Q. I am in my mid-fifties and for the first time in my life, I’m seeing signs of “middle-age spread”. Although I lead an active life, I have never exercised on a regular basis. Is it too late for exercise to make a difference?
A. Until recently, conventional wisdom dictated that the human body begins to deteriorate at around age forty-five and there was little to be done about it. It is true that, by about that time, there is a noticeable decline in muscles and an increase in body fat, and with each passing decade the average adult loses up to seven pounds of lean body mass. What is not known, however, is that this decline is not inevitable, and in fact, a rigorous exercise program can prevent or even reverse some of these changes.
We now know that at any age – from nine to ninety – exercise can make a real difference in how you look and feel. And there are solid studies that can prove this, such as the one performed by Dr. Maria Fiatarone at the Hebrew Rehabilitation Center for the Aged, a long-term care facility in Boston. Dr. Fiatarone developed a carefully planned strength training program to counteract muscle weakness for sedentary women and men in their eighties and nineties. Three days a week, for forty-five minutes at a time, the men and women in the study worked out with weights and on exercise training machines under close supervision.
At the end of ten weeks, Dr. Fiatarone found an average of 113 percent increase in muscle strength among the study’s participants. The exercisers also experienced a 12 percent increase in walking speed and a 28 percent increase in their stair climbing power. What I find particularly interesting is the fact that the people who participated in the study also began to take part in more of the recreational and educational activities offered at the home.
In sum, the exercise not only improved muscle mass and strength, but also had a profound impact on mobility and lifestyle. Think about it: if a ten-week strength training program can have such a dramatic effect on the bodies and minds of women and men in their eighties and nineties, just imagine what it can do for a woman in her fifties or sixties!
There are compelling reasons for women to exercise at any age. First, exercise will certainly help to strengthen and tone your body and can reduce and even eliminate middle-age spread. We also know that regular exercise can bolster the immune system, reduce the risk of developing many different forms of cancer, and can even help prevent heart disease and stroke. For women, weight-bearing exercise, such as walking, running, or jogging, can protect against osteoporosis by helping to maintain bone mass and by increasing muscle mass, which can prevent fractures by absorbing the shock of the fall.
Whether it is working out at the health club, powerwalking with a friend, or following an exercise video, regular exercise is essential for good looks and good health.
Marianne J. Legato, MD, Ph. D. (hon. c.), FACP is an internationally renowned academic, physician, author, lecturer, and pioneer in the field of gender-specific medicine. She is a Professor Emerita of Clinical Medicine at Columbia University College of Physicians & Surgeons and an Adjunct Professor of Medicine at Johns Hopkins Medical School. Dr. Legato is also the Director of the Foundation for Gender-Specific Medicine, which she founded in 2006 as a continuation of her work with The Partnership for Gender-Specific Medicine at Columbia University. She received an honorary PhD from the University of Panama in 2015 for her work on the differences between men and women.
At its core, gender-specific medicine is the science of how normal human biology differs between men and women and how the diagnosis and treatment of disease differs as a function of gender. Dr. Legato’s discoveries and those of her colleagues have led to a personalization of medicine that assists doctors worldwide in understanding the difference in normal function of men and women and in their sex-specific experiences of the same diseases.
She began her work in gender-specific medicine by authoring the first book on women and heart disease, The Female Heart: The Truth About Women and Coronary Artery Disease, which won the Blakeslee Award of the American Heart Association in 1992. Because of this research, the cardiovascular community began to include women in clinical trials affirming the fact that the risk factors, symptoms, and treatment of the same disease can be significantly different between the sexes. Convinced that the sex-specific differences in coronary artery disease were not unique, Dr. Legato began a wide-ranging survey of all medical specialties and in 2004, published the first textbook on gender-specific medicine, The Principles of Gender-Specific Medicine. The second edition appeared in 2010 and the third edition, dedicated to explaining how gender impacts biomedical investigation in the genomic era, won the PROSE Award in Clinical Medicine from the Association of American Publishers in 2018. A fourth edition is forthcoming.
She also founded the first scientific journals publishing new studies in the field, The Journal of Gender-Specific Medicine, and a newer version, Gender Medicine, both listed in the Index Medicus of the National Library of Medicine. She has founded a third peer-reviewed, open access journal, Gender and the Genome, which focuses on the impact of biological sex on technology and its effects on human life.
Dr. Legato is the author of multiple works, including: What Women Need to Know (Simon & Schuster, 1997), Eve’s Rib (Harmony Books, 2002), Why Men Never Remember and Women Never Forget (Rodale, 2005), Why Men Die First (Palgrave, 2008), The International Society for Gender Medicine: History and Highlights (Academic Press, 2017), and most recently, The Plasticity of Sex (Academic Press, 2020). Her books have been translated into 28 languages to date.
As an internationally respected authority on gender medicine, Dr. Legato has chaired symposia and made keynote addresses to world congresses in gender-specific medicine in Berlin, Israel, Italy, Japan, Panama, South Korea, Stockholm, and Vienna. In collaboration with the Menarini Foundation, she is co-chairing a symposium on epigenetics, Sex, Gender and Epigenetics: From Molecule to Bedside, to be held in Spring 2021 in Italy. She maintains one of the only gender-specific private practice in New York City, and she has earned recognition as one of the “Top Doctors in New York.”
