Rebounding for Health, Oral Care Saves Lives, 90/10 Rules
Lightbulbs & Pearls | 015
On the Rebound(er) for Women’s Health
Several months ago—for no particular reason—the thought popped into my mind that I’d like to get a mini-trampoline again. I remember having one in the 80s when they were trendy, but I don’t remember using it very much after the novelty wore off, and I probably donated it to Goodwill. Whatever the case, it’s gone, and I found myself wishing I still had it and thinking I would enjoy using it for an occasional change of pace.
Ironically, while ruminating on the matter, I came across this study about trampoline jumping as an intervention for female health. What a crazy coincidence! I decided to read further. This was a 12-week study of postmenopausal women, intending to examine the effects of mini-trampoline jumping on bone density and pelvic floor strength, both issues that become significant sources of concern as women age.
After a woman endures the trials and tribulations of menopause, the loss of bone mass accelerates, which can lead to osteoporosis and all its related risks (breaks, fractures, etc). Additionally, many women experience weakened pelvic floor muscles, which results in varying degrees of continence issues. Lovely.
The two cohorts of 50-69-year-old women had very similar baseline characteristics in terms of overall bone mass density (BMD), pelvic floor muscle strength, and stress urinary incontinence (SUI). The intervention group followed a program of 40-minute jumping sessions three times a week using a mini-trampoline with a handlebar and wearing a heart rate monitor to ensure a heart rate of between 40% and 75% intensity.
According to the studies’ conclusion, at the end of the 12 weeks, the fortunate exercise group showed improvement in both focus areas. Regarding BMD, there was a significant increase in overall density, which continued to improve at the three-month follow-up, although the rate of improvement had slightly slowed from the 12-week check-in. Regarding the pelvic muscles, there was a decrease in the SUI scores (meaning there were fewer instances of incontinence), which became statistically significant at the three-month follow-up—translating to an accelerated rate of improvement. Great news on both fronts!
The study confirms the widely held belief that exercise, in general, is a mitigating factor in many age-related health issues. In particular, despite being considered low-impact, it is encouraging to see that the mini trampoline could lead to such noteworthy improvements in bone density metrics. Because I like to challenge my body in various ways, a mini-trampoline is an excellent addition to more traditional load-bearing exercises with proven bone benefits, such as power walking and weight training.
As a side note, I was curious about how the program was structured and what sort of movements were in the sessions, as this was more than simply bouncing up and down. It was a synergistically designed regime, and the difficulty and combination of exercises are impressive! For instance, in weeks 10-12, the participants (as a reminder, ages 50-69) progressed to challenging compound movements with weights and balls. If you are interested, there is a program chart on page 22 of the study.
Oral Care Can Save Lives
The older I get, the more I realize how essential the basics are. It sounds trite, but life really comes full circle. Oral care is one such basic. Starting at a very young age, I vividly remember going to the neighborhood dentist (literally at the end of my street) and being taught how to brush my teeth. Then, I tested my skills with the chewable little red pill, revealing all the plaque I’d missed.
I’m sure you may have similar memories. From a very early age, we all know how critical it is to take care of our teeth, yet I’ve had stretches where I haven't always been as diligent as I should be. However, in the last few years, as I’ve developed a heightened awareness of how interconnected overall health is, I’ve recommitted myself to being more fastidious with a solid regime. A recent post on the eponymous Peter Attia website reported an eye-opening meta-analysis that has further steeled my resolve.
At first blush, this seems like a no-brainer. It’s common knowledge that bacteria in the mouth can have very adverse health effects if they aren’t kept in check; hence, brushing twice daily is recommended. Past studies have linked oral bacterium to possible heart and respiratory ailments, but this meta-analysis uses extreme cases to illuminate how critical good habits are to our health.
The studies’ authors focused on hospital-acquired pneumonia (HAP) in ICU patients (especially those on ventilators (VAP)). Although ICU patients generally have oral care consisting of antiseptic mouthwashes, brushing and flossing aren’t typically part of the protocol. Because these patients are the least likely to be brushing their teeth, they are at high risk of an overgrowth of oral bacteria.
This study randomized a toothbrushing intervention with remarkable results. There was a 33% lower HAP risk, which fueled a 32% reduction in VAP rates. Conservatively, this could reduce VAP mortality to 13.6%, resulting in 17,000 fewer deaths yearly. Think about that for a moment: simply brushing the teeth of these critical care patients twice daily can mean the difference between recovery and death. That’s astonishing.
While thankfully, most of us won’t have the misfortune of being in this dire situation, we can apply the knowledge to ourselves and our loved ones—especially those in their advanced years. Chronic periodontal disease affects 46% of adults in the United States and is associated with a 3.5-fold increase in the risk of atherosclerotic cardiovascular disease and a 1.7-fold increase in Alzheimer's disease. While pernicious bacteria in the mouth may not initiate disease, it appears to have a definite role in fueling its progression.
90/10 Rules
As I was writing this week's Lightbulbs post, I took an early afternoon break to savor a piece of chocolate, and it dawned on me—this is my pearl.
You may know by now that I have a reasonably disciplined mindset. It’s both a blessing and a curse. The blessing is that I am steadfast in my lifestyle habits, whether it is diet, exercise routine, bedtime, etc. (The long list of curses isn’t pertinent to this, so I’ll skip over them!) You may think indulging in chocolate doesn’t sound very disciplined, but it is.
The one dictum I apply to my diet to empower discipline is the 90/10 rule. (I’ve heard some people say for them, it’s 80/20, and truth be told, I suppose I, too, sometimes dip into that range.) For those unfamiliar with the concept, it means I’m on track 90% of the time, and 10% of the time, I’m intentionally off the proverbial track. Over time, I’ve come to realize and appreciate that the 10% is the key to maintaining the 90%.
From my share of weight ups and downs over the years, I’ve learned that success inevitably boils down to willpower. I have found that promising myself a distant treat can bolster my resolve and help me fend off urges to dip into the chips (we have a steady supply, thanks to my 17-year-old). So, many moons ago, my husband and I delineated particular meals during the week as “splurges.” For instance, Thursday was our “grease lunch,” meaning French fries, onion rings, root beer—the works. Saturday was pizza night, and Sunday morning breakfast was anything goes—pastries, pancakes, hash browns…
Over time, my splurges have shifted slightly, but I’ve maintained the primary practice. We still religiously observe Saturday pizza and Sunday ooey-gooey breakfast, but the Thursday grease lunch has given way to my chocolate treat, which I allow myself several times a week. Whenever my internal dialogue begins to bargain for a little something, I can stave off cravings because I’d rather save those calories for a sumptuous piece of extra-dark chocolate.
That’s the beauty of the 90/10 rule…10 rules the day.