Florida Trend Web Jan 2014 : Page 46
Executive Health and Wellness By Cindy Krischer Goodman 40s Your Your Decade Decade by Health concerns change as patients get older. Doctors at executive health programs in Florida recommend taking specific actions during your 40s, 50s, 60s and 70s. 46 JANUARY 2014 FLORIDATREND.COM 50s 60s Your Your 70s
Executive Health: Decade By Decade
Cindy Krischer Goodman
Health concerns change as patients get older. Doctors at executive health programs in Florida recommend taking specific actions during your 40s, 50s, 60s and 70s.
Executive Health programs throughout Florida encourage individuals to become proactive about their health and provide strategies for taking charge of wellness. Most programs tailor evaluations to an individual’s age, gender, family history, personal history and other risk factors. Following are some issues that are particularly important to monitor at specific times of life.
Physicians say the 40s are critical for laying the groundwork for your personal health later in life. This is the time when weight loss becomes more difficult and diet more essential. During health examinations, doctors will key in on lifestyle, eating habits, exercise and sleep routines.
“This is the age that people are climbing the corporate ladder and adopting lifestyles that stick with them as they get older,” says Dr. Mark Moon, medical director at Mayo Clinic’s Executive Health Program in Jacksonville. “We’re going to talk to them about the importance of exercise and adequate sleep and living a balanced life because the cumulative effects of neglect only get worse with time.”
The 40s are about prevention, says Dr. Henrique Kallas, medical director at UF Health’s Douglas Williams Executive Health Program in Gainesville. “We’re going to encourage you to eat more healthy sources of protein, avoid too many sweets, do some aerobic exercise three times a week and resistance exercise twice a week,” Kallas says. “We also recommend stretching regularly for flexibility and posture.”
Executives also should learn their full family medical histories to help doctors detect conditions that can be hereditary, like heart disease and cancer. Celebration Health Florida Hospital conducts genomic testing using a saliva collection kit; results can identify inherited conditions and help manage medication and reduce health risks, including some cancers and heart conditions, that result from hereditary factors. Kallas suggests having your metabolism checked: “Your metabolism does slow each decade so caloric intake will need to decrease gradually over time in combination with exercise.”
Executives already experiencing a high level of stress in their 40s will need to devise an exercise routine that fits their lifestyle, says Dr. James Rippe, founder and director of Rippe Lifestyle Institute and professor of biomedical sciences at the University of Central Florida in Orlando. “Exercise is one of the most potent anti-stress tools. I recommend at least 30 minutes of moderate intensity on most days. It really doesn’t need to be anything more than brisk walking.”
Certain tests are recommended as the body changes. Physicians feel this is when men should have their testosterone level tested because it may start to dip. For women, it is the age when they should begin to have mammograms. Along with those tests, consider an eye exam. “Sometime in your mid-40s, your eye muscles that focus start to give in and get weaker. You may start to lose your ability to read up close,” says Dr. Richard Awdeh, a cornea and refractive surgeon at Bascom Palmer Eye Institute in Miami.
Treat Symptoms Now
This is the decade to hone in on any medical issues and treat them before they worsen because the risk for many health problems increases with age. ”You need to pay more attention to signs you have blown off before,” says Dr. Eudene Harry of Oasis Wellness and Rejuvenation Center in Orlando. “If you meant to make a change in your 40s and didn’t get around to it, this is when you could see the physical manifestation of it.”
Physicians advise having a colonoscopy, a CT scan of the lungs (for smokers), a screening for prostate cancer and a bone density scan. “With bone density, you want to establish a good baseline in your 50s, particularly if you are someone who has risk factors,” Kallas says. Rippe often gives his patients at the Rippe Lifestyle Institute in Orlando a high speed CT scan of the coronary arteries. “We are looking to see if there is calcium in the arteries for anyone who is smoker or former smoker. It can help detect lung cancer early,” Rippe says.
Dr. Dario Pancorbo, medical director for Baptist Outpatient Services’ Executive Health and Wellness program in Miami, says the 50s are when his patients begin to realize they may have symptoms of diseases that need to be treated. “It is the time when mildly uncontrolled cholesterol becomes coronary disease and when mildly uncontrolled sugar levels become diabetes,” he says. “It’s also the time when patients have to go on medication to control those illnesses.”
Pancorbo finds patients often need to change their diets in their 50s, when the reality of a slowing metabolism and high stress lead to increased body fat and lower energy levels. “We recommend meeting with a nutritionist and having a customized diet that works for you.”
In scrutinizing calorie intake, consider drinking alcohol in moderation only, Moon at Mayo Clinic advises. “This is one area where executives can make headway in cutting calories. Oftentimes when conducting business over dinner or attending functions, you might have a glass of wine or cocktail or two and that adds up. Those are empty calories. If you want to slow down weight gain and cut calories, alcohol is a great place to start.”
Women may experience hormonal imbalance as a result of menopause in their 50s and some may need hormone supplementation to help bring their bodies back into balance.
Appreciation or Regret?
Kallas at UF Health says the 60s are when he sees the toll of an executive lifestyle on his patients’ health. Orthopedic concerns are an example; some patients who didn’t stay fit earlier in life want to make up for lost opportunity, but they can’t because they are in pain with their hips or knees or back, he says.
About a third of people have insufficient vitamin D by the time they reach their 60s, which is important to remedy because it may play a role in fighting cancer, diabetes and heart disease.
At this age, doctors recommend a memory screening and a gait and balance assessment. “If we find a problem, we would refer you to a physical therapist or trainer,” Kallas says.
Because thinning of the bones occurs in the 60s, Kallas recommends both women and men get a measure of bone density. The bones that are most commonly tested are located in the spine, hip and forearm; a screening would determine if you have osteoporosis — a disease that causes bones to become fragile and more likely to break.
Physicians also advised paying close attention to blood pressure. If high, it could put you at risk of a heart attack.
During the last decade, the number of Americans with high blood pressure has increased by 30%. According to the Centers for Disease Control, only half of people with high blood pressure have their condition under control. Age is a major risk factor of hypertension. Rippe notes that blood pressure increases with age in both men and women and more than half of Americans over age 60 have hypertension. “What you do in your daily life can help. You can lose weight, get regular exercise, lower your salt intake and increase your potassium. But you still may need to be on medication.”
One of the complications of high blood pressure is sleep apnea, a disorder in which breathing halts briefly but repeatedly during sleep. If a patient is getting less than seven hours of sleep, awakening during the night or rising in the morning feeling fatigued, Moon recommends he or she see a sleep specialist. “Getting too little sleep can increase your risk for certain health problems,” he says.
Eye health becomes even more necessary in the 60s, Awdeh says. Now is the time to get examined for cataracts, particularly in Florida because UV rays accelerate cataract growth, he says. If you need surgery, you will find the treatment has become advanced, he says. “The precision of the laser has improved. It can eliminate astigmatism (blurred vision from the irregular shape of the cornea) and give you excellent vision after surgery,” says Awdeh. Getting a hearing screening is a good idea, too.
If you have made some unhealthy lifestyle choices in prior decades, now it becomes even more important to take care of not only your physical health, but also your mental and emotional health. Dr. Harry at Oasis Wellness and Rejuvenation Center in Orlando says professionals’ risk of anxiety and depression starts escalating in their 60s. “We are more prone to mood disorders so it becomes important to make sure you have social interaction. Executives have a way of isolating themselves when they are busy with work.”
Physicians say those who are engaged in their jobs tend to be in good shape. “Often, they enjoy their work and are fulfilled by what they do,” Moon says.
In the 70s, executives likely will notice changes in their energy levels, body shapes and ability to resist and control infections. Doctors recommend annual flu shots, more careful attention to preventive screenings, regular vision and hearing exams and at least 30 minutes of exercise a day.
Intake and Output
Nutritional consideration and exercise play a bigger role as you age.
Today, a number of executive health programs include a nutritional analysis, and even those that don’t recommend an analysis encourage meeting with a nutritionist or dietician, along with getting an evaluation of eating and exercise behaviors. Often, busy executives, particularly those who travel, tend to eat quick meals and fatty foods. They prioritize work over fitness.
As you move into your 40s, your metabolism slows. That means eating and exercise habits need to change. “Most men and women start to see it above the belt,” says Sheah Rarback, director of nutrition at the UM Health’s Mailman Center for Child Development. “Indulging in foods you could handle in your 20s and 30s is not going to work anymore. If someone hasn’t been eating fish twice a week, it’s a good time to start doing that,” Rarback says. She also suggests eating fewer sugary treats, having one less cocktail and resisting the office doughnuts.
There are other things to consider. When nutritionist Kathryn Parker meets with professionals who participate in the University of Florida’s executive health program, she encourages them to examine their drinking habits. “Water is the most important nutrient no matter how old you are or what you do for a living,” says Parker, who also is a program manager for diabetes education at UF Health. “I tell my clients, don’t be thirsty. If you’re thirsty, you’re 2% dehydrated.”
The 50s, Rarback says, is the age when people start having heart issues.
She suggests increasing B vitamins. “This would include consuming beans, fruits such as cantaloupe, oranges and papaya and vegetables such as dark leafy greens.” Rarback encourages setting a goal of five servings of fruit and vegetables a day.
Another concern is cholesterol levels often start creeping up. Rarback advises increasing the amount of whole grains, oats, lentils and beans — “you can throw them into a salad.” She also recommends increase vitamin D through foods like fish or shitake mushrooms. “Vitamin D is particularly important for women because of bone health,” she says.
The 60s also present a greater risk of high blood pressure and diabetes. By this age, you need to know how to read food labels, she says. Nutritionists encourage people in their 60s to double efforts to cut back on foods high in sodium and sugar.
In May, the Institute of Medicine concluded that Americans typically consume an average of about 3,400 milligrams of sodium a day and should reduce that to 2,300 to minimize cardiovascular risks. Nutritionists recommend cutting back on processed foods and replacing salt with other spices that give flavor and have health benefits. “There are spices such as turmeric that are great anti-inflammatories and add flavor,” Rarback says.
In your 60s, your skin starts to thin, making bruising more noticeable. To help, Rarback advises consuming more foods with vitamin K such as dark greens.
Dr. James Rippe, founder and director of Rippe Lifestyle Institute in Orlando, believes the top nutritional problem Americans grapple with is overconsumption. When patients come for a physical exam at his executive health program, he asks them to arrive with a three-day food diary. “That helps us give the patient specific advice.”
The one thing that changes between the 40s, 50s, 60s is people become less active, Rippe says. “That means you need to pay more attention to nutrition and what you are eating.”
The Look of Success
New techniques allow for quick turn-around times.
When an executive walks in for a consultation for a cosmetic treatment, Miami dermatologist Joely Kaufman knows that he or she usually has the same requirement — minimal downtime.
Fortunately, new procedures available today allow Kaufman to accommodate that request more often. “There are treatments we can do at end of day and they can return to their offices the next morning. That’s the executive approach,” Kaufman says.
Youth-enhancing cosmetic treatments and aesthetic procedures are seen as a career investment. It’s rare that Florida’s executive health programs include consultation with a cosmetic surgeon or dermatologist. However, most will refer patients if they request it.
The most popular in-office procedures without major surgery include laser treatments, Botox, fillers and cool sculpting. Florida’s specialists say they are accessing the continual stream of new tools, FDA approvals and treatments that reduce bruising, improve results and give them new options for better outcomes to enhance appearance.
One of the most requested new procedures is mini-fractional laser treatments. “These are lighter versions of the heavy office procedures for pigment, wrinkles, skin texture, tone and acne stain removal. By doing a lighter version more frequently (three treatments, a month apart), you can reduce pore size, fine lines and make skin glow without undergoing an intensive procedure,” Kaufman explains: “The advantage is that patients can return to work 30 minutes to an hour later.”
For deeper wrinkles, though,professionals are turning to fillers and Botox.
Carlos Wolf, a Miami facial plastic surgeon, says he uses fillers such as Juvederm Voluma and Restylane to replenish volume in the face. “Often CEOs work hard. They are doing exercise, but they still look older and tired. I use filler to address that.”
Botox remains the top requested procedure, specialists say. Most commonly, the dermatologist or plastic surgeon injects it in areas of the face and neck to reduce wrinkles, create a more defined jaw line or lift the forehead or brows. To tighten skin on the abdomen or arms, professionals may use Thermage, a skin-tightening procedure done in the office. And to eliminate muffin top, belly fat or love handles, Wolf says, cool sculpting doesn’t involve major surgery. That procedure also is done in the office with little down time.
The increased interest from executives in minimal downtime has sparked one of the newer advancements — ingestible skin care supplements. They are Prescribed in combination with aesthetic treatments or surgery to speed recovery and improve results, says Corina Crysler, executive director for GliSODin Skin Nutrients, a line of six cosmetic nutrition products. “They help with swelling and inflammation and encourage the production of collagen so the patients see the results of Botox, fillers and other treatments faster,” Crysler says.
There are still options for elective surgery to achieve permanent changes. Wolf says he has seen more male executives who want to get rid of the bags under their eyes. “That’s surgery with seven to eight days down time,” he says. He also finds executives asking for liposuction, rhinoplasty and facelifts.
Experts urge those considering procedures to choose a medical professional carefully. “It’s not the medicine that creates risk; it’s who is injecting it,” Wolf says. “It’s important to know the credentials of who is doing the treatment and to know when it is or is not going to be effective for what you want to achieve.”