Staying Active as You Age
Dr. Steven Montague shares why it's important to stay active and healthy as you age, different ways to stay motivated, the many physical and mental benefits of staying active, and how your provider can help build a plan with realistic goals.
Melanie Cole, MS (Host): We hear so much about the importance of staying active as we age and staying active for a good healthy weight, but there are so many other benefits. To tell us about those today is Dr. Steven Montague. He’s a concierge primary care physician at Evergreen Signature Care. Dr. Montague, what a great topic. Certainly in my wheelhouse and something I love to talk about. So we hear about this importance, but why is it even more important as we age, and what are some of these other benefits I mentioned.
Steven Montague D.O. (Guest): Well, thank you Melanie. That’s a great part of this topic. Of course, as for you being an exercise physiologist I'm equally excited about this. The thing is is if I were to compile a top 10 list of the reasons why you want to stay active as you age, I would put weight loss towards the bottom. It wouldn’t even make the top five because there's so many other very important benefits to staying active. Multiple studies have confirmed that if you take a group of older people and you break them down into the exercisers and the non-exercisers and you study them over a say 10 year period, all-cause mortality is decreased in that group of exercisers. That means that death by all causes is less in the exercising group than in the non-exercising group. Not to mention the risk of decreased cardiovascular disease, stroke, and certain kinds of cancers such as breast and colon and lung cancer. So there's a lot of good reasons other than maintain a healthy weight to exercise as you age.
Host: Well, I couldn’t have said it better myself. As you pointed out, there are so many benefits. How do you help your patients Dr. Montague? What tips and ideas? People are probably always asking you for motivational ideas. How can I get started? How can I keep motivated? That seems to be the hardest thing for everyone.
Dr. Montague: Well, it certainly is. Yes. Probably the first thing I usually share with them, Melanie, is that of all the people that begin exercising and stay exercising, about 75% of those people do it at the beginning of their day. That’s often times the last part of our day where we have control. You go on about your day, and then often times you're at the beck and call of other people. If you're still working, you go to work and then you completely lose control of your day. So for people who I want to continue exercising, I say start out by doing it at the beginning of your day when you still have control.
Host: I agree with you 100%. The dropout rate later in the day is so much more. So give us some more of them.
Dr. Montague: Well, so then at that point we try to personalize this. It’s important to try to find out what motivates a given person. It might be that maybe they want to try and keep up with their grandkids. They want to have the endurance that’s required to take their kids to Disneyland or go for a walk in the park or just even pickup grandchildren. What motivates them? Often times people really enjoy music. With me as a former musician, I'm always listening to music when I'm exercising. The other thing is all these books on tape now. You can just learn so much and kind of multitask as you listen to books on tape while you exercise. Oftentimes people enjoy listening to newscast. Do it while you're exercising. Certainly if you're doing cardiovascular work and you're going for a walk on the trail or you're on a treadmill or whatever, it’s really easy to be listening to a book or listening to a newscast or just enjoying great music. Other people enjoy getting out in nature and that’s the thing that really turns them on to exercise and keeps them going.
I find rewards are very helpful. Even older people are basically just big kids. Having that kind of reward really helps perpetuate the whole exercise thing. Sometimes it can be just minor rewards. I was talking to a lady who we were trying to get her to exercise. Finally she just on her own found this Fitbit. Every once in a while if she walked for a certain amount of steps, the Fitbit would tell her say, for instance, that she’s cross the Sahara Dessert or whatever. The number of steps she’d taken would be enough to get her across the Sahara. Now five years later she’s walked around the world actually because she gets these little messages from her Fitbit of these little reward messages of how far she’s walked and how well she’s done with her exercise program. Some people, they can buy themselves little treats. It might be a new book or a new piece of music or meet a certain goal and go on a trip with the family. There are lots of things you can do. Kind of in some ways you’ve got to reward yourself like you reward a child with a spoonful of sugar to help the medicine go down.
The other thing, of course, is hopefully the medicine is not bad to begin with. You find a good form of exercise that you really enjoy. It might be swimming, or it might be hiking, or it might be dancing. In our concierge practice, we try to do things to encourage our patients to exercise. We have a full time yoga teacher on staff. She teaches two yoga classes for our patients. We have a health and wellness coach who has masters level training in both exercise physiology and nutrition so she can help. I just found out she was actually on the ballroom dance team in college. So now we’re doing some ballroom classes for our patients just to get them active. The other thing we do to just keep them going—and any medical practice can do this—is once a month we just have this walk with your doc thing where anybody who wants to can come and meet me and my partner and we just go for a half hour walk. It could be on a trail; it could be anything. Just encouraging people to get up and get moving. As we all know, sitting is the new smoking. So we’re trying to get people up and moving.
Host: How wonderful. Everything that you said, I couldn’t agree more. I love books on tape. That’s a fantastic way to keep walking. Really you just get immersed in a book—like Harry Potter is amazing—and you can walk for so long. I also love walk with a doc because that does give your patients that chance to walk with you and converse. What a great program that you've got going Dr. Montague. So besides exercise, because we hear about nutrition, supplements, all of these things, what about the importance of social interaction? As people age, they can get lonely. Kids move away. Grandkids live far. In this day and age, there's Facebook and Instagram and all these things. Do we get the same benefit from those social interactions online?
Dr. Montague: I wish I could give you some research to give you a definitive answer on that and I can't. So I have to preface this by saying what I'm about to say probably I couldn’t give you scientific backup for. My personal opinion after 27 years of practice is that it’s not the same. You lose a lot when you're looking at someone’s Facebook posts. First of all, it’s not in real time. Second of all, it’s tough to get all the inflections. When you and I talk, at least I can pick up on the tone of your voice and I can get added meaning by what you say and the pregnant pauses between words and all those kinds of things. If we’re talking face to face, I get even a ton more information about how I think you're feeling and how I feel you're thinking about certain things. I can look at your facial expressions. You just don’t get that with social media. I think it’s a poor substitute for socialization.
Socialization, of course, is another good—I don’t want to beat a dead horse here—but another way to get back to motivation. Some people really like to do their exercise in groups. You can get the benefit of that socialization as well as your exercise when you find a team of people that exercise together. The whole idea of getting that social contact has been shown time and time again to correlate with reduced risk of dementia and especially Alzheimer’s type dementia and cognitive decline. So I think it’s important to have that social interaction. I'm not totally sure that you're going to get the kind of social interaction you need if you just rely on social media. Now, of course, social media has it’s benefits. I would also encourage my patients to have face to face time with another human being because I don’t think there's any replacement for that.
Host: Oh, I couldn’t agree more. It does give you a little added—Like you pay attention to somebody who maybe you haven’t seen in a long time. It does give that especially if you're a distance. But you're right. Face to face time makes so much more of a distance. If you could give your patients listening and the community at large your best piece of advice on steps that people can take today, what they can do right now, and to working with their provider to set those smart goals and to get going with exercise, and to take a look at what they're eating and how they're eating. All of these things—and it can be very confusing for listeners Dr. Montague. If you could really give them one best piece of your best advice, what would that be?
Dr. Montague: Well that’s difficult because as you know, this is a big subject. I tell my patients with regards to exercise—If I could hone it down to one thing I guess I would say five minutes is better than zero minutes. Don’t you agree? I mean you as an exercise physiologist, I mean getting out and just get five minutes of a walk or five minutes on the treadmill or the stationary bike, that’s better than zero minutes. It’s funny. I told that to somebody the other day and they said, “Woah, I never thought of that.” It’s like they're operating on this base two system whether it’s either off or on, all or nothing. That’s not the case. You just go out and get started. Pretty soon five minutes turns into seven and seven turns into ten. Then you start to feel stronger. You get not a vicious cycle, but a virtuous cycle going where rewards builds confidence builds more success builds more rewards and you spiral upward instead of downward.
Host: Wow do I love that. Virtuous. What a great way to end this excellent segment. Dr. Montague, thank you so much for coming on and discussing this with us and giving such real usable tips that we can all get started today. Thank you again. That wraps up this episode of check up chat with Evergreen Health. Head on over to our website at evergreenhealthsignaturecare.com for more information and to get connected with one of your providers or even to do the walk with doc program because that is such a great way to connect with your provider. If you found this podcast as cool as I did, as fun to listen to, share it with your friends and your family. Share on social media because that way we’re all learning together and that way we can all get motivated and get moving together. Until next time, I'm Melanie Cole.