Multivitamin-Multimineral Supplements and Longevity

Introduction

I’ve long advocated taking multivitamins and multiminerals as an older athlete. Why? Because despite eating a healthy balanced diet full of fruit and vegetables, a hard training athlete of any age needs to ‘cover their bases’. Thus, a typical multivitamin and multimineral supplement that has moderate levels of B-group vitamins and sprinkling of other vitamins and minerals just gives me the piece of mind that I am getting the nutrients I need to keep training and performing.

Some research published in 2011 from The Iowa Woman’s Health Study showed an increased risk of death in 38,772 older women with an initial average age of 61.6 years  were regular supplementers and tracked since 1986. This study showed that regular use of multivitamins increased the risk of death by 2.4% compared to non-users. Increased risk of death in other vitamins and minerals included vitamin B(6) (4.1%), folic acid (5.9%), iron (3.9%), magnesium (3.6%), zinc (3.0%), and copper (18.0%) were associated with increased risk of total mortality when compared with corresponding nonusers. in contrast, use of calcium reduced mortality by 3.8%. However, this study was clouded by the fact that supplement use was higher in those with a history of disease and therefore more likely to pass away. So what does research say about regular use of multivitamins and multiminerals and how long we live for?

The Research

A group of Australian scientsist from Melbourne’s Swinburne University of Technology performed a large (meta-) analysis of all the vious research studies examining longevity and multivitamin and multimineral use. 21 eligible studies (91,074 people and 8794 deaths) investigated daily multivitamin-multimineral supplementation for ≥1 y. Studies using people described as institutionalized or as having terminal illness were excluded.  The scientsists used sophisticated statistical analysis to determine what we call the relative risk (a ratio of the probability of the event occurring in the exposed group versus a non-exposed group) of death.

The Results

The average age of the sample was 62 years and the average duration of supplementation was 43 months. Across all 21 studies, no effect of multivitamin-multimineral treatment on all causes of death was found. Furthermore, use of multivitamin-multimineral supplements had no effect on mortality due to vascular causes (eg. stroke, heart disease) or cancers.

The So What

This very rigorous study highlights that use of multivitamin-multimineral supplements won’t help us live longer. However, in older athletes who train regularly, use of a multivitamin-multimineral supplement that has a range of vitamins and minerals included in them should be considered. Importantly for older endurance athletes or those who train hard and often, multivitamin-multimineral supplements should be considered. For the most definitive discussion related to sports nutrition for older athletes that you will ever read (biased as I am!) check out Chapter 16 (Nutrition for the Masters Athlete) of my book The Masters Athlete, now available online in pdf format as a whole book or chapter by chapter. Also strongly consider a visit to a sports dieticiano have your own dietary needs and food intake analysed by a professional. In Australia you can find one by clicking here. In the USA, click here, and the UK here.

Source: Macpherson, H. and others (2012). Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition, Dec 19. [Epub ahead of print]

Heart damage from too much training??

Introduction

There’s been some recent media speculation that older endurance athletes are more prone to heart problems than healthy age-matched people. Just after one of our readers advised me of this negative press, a mate in his mid-60′s and pioneer of Ironman triathlon in Australia and now a lecturer in sport coaching at an Ozzie university told me he has had a pacemaker inserted. This goes against the common belief that aerobic exercise is good for you in that it keeps many of the heart disease risk factors in check. So what does the research really say when it comes to this supposed increased risk of heart problems in older endurance athletes?

The Facts

Exercise is increasingly been seen as medicine. In fact, internationally, there has been a movement started called Exercise is Medicine. The movement is being driven by the enormous amount of scientific evidence supporting the value of doctors prescribing exercise as medicine rather than pills!! Consistently and unequivocally recent research has found that regular exercise prevents and treats many of our common and deadly chronic diseases including:

  • coronary artery disease
  • diabetes
  • obesity
  • high blood pressure
  • heart failure
  • depression

Moreover, people who do regular physical activity have lowere rates of disability and an average life expectancy about 7 years longer than non-exercisers.

However, as with any drug there appears to be a safe upper range dose of activity above which there may be adverse effects that may outweigh the benefits above. For example, a long-term study published in 2011 in the highly prestigous medical journal the Lancet tracked 416,000 Taiwanese people over about 8 years and found that there was a protective health effect up to about 60 minutes of daily vigorous (huff and puff!) exercise. Another recent longitudinal study 0f 52,000 adults found that running distances of up to 19.9 miles/week, speeds of 6-7 miles/hour, or frequencies of 2-5 days/week were associated with a lower risk of all-cause mortality, whereas higher mileage, faster paces, and more frequent running were not associated with better survival.

Very recently, there has been some suggestion that long-term endurance vigorous training such as that greater then the doses above may increases the risk of atrial fibrillation (irregular heart beat). This review article presented many studies conducted over the last 15 years that have suggested training too hard for too long can increase the risk of atrial fibrillation in healthy middle-age men. They suggested that although such training may prevent coronary artery disease, it might also cause of atrial fibrillation.

An increasing amount of research evidence also suggests that training and competing long term in ‘extreme’ endurance events such as marathons, ultramarathons, ironman triathlons and very long cycling or swimming events can cause transient problems and damage to the heart walls and chambers as evidenced through blood markers. However, these problems return to normal within 7-10 days after stopping training.

In veteran extreme endurance athletes such as my mate, this consistent heart muscle damage and repair process may lead to heart fibrosis (thickening and stiffening of the heart valves and muscle). Over years, this may lead to heart arrythmias (irregular heart beats).

However, recently another group of cardiology researchers critically analysed these studies that suggested increased risk of heart issues in older endurance athletes (like me and my mates) who train long and hard and often. These researchers concluded that the

  1. the incidence of atrial fibrillation in middle-aged endurance athletes is rare
  2. if a risk exists, it is limited to vigorous endurance exercise only and in those middle-aged men with other risk factors such as smoking or high blood pressure
  3. there is no increased risk in healthy middle-aged men with a normal heart who have no blood pressure issues and no other risk factors
  4. Critically, the researchers concluded that the beneficial effects of exercise will offset this low risk which, even if increased, remains very low.

The So What?

As with any issue in science, research typically is inconclusive. There are always studies and papers that contradict each other. While a number of studies over the years have shown a potential increased risk of heart issues in older athletes who train long and hard and often, other studies suggest the risk is very low in these athletes if they are healthy and have no other risk factors. Moreover, the current concensus appears to be that while the the risk is very low, the benefits of such training outweigh the low risk of heart issues. For me, I intend to keep training regularly unless my body tells me otherwise!

Chapter 4 (Principles of Training the Masters Athlete), Chapter 6 (Endurance Development in the Masters Athlete), Chapter 10 (Periodisation and Peaking for the Masters Athlete), Chapter 13 (Preventing Overtraining in the Masters Athlete) and Chapter 14 (Staying Healthy and Illness-Free) are excellent guides and how-to chapters when it comes to optimising your training and preventing health issues as an older athlete. Each chapter is now available online as a pdf. Check it out by clicking here.

Sources:

  1. Delise, P. and others (2012) Does long-lasting sports practice increase the risk of atrial fibrillation in healthy middle-aged men? Weak suggestions, no objective evidence. Journal of Cardiovascular Medicine, 13: 381-385.
  2. Patil, H and others (2012) Cardiovascular damage resulting from chronic excessive endurance exercise. Missouri Medicine, 109(4): 312-321.

Testosterone and masters athletes – what does the research say?

Introduction

Did you know moderate intensity training in males is useful in the prevention and treatment of sexual dysfunction? Howver, in young athletes, high intensity training, especially in endurance athletes, can reduce testosterone levels.

Low testosterone levels in young athletes has been shown to lead to reductions in both health and performance. Specifically, low levels of the hormone have been linked to overtraining, decreases in muscle mass, increased risk of bone fractures, cardiovascular accidents, and sports-related anemia, as well as stress-related diseases such as hypertension.

Critically for competitive athletes both young and old, testosterone deficiencies can also reduce muscle strength, reduce aggressiveness in competition, lower the regeneration of muscles after training, and lower the sex drive! Not good I say! Here is some Italian research I recently read that investigated the prevalance and symptoms of undiagnosed testosterone defeiciency in athletes between 50 and 80 years old.

The Research

183 caucasian male athletes >50 years were examined as part of pre-participation health screening by medical practitioners. The athletes were from different sports (tennis, swimming and track and field), were not taking supplements or drugs that affected results, had no previous diagnosis or awareness of testosterone deficiency. They had been training regularly for the last 10 years for an average of 8.1 hrs/week. Serum total testosterone was measured in the blood, and questionnaires administered as measures of erectile dysfunction (International Index of Erectile Dysfunction), depression levels (Center for Epidemiological Studies Depression Scale) and  amount of physical activity (International Physical Activity Questionnaire). Hypogonadal athletes (mild or severe testosterone deficiency) were statistically compared with eugonadal (normal testosterone levels) athletes as controls.

The Results

Severe or mild testosterone deficiency was observed in 12% and 18%, respectively, of the athletes. The highest prevalence of testostreone deficiency was in athletes >70 years (27.5% – severe deficiciency and 25.0% – mild deficiency). Testosterone levels were not related to age, training duration, or questionnaire scores. No differences were observed for erectile dysfunction, levels of depression or chronic disease markers such as hypertension between normal and severely testosterone deficient athletes.

So What?

The results strongly suggest that many masters athletes over 50 years of age may be testosterone deficient and not know it. This would suggest that as part of our yearly check-up (yes guys get it done – and find a doctor with a small hand for that prostate test!), we might consider getting our testosterone levels checked. If deficient in that area, consider testosterone replacement therapy after discussion with your doctor. Talk over and contraindications to the therapy and ensure that if you compete you look at getting a therapeutic use exemption from your peak sporting body.

Source: Di Luigi, L. and others (2010).  Prevalence of Undiagnosed Testosterone Deficiency in Aging Athletes: Does Exercise Training Influence the Symptoms of Male Hypogonadism? Journal of Sexual Medicine. 7(7): 2591-2601.

Does Playing Team Sport into Older Age Protect Us from Chronic Disease?

Introduction

We all know that being active into older age helps protect us from the ravages of chronic disease and many age-related disorders. Indeed, research has shown that the more aerobically fit we are the better off we are in preventing cardiovascular disease, diabetes, hypertension, and some forms of cancer. But what about older people that play team sports? Are they as well protected against these age- and lifestyle-related diseases as masters endurance athletes.

A mate of mine, Associate Professor Mike Climstein, from Bond University on Australia’s Gold Coast has looked into this question and recently published his findings.

The Research

Mike and his international research team conducted an online survey of 216 35-plus year old Rugby Union players attending the International Golden Oldies World Rugby Festival. They examined the player’s medical history and some physiological measures then statistically compared the under 50′s and over 50′s players then compared the incidence of chronic disease and conditions with those of a normal Australian population.

The Results

Below are dot-pointed findings from the study:

  • The incidence of smoking was low (8.8%) at averaged 72.4 cigarettes per week
  • The percentage drinking alcohol was high (93.1%) at 11.2 drinks per week (Recommended is 2 drinks per day)
  • The top 6 chronic diseases/conditions reported were: 1. hypertension(18.6%) 2. arthritis (11.5%) 3. asthma (9.3%) 4. high blood fats (8.2%) 5. diabetes (7.5%) 6. gout (6%)
  • When compared to the incidence of chronic disease/conditions in a normal age- and gender-matched Australian population, the older rugby players had significantly lower incidence of anxiety, arthritis, and depression but higher incidence of diabetes, and hypertension
  • Medications were common with 13% taking blood pressure tablets, 8% blood fat lowering medications, 6% anti-inflammatories and 4% blood thinning drugs. Those over 50 years of age were taking significantly more blood pressure, blood thinning and blood fat lowering drugs than the younger players.
  • The rugby players over 50 years had a higher waist circumference (a heart disease risk factor) than the younger players.
  • In general, the players under 50 reported a higher incidence of most chronic conditions and diseases compared to the older players.

So What?

The results suggest that playing team sports into older age may not protect masters athletes from some chronic diseases/conditions such as diabetes and hypertension. Moreover, the results suggest that younger team players need to be more aware of their lifestyle habits than older players when it comes to maintaining optimal health into older age.

For more reading based on what science supports for successful aging, read Chapter 1 of my book The Masters Athlete that identifies the Keys to Successful Aging.

Source: Climstein, M. and others (2011). Incidence of chronic disease and lipid profile in veteran Rugby athletes. World Academy of Science, Engineering and Technology, 80: 1095-1099.

Fitter Men Live Longer

Introduction

It pays to invest in aerobic fitness into older age with the dividend being extra years added to your life. A long-term study from the USA has just found that men who scored highly on aerobic fitness while in their 40′s and stayed fit into their 50′s were 30% less likely to die over the next decade than their unfit mates. The same study also found that men who improved their endurance fitness over that time lowered their risk of death by 40%.

The Research

The researchers examined the separate and combined relationships of changes in endurance fitness and body mass index (BMI)  with death rates from both all causes and death rates from cardiovascular disease (CVD) in 14,345 men (average age 44 years). Fitness was estimated from maximal treadmill test. Changes in fitness and BMI were tested after 11 years and the men were classified into loss of fitness, stable fitness, or gain in fitness groups.

The Results

At the time of the last test, 914 of the men had died from all-causes and 300 from CVD. The men who had maintained fitness showed a 30% lower risk from all causes and 27% lower risk of dying of CVD. However, the men who improved their endurance fitness lowered their risk of all-cause death by 40% and CVD death risk by 42% compared to the men who lost fitness. Crucially, for every 5-10% improvement in aerobic fitness, the risk of death dropped 15% and 19% for all-cause and CVD death, respectively. Moreover, aerobic fitness was far more important than BMI change in determining the risk of death.

So What?

Yet more evidence that we masters athletes need to stay active into older age. Masters endurance athletes know how important aerobic exercise is for both quality and quantity of life. Interestingly, our power / strength and team playing colleagues also benefit from the relatively smaller changes these type of training have on aerobic fitness.  So stick with it team!

For more information on successful aging and what science says are the keys to successful aging, see Chapter 1 of my book The Masters Athlete.

Source: Lee, D.C. and others (2011). Long-term effects of changes in cardiorespiratory fitness and body mass index on all-cause and cardiovascular disease mortality in men: the Aerobics Center Longitudinal Study. Circulation 124(23): 2483-2490.