#46 -- Forestalling Age with Fitness with Dr. Stephen Black

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Dr. Stephen Black is the CEO and Owner of Rocky Mountain Human Performance Center.  He is an acknowledged leader in the field of sports medicine, rehabilitation, fitness, and sports performance. Dr. Black has worked extensively with professional and amateur athletes in many sports, leveraging his holistic and integrative approach to improve performance.

Dr. Black is himself a long-time, high-level athlete, who knows personally as well as professionally the challenges and opportunities available to us all for slowing the effects of aging with individualized programming for higher fitness and superior performance.  

Dr. Black’s philosophy is to proactively addressing imbalances, deficiencies, and poor movement patterns to help older athletes become healthier and stronger while having fun. 

Show Notes:  not a transcript but a summary of the key points discussed with links to other material mentioned.

Key Points Summary:

1. Age: Chronological vs. physiological age:  create a gap in your favor
2. Start Early:  the earlier you start in athletic, the better your health as you get older (don’t wait!)
3. Be Proactive:  avoiding health problems has a much bigger payoff than solving health problems after they arrive.
4. Consistency & Moderation:  for the older athlete, consistency is key to derive the benefits of healthy behaviors, and moderation is important as we shift to prioritizing health over performance.
5. Patience:  progress toward health and fitness is a journey, not a destination.
6. 47 foods:  stay within your food selections to find consistency
7. Protein: 1.5-2.2 grams of protein per kilo of body weight for an active person working out 1-3+ hours per day.  And, err on the side of too much to compensate for worsening digestion and signaling in our bodies as we get older.  Eat protein with carbs (1-to-3 ratio of protein to carbs)
8. Weight-bearing Resistance Exercise:  older athletes must get some weight-bearing resistance exercise to retain muscle mass and maintain bone health.
9. Recovery:  Use a 1-to-3 ratio.  For every 1 dose of high intensity, 3 does of recovery.  Dose = time exercising.  “I’m as good once as I ever was”.  But get the recovery to avoid injury and/or catastrophe.

Q: Connection between Health and fitness today as well as between health and fitness into the distant future.

Consider two sides of that questions:  chronologic age vs. physiological age.

One thing is the younger a person started participating in athletic activity, the greater their health as chronological age progresses.  Exceptions can occur due to lifestyle changes and accidents.  But putting deposits into the fitness bank helps delay aging.

Q:  One of the key questions is, for each person, what are the interventions that will make the most impact for the least investment, least effort?  I assume it will be a unique conclusion for each person, as everyone is different genetically, and has had a unique life to date, but also each person has attempted in his or her own way to compensate for the impact of aging on health and fitness.  So, how do you find those best few things for each person you work with?

I’ll start by saying it is always better to be proactive than reactive.  If you can get ahead of issues, you’ll get further than you will by trying to solve issues after they arrive.

If proactive is the goal:  take a close look at your current level of health.  Get blood test, physiological testing (HR, VO2Max, etc.)….get objective measures.  Then set some reasonable goals, and develop a plan to move toward those goals.

Consistency and moderation are two important strategies for the older athlete.  Apply to everything: nutrition, supplements, exercise prescription with a balance of cardio and strength as well as flexibility and mobility.  And then a reasonable timeframe.

Q:Want to come back to consistency…..touch on habits, breaking and setting habits

Q:First let’s talk some specifics.  In your long experience, are there some actions that come up again and again with your clients as important things to do….that fall into that bigger impact category for many or most older athlete?

Absolutely.

Let’s hit a couple of categories.  

Blood work;  I mentioned getting blood work done to find out what is going on metabolically in your body.  3 things to quantify and control to impact health:  sugar, salt, fat.

1. Blood sugar – A1C test
2. Salt – hypertension
3. Fat – cholesterol levels.

Maximum heart rate:  not calculated, because that is based on age.  But a physiological test.  A normal stress test from your doctor will not determine your maximum heart rate.  Your physician will take you to your predicted max, which could be far below your actual max HR if your physiological age is less than your chronological age.  Plus, they often say you don’t want to exceed 60% of your calculated maximum, which will not be able to assess your fitness unless you are very, very unfit.

With this information, an exercise program can be constructed to meet your goals over time.

I talk about Nutrition, not diet, whichI think of as short term success and long term failure.  Fuel the body like you are fueling with the optimal fuel for optimal performance, regardless of how you define performance.  Nutrition is a key factor in healthy longevity.  Amounts of fats, carbs, protein, electrolytes, minerals.

Q:  Does activity type come into play when scheduling nutrition?

Yes, set the baseline via the blood work numbers plus what they do as an athlete and where they are in their annual plan (building, competition, recovery).

Calories, types of foods.

1 week food diary, and then a monthly food diary.

People migrate to about 47 different foods, and they will not comply with anything outside their list.  So you have to work within they will eat.  Give them the right amount of calories, but also work in the proper balance of carbohydrates for the level of effort in the workplan. 

Q: What about protein volume?

Protein is extremely important in all phases.  Whether in competition or recovery, we are breaking down protein and we need to consume enough.  A complete protein is important.  A plant based diet is okay but you have to be careful to combine foods to get a complete protein.

An active person working out 1-3+ hours per day:  needs 1.5-2.2 grams per kilo of body weight.

Q:  does the amount needed increase as we get older?

Yes.  There are two parts to this answer.  One, we don’t digest and assimilate protein as well as we get older, so we need to eat more.  Two, related to “leaky gut syndrome”,  because of poor diets and medications which increases inflammation in the body and further decreases ability o digest the proteins we eat.  So, yes, eat even more protein as you get older to be sure you get enough.

Another point on protein.  There is an optimal ratio of protein to carbohydrates.  A 1-

to-3 ratio, meaning 1 gram of protein with 3 grams of carbs provides optimal uptake.  

Ed Burke:  https://books.google.com/books/about/Optimal_Muscle_Performance_and_Recovery.html?hl=fr&id=O_7XIjDhAMYC

And, always start with real food first…..use supplements or manufactured products only to fill gaps.

Q: I tried a plant-based diet at one point in an experiment to see if I got any recovery benefit that I had heard others had gotten.  I did seem to get a recovery boost but I couldn’t get enough protein without supplementing with protein power.  I felt like I was constantly drinking plant protein shakes so I went back to eating fish.  I did think I got a recovery benefit, and I never felt like I lost it, for whatever reason.

Plant based proteins are not complete and so breakdown faster for easier digestion, less taxing on the system leading to better quality of sleep which leads to better recovery.

Q:  Anything else on the typical findings of what older athletes tend to need to focus on to get the biggest bang for their efforts?

One additional thing that the older athlete needs to include in a good training plan is resistance exercise to maintain muscle strength and preserve bone health.  There needs to be weigh bearing resistance exercise to be most effective.  Balance and coordination are supported as well.

Body weight and band work is good for maintain what you have, but weights are necessary to get stronger.  Often cyclists and runners will say they don’t need to lift lower body because their legs are already getting a workout.  This is false.  They would be stronger if they lifted weights with their legs as well as upper body.  If they did HIIT using weights to get the best results for the time invested.

Q: What about getting too tired from lifting…and then you can’t do your cycling or running workout?

Everybody needs a annual, periodized plan.  Sometimes you need more gym work and less bike/running work.  If people are doing the same thing all year long, they are working against themselves….the body will adapt.

And go to where the cyclists hang out, and see which one’s stand with a hunched over posture and have “olive oil” arms.  They are the ones who are not working on getting rid of muscle imbalances caused by their sport (and by sitting too much).  This is related to the idea of not just focusing on getting faster and stronger in your sport but also working on your health for the future.  These are obviously related but still separate ideas.

John Jerome. Author and Sports psychologist.  High ranking tennis player.  Wrote Sweet Spot in Time.  

https://www.google.com/books/edition/The_Sweet_Spot_in_Time/HKm6tAEACAAJ?hl=en

You are too old to die young.  Dan Zeeman.  Athletes need to make the transition from competition to lifestyle.  Switching the mindset away from performance and toward more lifestyle for health and longevity.  Nutritional, cardio, strength, mobility, agility.  

https://medium.com/46-to-64/introduction-to-youre-too-old-to-die-young-by-dan-zeman-64d397940321

Q:  To be clear, cycling help me to compensate for having an otherwise sedentary lifestyle, but doesn’t compensate for me sitting so much of the day, which is roughly the same body position as sitting on a bike.  So, I need to compensate for that too, right?

Yes.  It’s important to be mindful of your current situation, and be aware that you need to change it frequently.  The body adapts to chaos better than I adapts to sedentary being.    After sitting to do this podcast, we need to be prepared to move afterwards.

We are only just scratching the surface of the power of the mind.

Q: How do you effect behavior change so you get the consistency in behavior that you need to get the benefits from a good nutrition plan, a good training plan?

For me personally, I am lucky in that I have daily contact with my clients.  That drives me to be a role model of effective behavior plus I get constantly reminded of what can go wrong if I was to lose focus and fall away from healthy behavior.

In addition, our wearables and reminders on our phones allows us to have the proper cues to drive good behavior.

Another factor is the social factor.  If you can become engaged in your healthy behaviors, it helps a ton in making sure it happens.

Simon Sinek.  Leadership podcast.  The characteristic of a Leader is to carry others along.  That’s also the meaning of the word Coach.  Also the philosophy of the team, like the Navy Seals:  one is none, two is one.

https://simonsinek.com/podcast

Building Strong Habits episode: https://www.wiseathletes.com/podcast/45-build-strong-habits-with-samuel-salzer/

Q: To summarize, we’ve chatted about (1) your process for identifying a personalized plan as well as (2) common fitness / health activities that apply to most people.  How can we summarize these for the audience.

1. Process:  Find out where you are today.  Establish a base.   Identify goals and the tools for figuring out what is needed to achieve goals.  Figure out where you have foundational gaps, and also identify which specific protocols will be best for the individual to achieve the goal.
   1. Get standard blood profile for assessing metabolic health.
   2. Measure physiology:  HR (max, resting), VO2Max (oxygen consumption)
   3. Evaluate past history:  injuries, illnesses, surgeries….input to considering in building an effective AND safe program.
   4. Motivators:  How does the person best respond to adding prescribed behaviors.  Find a buddy, use an app.  
   5. Ongoing assessment for managing the process and outcomes of improvement.
2. Fitness activities:  A balanced set of activities for well-rounded health and fitness.  
   1. Strength / Mobility / Flexibility.  Every older athlete is going to need some weight bearing resistance to build and keep muscles and bone health.
   2. Cardiovascular.  The heart doesn’t know what sport you are doing, it only responds to a demand.   So pick any activity that gets the HR up to the levels identified as appropriate for the person to be safe and to achieve fitness goals and to burn calories to stave off cardiovascular disease.  Over a week, the plan typically is:  1 day of intervals, 1 day of mid-distance sustained HR (60-80%),  and the rest is recovery (55-60%).
   3. Recovery.  The older we get the more we have to work on helping recovery to work well enough. 
      1. Use a 1-to-3 ratio.  For every 1 dose of high intensity, 3 does of recovery.  Dose = time exercising.
      2. “I’m as good once as I ever was”.  But get the recovery to avoid injury and/or catastrophe.
   4. Balance:  the key is to balance spirit, mind and body to uncover a healthier, happier longevity.  A good, balanced portion of:  physical activity, mental stimulation, rest and recovery, and enjoyment.