How to Help Clients Track Longevity Progress as a Nutritionist?

Highlights:

• Longevity is a complex issue, and your clients can feel unsure whether they are making meaningful progress
• Regularly measuring body composition, physical performance, and blood pressure gives clients a clearer picture of how well they are doing
• Helping clients interpret measurements is key to keeping them on track and motivated

Introduction

Tracking progress helps your clients stay focused and engaged on the way to reaching their goals. This is especially important with longevity which is as distant of a goal as any. It poses a unique problem when it comes to measuring progress. No single marker clearly shows how well a person is doing. It requires monitoring and interpreting a variety of different numbers. In this article, we will focus on those that can be modulated by lifestyle interventions such as changes in diet, exercise, or sleep.

Changes in body composition

Measuring body composition is an easy starting point because it is something that nutritionists and health coaches often already do. Being overweight or obese is a risk factor for diabetes, cardiovascular disease, cancer, and neurodegenerative disorders. Body Mass Index (BMI) is the most common way to assess obesity. Your clients should aim for a BMI between 18,5 and 25 to be considered normal weight; values above are considered overweight or obese.

Unfortunately, BMI only takes into account weight and height. We know that proportion of muscle and fat mass matters too. For example, sarcopenia, a decline in muscle mass and function, is a health risk everyone will have to face in old age (1). The most precise methods that assess muscle and fat tissue proportions use magnetic resonance or computed tomography, but these are not available or cost-effective for most people. Dual-energy X-ray absorptiometry (DEXA) scans also offer a very high level of accuracy at a much smaller price though they are still not practical for frequent measurements.

Bioimpedance scales offer good accuracy at a fraction of the cost and can be excellent for seeing changes in body composition over time (2). These scales send a weak electrical impulse through the body, which encounters varying levels of resistance from the different tissues. They can also track dangerous visceral fat, which should be kept as low as possible (3). A healthy fat percentage range for men is typically recommended to be between 10-24% and for women between 18-31%. It is essential to consider body type, current health status, and athletic goals when helping a client interpret muscle and fat percentages.

Measuring physical performance

Physical performance is another important variable to measure in pursuit of healthy longevity. There are several ways you can help your clients objectively track their strength, mobility, balance, and aerobic fitness.

Grip strength is well-studied as a predictor of disease and risk of mortality. Studies show that grip-strength measurements of less than 26 kilograms (57 pounds) for men and less than 16 kg (35 pounds) for women are associated with a higher overall risk of death and higher risk for various diseases. Each 5 kg (11 pounds) increment below these numbers correlates with a 20% increase for women and a 16% increase for men in the risk of death from all causes (4). Grip strength measurement devices are relatively inexpensive and easy to use.

Balance can be measured via a one-legged stance. A study looking at people between ages 51 and 75 found that an inability to stand on one leg for ten consecutive seconds is linked to a near doubling in the risk of death from any cause within the next ten years (5). Your older clients can use this as a simple benchmark.

Walking is not something that comes to mind when talking about physical performance, but studies show that gait speed is a good predictor of mortality. Research looking at people aged 65 or older shows that gait speed faster than 1 meter per second suggests better than average life expectancy and above 1,2 m/s exceptional life expectancy (6). This can be tested by measuring the number of steps of a 10-meter distance using an average walking speed. For more accuracy, it helps to add a few meters for acceleration and repeat the test 3 times.

Utilizing wearables

The popularity of fitness trackers and other wearables is rising and presents an excellent opportunity for longevity. Sleep tracking is a good example of this. Fitness trackers are not yet very precise at differentiating between sleep phases such as rapid eye movement (REM), deep and light sleep (7). On the other hand, those devices use motion and heart rate sensors, which accurately detect total sleep time (8). And studies show that human longevity is associated with a regular sleep pattern (9). This means that wearables can help track the duration and regularity of sleep. These two aspects of sleep can give clients a realistic idea about how well they are doing with their sleep.

Heart rate sensors are also a field where current wearables are accurate. Some devices already offer the ability to track Heart Rate Variability (HRV). This is a measure of the variation in time between heartbeats, which reflects the balance between activation of sympathetic and parasympathetic nervous systems. HRV depends on many individual variables, but studies show that it declines with age (10). Tracking HRV over the long term could be used to evaluate how well a longevity intervention is working.

Monitoring blood pressure

Elevated blood pressure, also called hypertension, has been established as a significant risk for cardiovascular disease. It is defined as 130 mm Hg or higher for systolic blood pressure (SBP) and 80 mm Hg or higher for diastolic blood pressure (DBP). New research is showing that it is worth reducing blood pressure even below this threshold. For every 5 mm Hg reduction in SBP, the risk of major cardiovascular disease goes down by 10% (11). This was shown even for people with normal or high normal blood pressure values. It seems like the appropriate SBP level is probably 110 - 120 mm Hg. Regularly tracking this marker can help your clients see if their longevity efforts are pushing them in the right direction.

Testing microbiome

Research shows that older adults with a unique pattern of changes to their gut microbe profile tend to be healthier and live longer than their peers with less microbiome divergence (12). Researchers speculate that modern diets rich in salty, sugary, or fatty processed foods may damage the aging gut. In contrast, higher fiber nutritious foods like fruits, vegetables, seeds, beans, and nuts, as well as regular exercise, can help protect a healthy gut microbiome balance. Testing the diversity of your client’s microbiome before and after a longevity intervention can provide an interesting insight. While the science in this field is still young, collecting regular snapshots of the changes in the gut microbiome can become valuable to your clients, especially as our understanding evolves over time.

Conclusion

Several different markers can help your clients see the progress they are making on their way to improving their health and longevity. As a nutritionist or a health coach, you should encourage them to track their body composition, various aspects of physical performance, sleep, blood pressure, and even microbiome. Helping them interpret the results and put value to each can make the difference between staying motivated and losing focus.

References:

1. Yu SC, Khow KS, Jadczak AD, Visvanathan R. Clinical Screening Tools for Sarcopenia and Its Management. Current gerontology and geriatrics research 2016;2016:5978523. 10.1155/2016/5978523
2. Lemos T, Gallagher D. Current body composition measurement techniques. Current opinion in endocrinology, diabetes, and obesity 2017;24(5):310-4. 10.1097/MED.0000000000000360
3. Kuk JL, Katzmarzyk PT, Nichaman MZ, Church TS, Blair SN, Ross R. Visceral fat is an independent predictor of all-cause mortality in men. Obesity (Silver Spring, Md.) 2006;14(2):336-41. 10.1038/oby.2006.43
4. Celis-Morales, Carlos A. et al. “Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK Biobank participants.” The BMJ 361 (2018): n. pag.
5. Araujo CG, de Souza E Silva CG, Laukkanen JA, Fiatarone Singh M, Kunutsor S, Myers J, Franca JF, Castro CL. Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. British journal of sports medicine [published online: June 21, 2022]. 10.1136/bjsports-2021-105360
6. Studenski S et al. Gait speed and survival in older adults. JAMA 2011;305(1):50-8. 10.1001/jama.2010.1923
7. Lee XK, Chee NIYN, Ong JL, Teo TB, van Rijn E, Lo JC, Chee MWL. Validation of a Consumer Sleep Wearable Device With Actigraphy and Polysomnography in Adolescents Across Sleep Opportunity Manipulations. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2019;15(9):1337-46. 10.5664/jcsm.7932
8. Roberts DM, Schade MM, Mathew GM, Gartenberg D, Buxton OM. Detecting sleep using heart rate and motion data from multisensor consumer-grade wearables, relative to wrist actigraphy and polysomnography. Sleep 2020;43(7):zsaa045. 10.1093/sleep/zsaa045
9. Mazzotti DR, Guindalini C, Moraes WA, Andersen ML, Cendoroglo MS, Ramos LR, Tufik S. Human longevity is associated with regular sleep patterns, maintenance of slow wave sleep, and favorable lipid profile. Frontiers in aging neuroscience 2014;6:134. 10.3389/fnagi.2014.00134
10. Almeida-Santos MA, Barreto-Filho JA, Oliveira JL, Reis FP, da Cunha Oliveira CC, Sousa AC. Aging, heart rate variability and patterns of autonomic regulation of the heart. Archives of gerontology and geriatrics 2016;63:1-8. 10.1016/j.archger.2015.11.011
11. Rahimi K et al. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. Lancet (London, England) 2021;397(10285):1625-36. 10.1016/S0140-6736(21)00590-0
12. Badal VD, Vaccariello ED, Murray ER, Yu KE, Knight R, Jeste DV, Nguyen TT. The Gut Microbiome, Aging, and Longevity: A Systematic Review. Nutrients 2020;12(12):E3759. 10.3390/nu12123759

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