol Ratio as Indices of Ischemic Heart Disease Risk in Men: The Quebec Cardiovascular Study. Arch Intern Med. 2001;161(22):2685–2692. doi:10.1001/archinte.161.22.2685

Mayo Clinic (USA): https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800

Silverman MG, Ference BA, Im K, et al. Association Between Lowering LDL-C and Cardiovascular Risk Reduction Among Different Therapeutic Interventions: A Systematic Review and Meta-analysis. JAMA. 2016;316(12):1289–1297. doi:10.1001/jama.2016.13985

Taylor F, Huffman MD, Macedo AF, Moore THM, Burke M, Davey Smith G, Ward K, Ebrahim S, Gay HC. Statins for the primary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD004816. DOI: 10.1002/14651858.CD004816.pub5.

Email contact: fitnessfunctionsmelb@gmail.com

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Recently on the social media platform LinkedIn I saw a post put up by someone who I believe was an orthopedic surgeon. He had on his post an image of a patient’s spine after they had had spinal fusion surgery. This is where rods and screws - and usually bone grafts - are implanted around two or more bones of the spine to reinforce that structure. It’s a risky procedure, despite many brilliant advances in the technology, and requires quite a significant rehab phase. The cervical and lumbar sections of the spine are common surgical sites, as these parts of the back are more vulnerable to injury - the lumbar spine being the main load-bearing structure of the back, and the cervical spine being the most mobile and least supported structure of that spinal column. Outcomes for this surgery are usually pretty good. More often than not patients will see reductions in pain, if at the sake of mobility. However, spinal fusion can increase the risk of pain from future osteoarthritis in the spine. The lack of mobility at the fused site can increase the stress put on other parts of the spine, thus accelerating osteoarthritis. And the site of the surgery itself can also degenerate over time, increasing the risk of further structural degeneration. Spinal fusion should always be thought of as a last resort - when pain becomes intolerable, and other options have been exhausted. So, the image was attached to a comment by the surgeon. To paraphrase, he stated that kettlebell exercises and weightlifting were BAD for the spine, and he advised any and all people he encountered to ONLY ENGAGE IN AEROBIC EXERCISE. He noted that the image shown in his post was from an older man who was swinging kettlebells for health and fitness, who had gone on to have a serious injury, thus requiring a major spinal fusion. Again. Weightlifting bad. Cardio good. End of story.

Further reading:

Fragala, M., et al. (2019) Resistance training for older adults: Position statement from the National Strength and Conditioning Association. Journal of Strength and Conditioning Research 33(8):p 2019-2052, August. DOI: 10.1519/JSC.0000000000003230

Izquierdo, M., Merchant, R.A., Morley, J.E. et al. (2021) International exercise recommendations in older adults (ICFSR): Expert consensus guidelines. J Nutr Health Aging 25, 824–853. https://doi.org/10.1007/s12603-021-1665-8

Rodrigues, F., Domingos, C., Monteiro, D., & Morouço, P. (2022). A review on aging, sarcopenia, falls, and resistance training in community-dwelling older adults. International Journal of Environmental Research and Public Health, 19(2), 874. https://doi.org/10.3390/ijerph19020874

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Episode 6 - The Clock is Ticking

Human psychology is a fascinating thing. The mind is the driver for all of our behaviour - it is our software driving our hardware. The mind gives us our sense of self, and allows us to utilise our intelligence. It projects our personality, and hides our self-perceived flaws. Our mind is sensitive to all manner of stimuli - physical, emotional, and environmental - and always refers to its memory bank stored within the many billions of neurons within the brain when executing behaviours, thoughts and feelings. It both helps and hinders us. It can be a driver of accomplishment, of ambition, or curiosity, but it can also sabotage us, it can be a prison that restricts us, that stunts us, that kills us.

When I am dealing with a new client, with someone who is new to exercise, I can usually tell within the first minute of an assessment whether or not that person is fully committed to the idea of exercise. Not because I have any special paranormal gift, not because I am especially gifted in reading body language. It’s because of one simple question - for most people it’s probably the hardest of all questions to answer, but the manner of their answer determines a lot: How much time are you prepared to give to exercise?

Email contact fitnessfunctionsmelb@gmail.com

Further reading:

Beresford, T.P. Psychological adaptive mechanisms: Ego defense recognition in practice and research. Oxford University Press USA. 2012. pp13-26.

Prochaska, J.O. The transtheoretical model of health behaviour change. American Journal of Health Promotion. 1997; 12 (1): 38-48. https://doi.org/10.4278/0890-1171-12.1.38

Weber, M.F., et al. Cancer incidence and cancer death in relation to tobacco smoking in a population-based Australian cohort study. International Journal of Cancer. 2021 Sept 1; 149 (5): 1076-1088. DOI: 10.1002/ijc.33685