Bartlit Fred - Choosing the StrongPath: reversing the downward spiral of aging

Praise

Reduced strength can have catastrophic consequences in loss of mobility, falls and fractures, and eventual withdrawal from an active life. Interventions to improve strength, such as described in Choosing the StrongPath, are critically important.

Jack M. Guralnik, MD, PhD,
Professor of Epidemiology and Public Health,
University of Maryland School of Medicine

Choosing the StrongPath offers a bright ray of hope to a generation known for living on their own terms: that they can truly enjoy, survive, and thrive in their golden years.

Bert R. Mandelbaum, surgeon, author, motivational speaker, Kerlan Jobe Institute at Cedars Sinai, FIFA IOC Medical Officer for the 2016 Summer Olympic Games

Choosing the StrongPath shares invaluable advice: You dont have to accept the inevitable effects of aging. If you want to stay in control of your health and your lifestyle for many years to come, you need this book.

Jason Pullara, Director of Sports Performance,
Northwestern University

This book is intended as a reference volume only, not as a medical manual. The information given here is designed to help you make informed decisions about your health. It is not intended as a substitute for any treatment that may have been prescribed by your doctor. If you suspect that you have a medical problem, you should seek competent medical help. You should not begin a new health regimen without first consulting a medical professional.

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For permission to reproduce copyrighted material, grateful acknowledgment is made to the following sources:

From Why I Want to Die at 75 by Ezekiel J. Emanuel from The Atlantic, October 2014.

Copyright 2014. Reproduced by permission of The Atlantic.

From Military physical training: Its a problem bigger than obesity, with no easy solution by Thomas E. Ricks from Foreign Policy, February 18, 2015. Copyright 2015. Reproduced by permission of Foreign Policy. All rights reserved.

From The Lord of the Rings by J. R. R. Tolkien, edited by Chistopher Tolkien. Copyright 1954, 1955, 1965, 1966 by J. R. R. Tolkien. Copyright renewed 1982, 1983 by Christopher R. Tolkien, Michael H. R. Tolkien, John F. R. Tolkien, and Priscilla M. A. R. Tolkien. Reproduced by permission of Houghton Mifflin Harcourt Publishers Company. All rights reserved.

From Life as the Ninth Inning Nears by Fay Vincent from the Wall Street Journal, February 24, 2016. Copyright 2016. Reproduced by permission of the Wall Street Journal.

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Print ISBN: 978-1-62634-476-1

eBook ISBN: 978-1-62634-477-8

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First Edition

We dedicate this book to Roger A. Fielding, PhD

Director of the Nutrition, Exercise Physiology, and Sarcopenia
Laboratory at the Jean Mayer USDA Human Nutrition Research
Center on Aging, Tufts University, Boston, Massachusetts

In his early 60s, Fred began to wonder if there was any scientific basis supporting beliefs he had developed in contrasting his life experience with those of his friends and colleagues in dealing with the issues of frailty in aging. He began searching medical-research resources for peer-reviewed science explaining his long-term personal experience with strength training. In 1995, Fred struck gold. He remembers first setting eyes on a literature study by Dr. Fielding titled Effects of Exercise Training in the Elderly: Impact of Progressive-Resistance Training on Skeletal Muscle and Whole-Body Protein Metabolism, presented at the winter meeting of the Nutrition Society, held at the Royal Society of Medicine on February 17, 1995.

Freds wife recalls him excitedly telling her, Jana, I am not crazy. You dont have to get old and weak. I was right. Exercise can save us all! And he told her of a new medical concept he had never heard of: sarcopenia.

Amazingly, Dr. Fieldings 1995 paper described in detail things Fred had been observing as a matter of experience for 15 years. Generally, from age 20 on, there is a slow, progressive loss of lean tissue. At age 65, the decline becomes rapid and then precipitous. The new term for this decline, sarcopenia, was coined in 1988 and was appearing in studies by the early 1990s. This loss of strength and lean mass dramatically impairs health, enjoyment of life, and happiness as people age. Physical disability becomes prevalent in a large segment of those over 55. Yet this decline may not be inevitable but, rather, related to a lack of activity. Older healthy individuals involved in strength training of appropriate intensity had gains in strength and muscle size comparable with young individuals.

Other scientists were working along the same lines, but it was this seminal study by Dr. Fielding that brought everything together. Dr. Fieldings work convinced Fred that he was on to life-changing science that could give billions around the world far, far better lives. Fred determined that the pursuit of this possibility would become his project of a lifetime.

When this book was conceived, Fred and Steven travelled to Tufts University and met with Dr. Fielding in his laboratory. Medicine was reaching a crossroads. Steven could see that disease born of unhealthy behavior was rising dramatically worldwide and that Dr. Fieldings overarching vision of integrating behavior modification in accord with the growing science of exercise physiology and nutrition was critical to medicine and human health in the long term, just as Fred had suspected. Dr. Fieldings vision proved a reliable map for an opening scientific frontier in health care. His guidance has been critical in the creation of this book.

The old that is strong does not wither.

J. R. R. TOLKEIN

Contents

Foreword

EARLY IN MY academic career, I was struck by the lack of importance given to the skeletal muscle system. This is the tissue in our bodies that is responsible for allowing us to get around, interact, play sports, burn calories, and in most cases lead productive working lives. Yet its study has typically been relegated to a single chapter in the physiology textbooks, where the fine points of muscle contraction, fatigue, and energetics are highlighted in great detail. It was not until I met my future mentor, Dr. William J. Evans, and initiated my studies in exercise physiology and metabolism that I began to understand the critically important and dynamic nature of this highly plastic and adaptable tissue. It was then that I began the long journey to understanding the central role that skeletal muscle plays in our own health and in our risk of disease.