Older Women – A Growing Population

Since the year 2000, the world’s population has increased by 22%. Over the same period, the number of women aged 45-60 has increased by 55%; the number aged 75+ has increased by 72%(1). As a population, older women are re-inventing mid-life and fighting the aging process with everything they can: diet, exercise, cosmetics, cosmetic surgery, vitamins, herbal and hormonal therapy.  They’re paying close attention to both mental and physical health, and are making healthy lifestyle choices in an effort to enjoy the middle and later years of life.

The majority of my clients are women aged 45 or older. Is it the look and feel of my private studio that appeals to them, or the person I am (a 46-year-old woman)?  Probably both. And in all likelihood, the studio’s suburban location has a role to play in my client demographics too.

Although every one of these women are unique, each with their own fitness goals and potentially battling with their particular injury or health issue, they all have something in common – they find themselves at a stage in their lives when they have the opportunity to make time for themselves and put themselves first.

Time is still a very precious commodity for these women, and finding ways to increase their physical activity levels outside of their training sessions remains a challenge. For a number of them, trying new things is daunting, and this can be with the case with exercise since regular exercise may be new in their lives.

So, it makes sense to turn to something that is easily accessible and will contribute towards their primary goal – wellness, particularly as they move into post-menopausal life.

Walking for Health and Fitness

The link between physical activity and the risk of coronary heart disease (CHD) has long been well-established(2). And now there’s mounting evidence of the importance of exercise in preventing strokes, some forms of cancer, type-2 diabetes, obesity, osteoporosis and sacropenia(3-5). But what type of exercise and how much of it is required?  Can walking deliver?

Meet Laura. She’s over the age of 40 and walks at 6.4 km/h (4mph) for 30 minutes three times a week. Walking at this speed requires 5.0 METs(6), so Laura’s exercise program delivers (3x30x5.0) ÷ 60 = 7.5 MET-hours/wk; classified as moderate-intensity exercise since the metabolic demand is below 6.0 METs.

Studies show that Laura’s exercise program could reduce her risk of both CHD and diabetes by 30% when compared to her sedentary peers. If she were to add another two walks each week, she’d see these risk reductions grow to around 40%.(7, 8)

And if Laura is only just starting out on her fitness journey, maintaining a program of five walks a week could increase her cardiovascular fitness levels (VO2max) by 9% in 6 months(9) and boost her HDL (“good”) cholesterol levels by as much as 6%.   This might not sound like a lot, but to put it into context, a 1% rise in HDL produces a corresponding 2% decline in the risk of a coronary event in adults who have stable coronary artery disease(10).

[Stable coronary artery disease is defined as an established pattern of angina pectoris, a history of myocardial infarction or the presence of plaque documented by catheterisation.]

Walking for Mental Well-Being

Just last week, further research was published supporting the link between regular exercise and depression(11, 12). Women are 70% more likely than men to suffer from depression at some point in their lives, so the protection exercise can offer shouldn’t be overlooked. And yes, it can be as simple as going for a walk.

According to one study(13), embarking on a 200-minute a week walking program is enough physical activity for female sufferers of depression to feel energized, to socialize more, to feel better emotionally and to not be as limited by their depression. Laura would need to add one more walk to her weekly program to enhance these mental health benefits.

Walking to Preserve Bone Density

Osteoporosis, the “silent disease” that sees bone mineral density decline, can go undetected until a person suffers a painful fracture, typically of the hip, wrist or spine.

Women are four times more likely than men to develop osteoporosis, and women over 50 have the greatest risk. Why?  Low estrogen levels and infrequent or absent periods can lead to loss of bone density – exactly what happens during perimenopause and menopause.

Walking is a weight-bearing exercise and healthy postmenopausal women who walk more than 7.5 miles (12 km) a week have a significantly higher whole body, leg and trunk bone mineral density than women who walk less than 1 mile (1.6 km) a week(14). Again, a fourth 30-minute walk each week would take Laura up to this evidence-based dose.

Another study(15) found walking effective in slowing the rate of bone loss from the femoral neck (hip) in perimenopausal and menopausal women. And since in the vast majority of cases, a hip fracture is a fragility fracture, walking could be considered a preventative step.

Walking has also been shown to prevent deterioration in postural stability in women over 50(16). Reducing the risk of a fall in those diagnosed with osteoporosis is critical in the management of the disease. Becoming inactive through fear of falling might be a short term “fix” for someone with the condition, but longer term, it could be hugely detrimental in other areas of life.

Conclusion

As a client population, we can expect older women to become a larger proportion of PT users. To be able support them fully, we need to appreciate where they are coming from, understand their lifestyle goals, and be attentive to the invisible battles they might be facing.

A regular walking program isn’t a magic pill, but there is plenty of evidence to suggest it’s worth adding to the arsenal. Having an awareness of the benefits of this simple exercise, and how much (or relatively little) is needed to receive them has given my clients a sense of purpose and the feeling they are doing something very positive for themselves.

References

  1. US Census Bureau, International Programs, International Data Base. Revised: 25 July 2017, Version: Data:17.0810, Code:12.0321
  2. Berlin, J. A., & Colditz, G. A. (1990). A meta-analysis of physical activity in the prevention of coronary heart disease. American Journal of Epidemiology, 132(4), 612-628.
  3. Blair, S. N., Kohl, H. W., Paffenbarger, R. S., Clark, D. G., Cooper, K. H., & Gibbons, L., W. (1989). Physical fitness and all-course mortality: a prospective study of healthy men and women. Journal of the American Medical Association, 262(17), 2395-2401.
  4. Blair, S. N., Kampert, J. B., Kohl, H. W., Barlow, C. E., Macera, C. A., Paffenbarger, R. S., et al. (1996). Influences of cardiovascular fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. Journal of the American Medical Association, 276(3), 205-210.
  5. Blair, S. N., & Morris, J. N. (2009). Healthy hearts – and the universal benefits of being physically active: physical activity and health. Annals of  Epidemiology, 19(4), 253-256.
  6. Ainsworth, B. E., Haskell, W. L., Herrmann, S. D., Meckes, N., Bassett, D. R., Tudor-Locke, C., et al. (2011). 2011 Compendium of physical activities: a second update of codes and MET values. Medicine and Science in Sports and Exercise, 43(8), 1575-1581.
  7. Manson, J. E., Hu, F. B., Rich-Edwards, J. W., Colditz, G. A., Stampfer, M. J., Willett, W. C., et al. (1999). A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. The New England Journal of Medicine, 341(9), 650-658
  8. Hu, F. B., Sigal, R. J., Rich-Edwards, J. W., Colditz, G. A., Solomon, C. G., Willett, W. C., et al. (1999). Walking compared with vigorous physical activity and risk of type 2 diabetes in women. Journal of the American Medical Association, 282(15), 1433-1439.
  9. Duncan, J. J., Gordon, N. F., & Scott, C. B. (1991). Women walking for health and fitness - how much is enough?  Journal of the American Medical Association, 266(23), 3295-3299.
  10. Devendra, G. P., Whitney, E. J., & Krasuski, R. A. (2010). Impact of increases in high-density lipoprotein cholesterol on cardiovascular outcomes during the Armed Forces Regression Study. Journal of Cardiovascular Pharmacology and Therapeutics, 15(4), 380-383.
  11. Harvey, S. B., Øverland, S., Hatch, S. L.,Wessely, S., Mykletun, A., & Hotopf, M. (2017). Exercise and the Prevention of Depression: Results of the HUNT Cohort Study, The American Journal of Psychiatry, published online on 3 October 2017, https://doi.org/10.1176/appi.ajp.2017.16101200
  12. Rogerson, M., Barton, J., Bragg, R., & Pretty, J. (2017). The health and wellbeing impacts of volunteering with The Wildlife Trusts. Green Exercise Team at the University of Essex, http://www.wildlifetrusts.org
  13. Heesch, K. C., van Gellecum, Y R., Burton, N. W., van Uffelen, J. G. Z., & Brown, W. J. (2015). Physical activity, walking, and quality of life in Women with depressive symptoms. Americnan Journal of Preventive Medicine, 48(3), 281-291.
  14. Krall, E., & Dawson-Hughes, B. (1994). Walking is related to bone density and rates of bone loss. The American Journal of Medicine, 95(1), 20-26.
  15. Ma, D., Wu, L. & He, Z. (2013). The effects of walking on the preservation of bone mineral density in perimenopausal and postmenopausal women: a systematic review and meta-anlysis. The Journal of the North American Menopause Society, 20(11), 1216-1226.
  16. Gába, A., Cuberek, R., Svoboda, Z., Chmelík, F., Pelclová, Lehnert, M., & Frömel, F. (2106). The effect of brisk walking on postural stability, bone mineral density, body weight and composition in women over 50 years with a sedentary occupation: a randomized controlled trial. BMC Women’s Health, https://doi.org/10.1186/s12905-016-0343-1

Deborah Savin I first entered the fitness industry as a group exercise-to-music instructor whilst completing my PhD in Applied Maths. Even then I was torn between the two worlds, having discovered how much I enjoyed using my energy and passion to engage and motivate others.

Maths took priority and, after a brief career in banking, I became a financial training consultant designing and delivering training courses for financial institutions worldwide, first in London then in Hong Kong.

This role gave me an opportunity to work with small and large groups and with very diverse populations. It was through doing this that I realised I enjoyed being in close contact with people and acting as a coach, trainer and mentor.

Exercise was always a big part of my life and in 2009 I began part time studies for an MSc in Exercise and Nutrition Science. It was while completing my dissertation, for which I recruited and trained study participants, I realised the science wasn’t as important to me as my connection with people. So I embarked on a career as a personal trainer.

While in Hong Kong I set up Movéo Fitness, taking exercise into the homes and favourite spaces of my clients. Over the following two years my client base expanded rapidly, and mostly by word of mouth.

At the beginning of 2015 I made the decision to leave Hong Kong and relocate to Cape Town. Movéo Fitness South Africa was born and now operates from a private studio purpose-built to offer a unique space to my personal training clients.