In the beginning of the new year, I do two important things in my practice. First, I ask every patient, “What intentional or inspirational word do you want to embody more of in the year ahead?” It must be one word. I write it down in my electronic medical record and throughout the year, I ask patients, “How’s that word going?” In 2023, most patients chose words related to wanting less stress.
Second, I create a patient challenge. For example, in 2023 I challenged all my patients to gain 3 lbs. of muscle. To get started, I invited patients to do an in-office body composition analysis. I know exactly where they started out regarding lean muscle mass and fat mass. Having an annual challenge keeps me focused on my conversation with patients. Reasons I want patients to gain muscle mass include:
Maintain Functional Independence: As we age, muscle is like gold. Muscle strength is crucial for performing everyday activities such as walking, climbing stairs, carrying groceries, and getting up from a chair. I say to patients, “I want to extend your middle age as long as we can. Building muscle mass will help you remain self-sufficient and reduce the risk of falls and injuries.” I am still a proponent of blood flow restriction bands during workouts to help patients build more muscle.
Metabolism and Weight Management: Muscle tissue is metabolically active and burns more calories at rest than fat. As people age, their metabolism tends to slow down, and they may find it easier to gain weight or lose muscle mass. This topic alone has given me many opportunities to write exercise programs and/or assist with weight-loss management. I talk a lot about various diets such as the Ketogenic diet and the Mediterranean diet, along with intermittent fasting.
Bone Health: I’ve advised many patients to get a DEXA and get ahead of or improve osteoporosis. Most patients seem to choose resistance training to build muscle, which also stimulates bone growth and density. The bare minimum exercise for bone health I’ve asked patients to do is simply jump and down 20 times daily. I’ve also talked a lot about nutritional bone health.
Disease Prevention: I get to help many patients with chronic diseases, such as type 2 diabetes and cardiovascular disease. The muscle-building activities they choose has positive effects on blood-sugar control, blood pressure, and cholesterol levels.
Improved Quality of Life: My greatest joy in the 2023 muscle building challenge was seeing the enhancements in physical fitness, energy levels, and mood, and the overall sense of accomplishment.
Pick Your Patient Challenges
I had a hard time deciding my 2024 challenges for my patients, but I finally narrowed it down to becoming an expert in managing your stress; and achieving as much ROM as possible. I guess you’ll have to wait for later in the year to ask me what I went with; or go to my website and see my latest newsletter.
No matter which way I go, I will ask patients to test themselves with some type of benchmark for the 2024 challenge. Here are a few of the challenges I’ve done in past years that you may want to suggest to your patients:
The “Walking Speed Challenge”
Ask your patients, “How fast do you walk per minute?” and “How fast is fast enough?” About 100 steps per minute might be a reasonable goal. Remember, counting steps in one minute is just the test. I don’t expect the entire walk to be this fast. If patients are already at that goal, I challenge them to get 10 more steps in per minute; then add another 10 steps up to 130 steps per minute.
Researchers have found that what constitutes brisk or moderate walking is consistent across studies: about 100 steps per minute (or about 2.7 miles per hour). From here, I am able to transition many patients into short running sprints for improved VO2max.
The “Hand-Grip Strength Challenge”
Challenge patients to see how long they can hold a chin-up position or how far they can walk around with a heavy kettlebell or a pair of heavy dumbbells. Researchers conducted a study including data from 143,143 individuals ages 35-70 years old. Hand grip strength was measured using a handheld dynamometer and the study found that lower hand grip strength was associated with an increased risk of all-cause mortality, as well as mortality from cardiovascular disease and respiratory disease.
Specifically, each 5-kilogram decrease in hand grip strength was associated with a 16% increased risk of all-cause mortality and a 22% increased risk of cardiovascular disease mortality. This challenge is simple and cost-effective all by itself.
The “Deep Breath Challenge”
This is an invitation to challenge patients to hold their breath for a longer duration than they typically can. Here’s how patients can take on the challenge:
The health benefit is improved lung capacity, allowing your patient to take in more oxygen with each breath. This becomes part of a stress reduction recommendation because breath-holding challenges can promote relaxation by engaging the parasympathetic nervous system. Deep, controlled breathing techniques can reduce stress and anxiety levels, enhancing overall mental well-being. Breath holding also strengthens your respiratory muscles, helps maintain healthy lungs and reduces the risk of respiratory conditions.
By training your body to use oxygen more efficiently, you can increase your overall energy levels and improve cognitive function. A daily practice of breath-holding encourages mindfulness and fosters a deeper connection with your breath. This heightened awareness can be applied to mindfulness and meditation practices.
All of my challenges are fun and motivating, and can make health improvement more engaging and enjoyable. I take the responsibility of being a biohacking, fitness, exercise, and nutrition adviser, especially now for my aging individuals.
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