Embracing the Unpredictable: Navigating Health Scares and Prioritizing Wellness in Midlife

By the time we've reached midlife, we've most likely experienced a health crisis, either ours or someone’s very close to us, and lost people we’ve known well and loved.

Yet, no matter where we are on the health continuum, a crisis is always a shock, especially if it’s our own

The reality is modifiable risk factors are largely responsible for the leading causes of death. And many of the risk factors are preventable years and even decades before a diagnosis. There is a LOT of research (and a lot of speculation) about how to delay the onset of disease by engaging in healthy habits. However, many people feel their risk is more due to aging than how they choose to live.

The common perception of an inevitable decline and marginal health towards the end of life is evolving and, in our opinion, is outdated! We talk about the 'how tos' for living longer and better as we age at Rumblings.  

As a registered and licensed dietitian and an exercise physiologist, we practice what we recommend to others. We're on this aging journey too. Our aim has always been to distill the science into understandable and actionable recommendations to help you improve your aging journey. We want to help women differentiate between personal health recommendations (e.g., I lost weight; therefore, I am an expert), beliefs of self-professed wellness experts (e.g., I took a 30-hour class to get a coaching certificate), and true research-based recommendations to cut through the confusion, improve health, and prevent risk factors for disease.

We're not perfect. I (Karyn) secretly love salty chips and crackers and love cheese. But I enjoy them in moderation. We're focused on creating a strategy and plan for our health and prioritizing behaviors necessary to increase our health span. 

Our intent is not only to delay death but to push off disease from the so-called four Horsemen (cancer, cardiovascular disease, metabolic dysfunction, neurodegenerative declines) and improve the quality of our lives as we age. Who doesn’t want to feel great, move pain-free, and engage fully in life until we die?

I was recently reminded, however, that all the awareness, diligence, and healthy habits in the world don't make us immune to experiencing health scares. A few months ago, I was flagged for having an abnormality in my blood via a screening done to donate plasma. It was a fluke because this serum protein electrophoresis (SPEP) is not typically done as part of a routine exam in the United States.

I felt great, and all my typical wellness checks – and a few additional tests I requested – had been at optimal levels for health. Although I'm not thin, I require no regular medications. After completing several other tests, including a CT scan and bone marrow biopsy (sedation during the procedure made it pain-free), I was determined to have monoclonal gammopathy of undetermined significance (MGUS for short), a precursor for multiple myeloma. 

Multiple myeloma is terminal cancer with no treatment, and the standard treatment is to treat the effects of cancer. These effects are often the first indication an individual might have this type of cancer. Multiple myeloma is one of the rarer cancers, with no modifiable risk factors other than possibly obesity, but the number of individuals with the diagnosis is increasing worldwide.

As someone who is a “worried well” individual, there is a processing and reckoning required to accept that, occasionally, our health is out of our control. There is no lifestyle behavior to be modified, no treatment or pharmacological intervention to improve the situation, and nothing that could have prevented this from happening to me. It wasn't easy to grapple with.  

Confirmation that I have MGUS, a precursor, and not cancer, was a huge relief. I may never progress into multiple myeloma, but thankfully, I now have the baseline of all of my measures from my test results and can monitor any progression along the continuum of conditions that are precursors to multiple myeloma.

It was also a good reminder that as pristine as we may be with our health, there are some things over which we have no control. Rather than let it all go and live la vida loca, I have re-evaluated my approach to my health and wellness. I want to share it; in case it might be helpful for anyone else who finds themselves in a similar situation.

I have changed my mindset to think about my lifestyle behaviors as self-care. Good health is not only the absence and prevention of disease but also about building a 'reserve' of good health in case I get sick. 

Here is what that means for me and links to previous blog posts if you want to understand a topic further.

- I engage in exercise and physical fitness that feels like play, but I also choose activities that allow me to spend time in nature. I've always found joy in moving my body because I can – no matter what that looks like at any given moment. 

- I eat healthfully, including choosing plants, hitting protein targets, monitoring calorie intake, and focusing on whole foods.

- I limit alcohol consumption. Research suggests there may be no healthy intake levels for some individuals, and consuming too much may increase cancer risk.

- I am  extra vigilant with scheduling and staying current with my preventive exams and screenings

- I'm encouraging all my midlife friends (especially all of you) to ask their providers to include a SPEP or CBC test as part of their routine blood work at their next preventive exam.

- I got a bone density exam. The results provide information beyond just understanding the risk for osteoporosis. One of the initial signs of multiple myeloma for many people is vertebral compression fractures. This situation is exacerbated if your bone density is less than optimal.

This is my list based on my current health status. I encourage you to renew your focus on joy and vitality, whatever that looks like for you. Health is more than your test results and screening numbers. It's about creating memories with those you love and experiencing the joy of being healthy to live it as fully as possible.

Too often, as we age, we look to the past without recognizing that the best way to stay young is to look toward the future. 

A wise friend once told me that time is short and the world is big. There are dreams I've yet to finish, and many I still need to start living. My spirit is young, and I want to put in the effort to make sure my body stays young, even as I age.

Here's to life! Such a gift I will not waste.

You can find out more about multiple myeloma and its precursors here.

The Health Condition Almost Everyone Has But No One is Talking About

There is great interest in enhancing healthspan - improving the quality of life to be free from the disability and disease that occurs during most people's last 16 years of life. For most of us, our vision for the future includes living vibrantly, independently, and joyfully until the end of our lives. 

The good news is you can achieve optimal health and flourish as you age, but you must understand the reality of health in our country and take action today!

Some research about achieving optimal health during aging is undeniable, such as the link between exercise and all-cause mortality. In other areas, the research is still in the early stage, with the results seen only in mice, and the enthusiasm is ahead of the science. 

What we do know is Americans are getting sicker. The healthcare system focuses on treating disease rather than keeping us healthy because it is structured to provide greater incentives for treatment rather than preventing or slowing the progression of the disease. 

What You Need to Know 

For non-smokers, 80 percent of the deaths are from four diseases: 

1. Heart and Vascular Disease: Examples are stroke, heart attacks, atherosclerosis, and Transischemic Attacks

2. Cancer - obesity and metabolic syndrome are the leading cause of cancer, second only to smoking 

3. Neurodegeneration: Diseases where the cells of the central nervous system stop working properly or die. Examples are Alzheimer’s Disease, Parkinson’s, and ALS

4. Metabolic Dysfunction: Examples are Type 2 Diabetes, insulin resistance, metabolic syndrome/pre-diabetes, and mitochondrial dysfunctions (how the cells regenerate). Recent research indicates that Alzheimer’s Disease should be considered to be Type 3 Diabetes that affects brain function.

The foundation of all these diseases is metabolic health, which, if not optimized, increases the risk of metabolic dysfunction diseases and other primary conditions. 

There are many ways to define metabolic health, but a simple explanation relates to how well the body can generate and process energy from food. Glucose is the precursor to energy creation throughout the body, and when the body can’t use glucose properly, it leads to metabolic dysfunction. 

Good metabolic health is defined as having optimal levels for five biomarkers (without the assistance of medicine).

You have metabolic syndrome (also known as pre-Diabetes) if you are high in three or more of the following markers: 

• Abdominal or Truncal obesity - a waist measurement of 35 inches for women and 40 inches for men

• High blood pressure - Systolic >130 OR Diastolic >85

• High fasting glucose  - > 100 mg/dL

• High fasting triglycerides - >150 mg/dL

• Low HDL cholesterol - <50 mg/dL for women,

Unfortunately, 52% of Americans have been diagnosed with metabolic syndrome (pre-diabetes) or Type 2 Diabetes. And new research showed that only 6.8 percent of Americans had optimal metabolic health, and that percentage is declining. That means 93% of Americans are metabolically unhealthy, and the rest are at risk for developing almost every chronic condition. More importantly, most people don’t even know they’re at risk. 

These diseases slowly progress and are responsible for much of the disability and deteriorating health Americans see in the last decade of life. The impact is also felt way before the actual diagnosis of the disease. 

Up to 10 years before developing metabolic syndrome, a person starts to experience a disruption in metabolic health.  This disruption causes a change in the chain reactions of how different body parts signal to each other about how to do their job. When that happens, the body cannot function correctly in getting glucose out of the bloodstream to use it as fuel. 

The disruption affects the cellular functioning of the liver, brain, heart, kidneys, muscles, and even fat. This disruption over time is what leads to metabolic syndrome. 

The conversation about early prevention is missing from the mainstream discussion and is frequently not part of the discussion with primary care providers. 

It’s time to start managing biomarkers for optimal health long before we get metabolic syndrome.

What You Can Do To Manage Your Metabolic Health

You can do many things to improve this outlook, prevent chronic diseases, or push them closer to the end of life. The goal is to live without debilitating disabilities and poor health that may shorten your lifespan but may also shorten your healthspan and diminish your quality of life. 

Many years before you have elevated levels of key metabolic syndrome markers, your body is experiencing unhealthy metabolic function, and you don’t even know it. 

For unknown reasons, testing for hormone insulin levels in the blood is not part of a standard fasting testing panel ordered by health providers. Increasing blood insulin levels can be a very early indicator of metabolic health long before the potential impacts of metabolic dysfunction leading to metabolic syndrome and those other primary diseases causing 80% of deaths. 

A high insulin level indicates a lot of blood sugar or glucose floating around the system and not being used. Knowing your insulin level allows you to take action to stop the progression toward metabolic syndrome. Requesting a fasting insulin test in addition to the glucose and lipid panel tests your provider orders can help you take early action. 

However, you don’t need lab tests to take action now to maintain good metabolic health. While you can manage metabolic syndrome with pharmacological treatments, medication will not improve overall metabolic dysfunction, so maintaining good function is essential. You can do many things related to lifestyle to maintain good metabolic health. 

• Eat whole, unprocessed foods, mostly plants. Avoid fad diets and caloric restrictions as they may provide a downward spiral for your metabolic health. 

• Move more, sit less. Physical activity and exercise can have the most dramatic impact on being metabolically healthy. Improving lean body mass and muscular strength is key to improving metabolic health. 

Unfortunately, years of chronic caloric restriction diets combined with insufficient exercise focused on improving muscular strength may have put you in peril for metabolic dysfunction. 

Resistance training and strength training to gain muscle strength and lean body mass is the best exercise for healthy metabolic function. Yet, even something as simple as taking a brisk walk after meals can reduce your blood sugar elevation. 

Move more throughout the day rather than having one workout at the end of the day. It’s not enough to sit all day and do one small chunk of physical activity. Read more on how to get more physical activity in your day. 

• Get appropriate amounts of sleep. It’s good for your body and your brain. Read more on getting better sleep. 

• Manage stress in healthy ways. Chronic exposure to physical or psychological stress is linked to metabolic diseases, including obesity, cardiovascular disease, and Type 2 diabetes. Look for ways to help you manage stress and be calmer. 

• Manage light. Getting bright sunlight early in the day while limiting bright light and screen time later in the evening can alter your metabolism. Scientists found bright light exposure increased insulin uptake compared to dim light exposure in the morning. In the evening, bright light caused higher peak glucose (blood sugar) levels.

Metabolic dysfunction is the root cause of many chronic diseases experienced today. Most people aren’t even aware it exists. It should be part of the mainstream conversation when talking about health. 

The good news is most of your metabolic health is within your control with simple dietary, exercise, and lifestyle changes.

It’s never too late to start. Even the smallest step towards better health, such as going from being sedentary to being more physically active throughout the day, can considerably improve your metabolic health and overall well-being! 

Don’t wait. Start today. If you need support, join us at an upcoming Reignite virtual course. You’ll learn how to take action today and leave with your personalized plan for living well and flourishing.