Background to the study:
As a Third year Health Science with Nutrition student from Athlone IT currently on work placement at True Fitness, I was extremely fortunate to be involved in the 6-week lifestyle intervention research study delivered by clinical exercise physiologist Dr. Diane Cooper, John Bolton and Nutritionist Ruth Kavanagh. The programme involved 24 inspiring participants over the age of 50 (50-75yrs) who had their own individual goals and targets. This program was not designed as an intensive weight loss intervention, it was a lifestyle and health education intervention. It comprised of two exercise sessions a week delivered by John as well as an education workshop which provided the women with a spectrum of knowledge in relation to nutrition, physical activity and their health. There was also a great social aspect to each of the sessions as the support among the group of women was phenomenal for each other, as they encouraged one another along the way.
Benefits on health and wellness:
Although there were fantastic physical changes among the women in relation to body measurements and circumferences, for me I noticed the greatest affect in the women’s moods. Each week I saw such confidence develop among the women and happiness in themselves. There were weeks where some of the women were slightly disheartened and frustrated because they hadn’t lost the pounds they had hoped to and worked for however these weeks were outweighed by the immense success of each of the participants who took everything on board in terms of their nutrition and physical activity.
Traditionally the women expressed that they measured success of lifestyle change with weight loss, but the education sessions taught them about the importance of improvements in body composition which can often negate weight loss.
Understanding the science of these adaptations to lifestyle intervention was a real game changer for the women. As the end of the six weeks has approached, I feel a great sense of pride and admiration for these women and have no doubt that they will continue to be a credit to themselves and a role model for their families in the future.
Physical activity benefits:
Personally, I have also become more aware of the process of ageing and have more of an appreciation for how lifestyle choices can have a serious influence on how it occurs. As we get older it becomes even more important for us to stay active to maintain our health and independence. That is why physical activity is so important, which involves anything that gets your body moving. Over the last few weeks I have been in contact with the women weekly where they have informed me of their physical activity patterns. Some of the women have answered the phone while out walking, gardening, and cleaning windows all contributing to their recommended weekly physical activity targets. Many people are aware of the effects of ageing as it influences all the body’s systems. In relation to the musculoskeletal system the density of bones begins to diminish in men and women in their thirties, however the loss of bone density is accelerated in women because of menopause. Physical activity increases bone mass and strength as well as reducing the risk of falls. On completion of the 6 weeks, physical activity has had a significant role in the success of the study.
Looking at the pre and post results although there has been a reduction in % body fat there has been a significant increase in muscle mass of the women, it is so important to replace or maintain muscle mass as we age to ensure we are able to perform activities of daily living and to avoid weakness and fatigue. Often exercise is seen as a task or a hinderance, I never heard any complaints from these women as they were delighted informing me of their minutes spent exercising. It was obvious there was particular enjoyment from the TRX sessions by the women, which involves a full body work out focusing on strength and is excellent for flexibility, balance and coordination. Showing that although such an exercise will get the heart pounding it can also be really enjoyable and fun.
Blood test analysis and effects of the intervention:
Prior to commencement of the study each of the participants were assessed in terms of their body weight and measurements, including % body fat and lean muscle mass as well as fasting blood tests to determine glucose levels in the blood and cholesterol levels. This provided a good indication of the health status of each of the women. The best way to prevent cardiovascular disease is to keep your cholesterol at a healthy level. Cholesterol is a type of fat found in our blood of which a certain amount is required to produce hormones. As described in the workshops by Diane there are two types of cholesterol known as HDL -high-density lipoprotein (the good) and LDL -low-density lipoprotein (the bad). LDL cholesterol is considered bad, as it can lead to the development of atherosclerosis which involves the build of fat within the arteries. The blockage of an artery with plaque can result in a heart attack if the plaque ruptures. If an artery to the brain becomes blocked it could possibly lead to a stroke. Consuming foods that are high in saturated fat for example; red meat, cheese and processed meat products can cause an increase of the LDL cholesterol. Foods which are recommended for a healthy heart include; leafy green vegetables, oily fish, avocados and wholegrains.
Unfortunately, Cardiovascular diseases accounts for the greatest contributor to death for both men and women in Ireland. Healthy lifestyle habits, which the women in this study have adapted can greatly reduce the risk of these diseases. HDL cholesterol is known as the good kind as its job involves collecting the cholesterol left behind in the arteries, bringing it to the liver to be broken down and removed from the body. Regular exercise and physical activity have been shown to significantly increase HDL levels. There are ways in which nutrition can help increase the HDL levels; olive oil has been shown to reduce heart disease risk by containing the antioxidant polyphenol which increases HDL levels, avocados are an excellent source of monounsaturated fatty acids which also increases HDL levels and lowers LDL levels. The educational workshops enabled the participants to gain a better understanding of cholesterol and its effect on the body, they learned the importance of “knowing their numbers” in regard to total cholesterol, triglycerides, HDL and LDL cholesterol. Their numbers should show a total cholesterol level of no more than 5 mmol/l including an LDL level no ore than 3 mmol/l, a HDL level more than 1 mmol/l and triglycerides no more than 1.7mmol/l.
Understanding Nutrition and Blood glucose levels:
Blood glucose levels are also very important to consider and should be between 3.5 and 5.7 mmol/l. People who are overweight, particularly people who have abdominal obesity, can be insulin resistance, which is a condition where they produce insulin, but it is not sufficient to keep their blood sugar levels in the normal healthy ranges. Over time this may lead to the development type 2 diabetes among individuals. Some of the pre-intervention blood sugar results were in the pre diabetic range. After the intervention the blood sugars were completely normalised. The results represent the level of knowledge developed in terms of the participants nutrition and how they made healthy changes. Initially some of the changes were significant for some of the women, for example correct portion sizes shocked them and the recommend 6-8 glasses of water was daunting. However, as the weeks went by everyone seemed a lot more relaxed and settled into a routine. Questionnaires were provided to the women prior to starting the programme and on completion, the level of nutrition knowledge pre-intervention varied however the workshops have provided a great detail of knowledge and understanding of healthy eating and living overall by empowering the women to make good choices by simply choosing one food product over another based-on understanding what is exactly on a food label.
I have taken a lot from the last few weeks and am so grateful to have witnessed such dedication and achievements among the women. The level of enthusiasm among the True Fitness team is something else, while demonstrating expertise it is also clear they have great satisfaction in changing people’s lives.