18829AUG2014
CNO Report 188
Release Date 29 AUG 2014
Draft Report Compiled by
Ralph Turchiano
In this issue:
- Rheumatologic diseases like lupus can initially look like neurological disorders
- Physically fit kids have beefier brain white matter than their less-fit peers
- Pica in pregnant teens linked to low iron
- Research underway to create pomegranate drug to stem Alzheimer’s and Parkinson’s
- Scientists uncover why major cow milk allergen is actually allergenic
- Green tea polyphenols protect spinal cord neurons against oxidative stress
- Gut bacteria that protect against food allergies identified
- Junk food makes rats lose appetite for balanced diet
- Fighting prostate cancer with a tomato-rich diet
- New study throws into question long-held belief about depression
- Lifetime of fitness: A fountain of youth for bone and joint health?
Rheumatologic diseases like lupus can initially look like neurological disorders
Can delay diagnosis for many months
MAYWOOD, Ill. – Lupus and other rheumatologic diseases can initially present as neurological disorders such as headaches and seizures, and thus delay diagnosis for many months, according to Loyola University Medical Center neurologists.
Moreover, treatments for rheumatologic disorders can cause adverse neurological effects, Dr. Sean Ruland and colleagues report in the journal Current Neurology and Neuroscience Reports.
Rheumatologic diseases include autoimmune and inflammatory disorders of the joints and soft tissues, such as lupus, systemic vasculitis and ankylosing spondylosis.
Lupus can cause heart problems that lead to strokes. More than half of lupus patients suffer headaches, and a third suffer migraines. About 1.5 percent experience “lupus headache,” defined as a persistent, severe and intractable headache that does not respond to narcotic medications. As many as 20 percent experience seizures, and a third experience cognitive dysfunction. As many as 20 percent of lupus patients experience mood disorders. Lupus psychosis, which can include paranoia and hearing voices, can be confused with schizophrenia.
Patients with systemic vasculitis can experience neurologic disorders such as headaches, seizures, stroke-like syndromes and optic neuropathies. A third will have residual neurological impairments and will require long-term treatment to suppress their immune systems.
Ankylosing spondylosis patients can experience headaches, cerebellar and brainstem dysfunction, cognitive impairments, seizures and cranial neuropathy.
“Rheumatic disorders presenting as neurological syndromes may pose diagnostic challenges,” Ruland and colleagues write.
Medications for patients with rheumatic disorders include immune-suppressing drugs and non-steroidal anti-inflammatory drugs. New medications have expanded treatment options. “However, these treatments also carry a risk of adverse neurological effects,” Ruland and colleagues write. “Therefore, familiarity with neurological manifestations of rheumatologic diseases, diagnosis and potential nervous system consequences of treatment is paramount.”
Physically fit kids have beefier brain white matter than their less-fit peers
CHAMPAIGN, Ill. — A new study of 9- and 10-year-olds finds that those who are more aerobically fit have more fibrous and compact white-matter tracts in the brain than their peers who are less fit. “White matter” describes the bundles of axons that carry nerve signals from one brain region to another. More compact white matter is associated with faster and more efficient nerve activity.
The team reports its findings in the open-access journal Frontiers in Human Neuroscience.
“Previous studies suggest that children with higher levels of aerobic fitness show greater brain volumes in gray-matter brain regions important for memory and learning,” said University of Illinois postdoctoral researcher Laura Chaddock-Heyman, who conducted the study with kinesiology and community health professor Charles Hillman and psychology professor and Beckman Institute director Arthur Kramer. “Now for the first time we explored how aerobic fitness relates to white matter in children’s brains.”
The team used diffusion tensor imaging (DTI, also called diffusion MRI) to look at five white-matter tracts in the brains of the 24 participants. This method analyzes water diffusion into tissues. For white matter, less water diffusion means the tissue is more fibrous and compact, both desirable traits.
The researchers controlled for several variables – such as social and economic status, the timing of puberty, IQ, or a diagnosis of ADHD or other learning disabilities – that might have contributed to the reported fitness differences in the brain.
The analysis revealed significant fitness-related differences in the integrity of several white-matter tracts in the brain: the corpus callosum, which connects the brain’s left and right hemispheres; the superior longitudinal fasciculus, a pair of structures that connect the frontal and parietal lobes; and the superior corona radiata, which connect the cerebral cortex to the brain stem.
“All of these tracts have been found to play a role in attention and memory,” Chaddock-Heyman said.
The team did not test for cognitive differences in the children in this study, but previous work has demonstrated a link between improved aerobic fitness and gains in cognitive function on specific tasks and in academic settings.
“Previous studies in our lab have reported a relationship between fitness and white-matter integrity in older adults,” Kramer said. “Therefore, it appears that fitness may have beneficial effects on white matter throughout the lifespan.”
To take the findings further, the team is now two years into a five-year randomized, controlled trial to determine whether white-matter tract integrity improves in children who begin a new physical fitness routine and maintain it over time. The researchers are looking for changes in aerobic fitness, brain structure and function, and genetic regulation.
“Prior work from our laboratories has demonstrated both short- and long-term differences in the relation of aerobic fitness to brain health and cognition,” Hillman said. “However, our current randomized, controlled trial should provide the most comprehensive assessment of this relationship to date.”
The new findings add to the evidence that aerobic exercise changes the brain in ways that improve cognitive function, Chaddock-Heyman said.
“This study extends our previous work and suggests that white-matter structure may be one additional mechanism by which higher-fit children outperform their lower-fit peers on cognitive tasks and in the classroom,” she said.
Pica in pregnant teens linked to low iron
August 20, 2014 By Melissa Osgood
ITHACA, N.Y. – In a study of 158 pregnant teenagers in Rochester, NY, nearly half engaged in pica – the craving and intentional consumption of ice, cornstarch, vacuum dust, baby powder and soap, and other nonfood items, reports a new Cornell study.
Moreover, such teens had significantly lower iron levels as compared with teens who did not eat nonfood substances.
Pregnant teens, regardless of pica, are at higher risk for low hemoglobin, which can lead to iron deficiency and anemia. Low iron in pregnant teens raises the risk of premature births and babies with low birth weights, which in turn increases infant mortality rates.
“In this study, the strength of the association between pica and anemia is as big as any known causal factor of anemia in pregnant teens; this is a very strong association,” said Sera Young, a research scientist in nutritional sciences in Cornell’s College of Human Ecology and a co-author of the study published online in the Journal of Nutrition.
In the study, pica behaviors and iron deficiency increased over the course of the pregnancies.
“As anemia increased, so did these behaviors, but we don’t know what happens first,” said Kimberly O’Brien, professor of nutritional sciences and the study’s senior author.
The study included African-American, white and Latina pregnant teens. Of the nearly 47 percent of adolescents who reported pica behaviors, most – 82 percent – craved ice, followed by starches, powders, soap, paper, plastic foam such as pillow stuffing or sponges, baking soda, and a few other items.
Texture appears to be very important to those engaged in pica and is one commonality among the types of substances consumed.
When people crave ice, they consume “cups and cups and cups of it,” said Young. At the same time, “ice is not going to change someone’s iron status,” said O’Brien, leading to her hypothesis that iron deficiency may have an effect on brain chemistry that leads to these cravings.
“The public health importance of pica really needs to be acknowledged,” said Young. “My hope is that these studies put pica on the radar as a legitimate public health issue.”
The study was funded by the U.S. Department of Agriculture and the National Institutes of Health.
Research underway to create pomegranate drug to stem Alzheimer’s and Parkinson’s
Dr. Olumayokun Olajide’s research will now look to produce compound derivatives of punicalagin for a drug that would treat neuro-inflammation
THE onset of Alzheimer’s disease can be slowed and some of its symptoms curbed by a natural compound that is found in pomegranate. Also, the painful inflammation that accompanies illnesses such as rheumatoid arthritis and Parkinson’s disease could be reduced, according to the findings of a two-year project headed by University of Huddersfield scientist Dr Olumayokun Olajide, who specialises in the anti-inflammatory properties of natural products.
Now, a new phase of research can explore the development of drugs that will stem the development of dementias such as Alzheimer’s, which affects some 800,000 people in the UK, with 163,000 new cases a year being diagnosed. Globally, there are at least 44.4 million dementia sufferers, with the numbers expected to soar.
The key breakthrough by Dr Olajide and his co-researchers is to demonstrate that punicalagin, which is a polyphenol – a form of chemical compound – found in pomegranate fruit, can inhibit inflammation in specialised brain cells known as micrologia. This inflammation leads to the destruction of more and more brain cells, making the condition of Alzheimer’s sufferers progressively worse.
There is still no cure for the disease, but the punicalagin in pomegranate could prevent it or slow down its development.
Dr Olajide worked with co-researchers – including four PhD students – in the University of Huddersfield’s Department of Pharmacy and with scientists at the University of Freiburg in Germany. The team used brain cells isolated from rats in order to test their findings. Now the research is published in the latest edition of the journal Molecular Nutrition & Food Research and Dr Olajide will start to disseminate his findings at academic conferences.
He is still working on the amounts of pomegranate that are required, in order to be effective.
“But we do know that regular intake and regular consumption of pomegranate has a lot of health benefits – including prevention of neuro-inflammation related to dementia,” he says, recommending juice products that are 100 per cent pomegranate, meaning that approximately 3.4 per cent will be punicalagin, the compound that slows down the progression of dementia.
Dr Olajide states that most of the anti-oxidant compounds are found in the outer skin of the pomegranate, not in the soft part of the fruit. And he adds that although this has yet to be scientifically evaluated, pomegranate will be useful in any condition for which inflammation – not just neuro-inflammation – is a factor, such as rheumatoid arthritis, Parkinson’s and cancer.
The research continues and now Dr Olajide is collaborating with his University of Huddersfield colleague, the organic chemist Dr Karl Hemming. They will attempt to produce compound derivatives of punicalagin that could the basis of new, orally administered drugs that would treat neuro-inflammation.
Dr Olajide has been a Senior Lecturer at the University of Huddersfield for four years. His academic career includes a post as a Humboldt Postdoctoral Research Fellow at the Centre for Drug Research at the University of Munich. His PhD was awarded from the University of Ibadan in his native Nigeria, after an investigation of the anti-inflammatory properties of natural products.
He attributes this area of research to his upbringing. “African mothers normally treat sick children with natural substances such as herbs. My mum certainly used a lot of those substances. And then I went on to study pharmacology!”
Scientists uncover why major cow milk allergen is actually allergenic
08-22-2014 – Cow milk allergy occurs in children and in adults. Scientists at Messerli Research Institute at the Vetmeduni Vienna, the Medical University of Vienna, and the University of Vienna investigated what actually makes the milk allergenic. A specific protein in milk known as beta-lactoglobulin is able to initiate an allergy only when being devoid of iron. Loaded with iron, the protein is harmless. The scientists discovered the same mechanism recently with regard to birch pollen allergy. Their findings help to decipher allergic reactions and were published in the journal PLOS ONE.
Milk allergy is frequently confused with lactose intolerance. However, these are two entirely different mechanisms that occur in the body. People with lactose intolerance do not digest lactose properly because they lack an enzyme known as lactase. In the case of the potentially much more dangerous cow milk allergy, however, the body’s immune system attacks milk proteins with its own IgE antibodies.
According to statistics, about two to three percent of children in Europe suffer from a genuine milk allergy. Less adults are diagnosed with the disease. The formation of so-called Th2 lymphocytes is initiated in these patients. Th2 lymphocytes contribute in great measure to the production of IgE antibodies to milk proteins. Hence, people develop an allergic reaction to milk.
Such an allergy may cause swelling of the mouth and mucous membranes, diarrhea, exacerbation of neurodermitis, and in rare cases even an allergic shock. Precise diagnostic investigation helps to differentiate between allergy and intolerance and thus avoid incorrect diets which, under certain circumstances, may cause malnutrition.
Lack of iron load transforms milk protein into allergen
One of the most important milk allergens, the so-called beta-lactoglobulin, belongs to the protein family of lipocalins. Lipocalins possess molecular pockets which are able to accommodate iron complexes. Iron is bound to the protein by so-called siderophores. The first author Franziska Roth-Walter and her colleagues now show that an “empty” milk protein, one without iron and siderophores, helps to activate Th2 lymphocytes. As a consequence, the production of IgE antibodies against the milk protein is stimulated. The patient gets sensitized and may develop an allergic reaction to milk. Roth-Walter, working at the department of Comparative Medicine at the Messerli Research Institute says: “Knowledge of the molecular structure of allergens has contributed very significantly to our conclusion about milk allergy. This is of enormous practical relevance.”
Investigating the difference between organic and conventional milk
As the next step the scientists want to find out, what contributes to the iron load of milk proteins. The lead investigator Erika Jensen-Jarolim explains: “One of the most burning questions we want to answer is: Why are these milk proteins loaded to a greater or lesser extent with iron? The manner of keeping and feeding cows may be a factor involved in this phenomenon. Iron loading may depend on whether the milk is produced organically or conventionally. This will be one of our major interests in the future. Lipocalins exist in all mammals. We assume that our conclusions will be applicable to the milk of other mammals as well.”
Green tea polyphenols protect spinal cord neurons against oxidative stress
Green tea polyphenols are strong antioxidants and can reduce free radical damage. Can they protect spinal cord neurons against oxidative stress? Jianbo Zhao and co-workers from the First Affiliated Hospital of Liaoning Medical University, China discovered that green tea polyphenol effectively alleviated oxidative stress and inhibit neuronal apoptosis, indicating green tea polyphenols play a protective role in spinal cord neurons under oxidative stress. The relevant study has been published in the Neural Regeneration Research (Vol. 9, No. 14, 2014).
Gut bacteria that protect against food allergies identified
Common gut bacteria prevent sensitization to allergens in a mouse model for peanut allergy, paving the way for probiotic therapies to treat food allergies
The presence of Clostridia, a common class of gut bacteria, protects against food allergies, a new study in mice finds. By inducing immune responses that prevent food allergens from entering the bloodstream, Clostridia minimize allergen exposure and prevent sensitization – a key step in the development of food allergies. The discovery points toward probiotic therapies for this so-far untreatable condition, report scientists from the University of Chicago, Aug 25 in the Proceedings of the National Academy of Sciences.
Although the causes of food allergy – a sometimes deadly immune response to certain foods – are unknown, studies have hinted that modern hygienic or dietary practices may play a role by disturbing the body’s natural bacterial composition. In recent years, food allergy rates among children have risen sharply – increasing approximately 50 percent between 1997 and 2011 – and studies have shown a correlation to antibiotic and antimicrobial use.
“Environmental stimuli such as antibiotic overuse, high fat diets, caesarean birth, removal of common pathogens and even formula feeding have affected the microbiota with which we’ve co-evolved,” said study senior author Cathryn Nagler, PhD, Bunning Food Allergy Professor at the University of Chicago. “Our results suggest this could contribute to the increasing susceptibility to food allergies.”
To test how gut bacteria affect food allergies, Nagler and her team investigated the response to food allergens in mice. They exposed germ-free mice (born and raised in sterile conditions to have no resident microorganisms) and mice treated with antibiotics as newborns (which significantly reduces gut bacteria) to peanut allergens. Both groups of mice displayed a strong immunological response, producing significantly higher levels of antibodies against peanut allergens than mice with normal gut bacteria.
This sensitization to food allergens could be reversed, however, by reintroducing a mix of Clostridia bacteria back into the mice. Reintroduction of another major group of intestinal bacteria, Bacteroides, failed to alleviate sensitization, indicating that Clostridia have a unique, protective role against food allergens.
Closing the door
To identify this protective mechanism, Nagler and her team studied cellular and molecular immune responses to bacteria in the gut. Genetic analysis revealed that Clostridia caused innate immune cells to produce high levels of interleukin-22 (IL-22), a signaling molecule known to decrease the permeability of the intestinal lining.
Antibiotic-treated mice were either given IL-22 or were colonized with Clostridia. When exposed to peanut allergens, mice in both conditions showed reduced allergen levels in their blood, compared to controls. Allergen levels significantly increased, however, after the mice were given antibodies that neutralized IL-22, indicating that Clostridia-induced IL-22 prevents allergens from entering the bloodstream.
“We’ve identified a bacterial population that protects against food allergen sensitization,” Nagler said. “The first step in getting sensitized to a food allergen is for it to get into your blood and be presented to your immune system. The presence of these bacteria regulates that process.” She cautions, however, that these findings likely apply at a population level, and that the cause-and-effect relationship in individuals requires further study.
While complex and largely undetermined factors such as genetics greatly affect whether individuals develop food allergies and how they manifest, the identification of a bacteria-induced barrier-protective response represents a new paradigm for preventing sensitization to food. Clostridia bacteria are common in humans and represent a clear target for potential therapeutics that prevent or treat food allergies. Nagler and her team are working to develop and test compositions that could be used for probiotic therapy and have filed a provisional patent.
“It’s exciting because we know what the bacteria are; we have a way to intervene,” Nagler said. “There are of course no guarantees, but this is absolutely testable as a therapeutic against a disease for which there’s nothing. As a mom, I can imagine how frightening it must be to worry every time your child takes a bite of food.”
“Food allergies affect 15 million Americans, including one in 13 children, who live with this potentially life-threatening disease that currently has no cure,” said Mary Jane Marchisotto, senior vice president of research at Food Allergy Research & Education. “We have been pleased to support the research that has been conducted by Dr. Nagler and her colleagues at the University of Chicago.”
Junk food makes rats lose appetite for balanced diet
A diet of junk food not only makes rats fat, but also reduces their appetite for novel foods, a preference that normally drives them to seek a balanced diet, reports a study published in the open-access journal Frontiers in Psychology.
The study helps to explain how excessive consumption of junk food can change behavior, weaken self-control and lead to overeating and obesity.
The team of researchers, led by Professor Margaret Morris, Head of Pharmacology from the School of Medical Sciences, UNSW Australia, taught young male rats to associate each of two different sound cues with a particular flavor of sugar water – cherry and grape.
Healthy rats, raised on a healthy diet, stopped responding to cues linked to a flavor in which they have recently overindulged. This inborn mechanism, widespread in animals, protects against overeating and promotes a healthy, balanced diet.
But after 2 weeks on a diet that included daily access to cafeteria foods, including pie, dumplings, cookies, and cake – with 150% more calories – the rats’ weight increased by 10% and their behavior changed dramatically. They became indifferent in their food choices and no longer avoided the sound advertising the overfamiliar taste. This indicated that they had lost their natural preference for novelty. The change even lasted for some time after the rats returned to a healthy diet.
The researchers think that a junk diet causes lasting changes in the reward circuit parts of the rats’ brain, for example, the orbitofrontal cortex, an area of the brain responsible for decision-making. They say these results may have implications for people’s ability to limit their intake of certain kinds of foods, because the brain’s reward circuitry is similar in all mammals.
“The interesting thing about this finding is that if the same thing happens in humans, eating junk food may change our responses to signals associated with food rewards,” says UNSW Professor Morris. “It’s like you’ve just had ice cream for lunch, yet you still go and eat more when you hear the ice cream van come by”.
The World Health Organization estimates that over 10% of the world’s adult population is obese and at least 2.8 million people die each year as a result of being overweight or obesity. Overweight and obesity are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases and cancer.
“As the global obesity epidemic intensifies, advertisements may have a greater effect on people who are overweight and make snacks like chocolate bars harder to resist,” adds Dr Amy Reichelt, lead author of the paper and UNSWpostdoctoral associate.
Fighting prostate cancer with a tomato-rich diet
Men who eat over 10 portions a week of tomatoes have an 18 per cent lower risk of developing prostate cancer, new research suggests.
With 35,000 new cases every year in the UK, and around 10,000 deaths, prostate cancer is the second most common cancer in men worldwide.
Rates are higher in developed countries, which some experts believe is linked to a Westernised diet and lifestyle.
To assess if following dietary and lifestyle recommendations reduces risk of prostate cancer, researchers at the Universities of Bristol, Cambridge and Oxford looked at the diets and lifestyle of 1,806 men aged between 50 and 69 with prostate cancer and compared with 12,005 cancer-free men.
The NIHR-funded study, published in the medical journal Cancer Epidemiology, Biomarkers and Prevention, is the first study of its kind to develop a prostate cancer ‘dietary index’ which consists of dietary components – selenium, calcium and foods rich in lycopene – that have been linked to prostate cancer.
Men who had optimal intake of these three dietary components had a lower risk of prostate cancer.
Tomatoes and its products – such as tomato juice and baked beans – were shown to be most beneficial, with an 18 per cent reduction in risk found in men eating over 10 portions a week.
This is thought to be due to lycopene, an antioxidant which fights off toxins that can cause DNA and cell damage. Vanessa Er, from the School of Social and Community Medicine at the University of Bristol and Bristol Nutrition BRU, led the research.
She said: “Our findings suggest that tomatoes may be important in prostate cancer prevention. However, further studies need to be conducted to confirm our findings, especially through human trials. Men should still eat a wide variety of fruits and vegetables, maintain a healthy weight and stay active.”
The researchers also looked at the recommendations on physical activity, diet and body weight for cancer prevention published by the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR).
Only the recommendation on plant foods – high intake of fruits, vegetables and dietary fibre – was found to be associated with a reduced risk of prostate cancer. As these recommendations are not targeted at prostate cancer prevention, researchers concluded that adhering to these recommendations is not sufficient and that additional dietary recommendations should be developed.
New study throws into question long-held belief about depression
New evidence puts into doubt the long-standing belief that a deficiency in serotonin — a chemical messenger in the brain — plays a central role in depression. In the journal ACS Chemical Neuroscience, scientists report that mice lacking the ability to make serotonin in their brains (and thus should have been “depressed” by conventional wisdom) did not show depression-like symptoms.
Donald Kuhn and colleagues at the John D. Dingell VA Medical Center and Wayne State University School of Medicine note that depression poses a major public health problem. More than 350 million people suffer from it, according to the World Health Organization, and it is the leading cause of disability across the globe. In the late 1980s, the now well-known antidepressant Prozac was introduced. The drug works mainly by increasing the amounts of one substance in the brain — serotonin. So scientists came to believe that boosting levels of the signaling molecule was the key to solving depression. Based on this idea, many other drugs to treat the condition entered the picture. But now researchers know that 60 to 70 percent of these patients continue to feel depressed, even while taking the drugs. Kuhn’s team set out to study what role, if any, serotonin played in the condition.
To do this, they developed “knockout” mice that lacked the ability to produce serotonin in their brains. The scientists ran a battery of behavioral tests.
Interestingly, the mice were compulsive and extremely aggressive, but didn’t show signs of depression-like symptoms. Another surprising finding is that when put under stress, the knockout mice behaved in the same way most of the normal mice did. Also, a subset of the knockout mice responded therapeutically to antidepressant medications in a similar manner to the normal mice. These findings further suggest that serotonin is not a major player in the condition, and different factors must be involved. These results could dramatically alter how the search for new antidepressants moves forward in the future, the researchers conclude.
Lifetime of fitness: A fountain of youth for bone and joint health?
Ongoing, comprehensive fitness and nutrition regimens may prevent bone and muscle deterioration, injury and disease
ROSEMONT, Ill.—Being physically active may significantly improve musculoskeletal and overall health, and minimize or delay the effects of aging, according to a review of the latest research on senior athletes (ages 65 and up) appearing in the September issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS).
It long has been assumed that aging causes an inevitable deterioration of the body and its ability to function, as well as increased rates of related injuries such as sprains, strains and fractures; diseases, such as obesity and diabetes; and osteoarthritis and other bone and joint conditions. However, recent research on senior, elite athletes suggests usage of comprehensive fitness and nutrition routines helps minimize bone and joint health decline and maintain overall physical health.
“An increasing amount of evidence demonstrates that we can modulate age-related decline in the musculoskeletal system,” said lead study author and orthopaedic surgeon Bryan G. Vopat, MD. “A lot of the deterioration we see with aging can be attributed to a more sedentary lifestyle instead of aging itself.”
The positive effects of physical activity on maintaining bone density, muscle mass, ligament and tendon function, and cartilage volume are keys to optimal physical function and health. In addition, the literature recommends a combined physical activity regimen for all adults encompassing resistance, endurance, flexibility and balance training, “as safely allowable for a given person.” Among the recommendations:
Resistance training. Prolonged, intense resistance training can increase muscle strength, lean muscle and bone mass more consistently than aerobic exercise alone. Moderately intense resistance regimens also decrease fat mass. Sustained lower and upper body resistance training bolsters bone density and reduces the risk of strains, sprains and acute fractures.
Endurance training. Sustained and at least moderately intensive aerobic training promotes heart health, increases oxygen consumption, and has been linked to other musculoskeletal benefits, including less accumulation of fat mass, maintenance of muscle strength and cartilage volumes. A minimum of 150 to 300 minutes a week of endurance training, in 10 to 30 minute episodes, for elite senior athletes is recommended. Less vigorous and/or short-duration aerobic regimens may provide limited benefit.
Flexibility and balance. Flexibility exercises are strongly recommended for active older adults to maintain range of motion, optimize performance and limit injury. Two days a week or more of flexibility training—sustained stretches and static/non-ballistic (non-resistant) movements—are recommended for senior athletes. Progressively difficult postures (depending on tolerance and ability) are recommended for improving and maintaining balance.
The study also recommends “proper” nutrition for older, active adults to optimize performance. For senior athletes, a daily protein intake of 1.0 to 1.5 g/kg is recommended, as well as carbohydrate consumption of 6 to 8 g/kg (more than 8 g/kg in the days leading up to an endurance event).
“Regimens must be individualized for older adults according to their baseline level of conditioning and disability, and be instituted gradually and safely, particularly for elderly and poorly conditioned adults,” said Dr. Vopat. According to study authors, to improve fitness levels and minimize bone and joint health decline, when safely allowable, patients should be encouraged to continually exceed the minimum exercise recommendations.