Dead butt syndrome, fish oil in the news, and the other HRT
July Midlife Roundup [2024]
We are well into summer around here. July is usually when things settle for me in terms of summer routine.
In this roundup, I’m sharing my recent injury and what I learned, a couple of studies that caught my eye, and links to some of the latest midlife-related pieces.
But first, a reminder about my survey. I'd appreciate it if you could fill it out and feel free to skip sections.
I’m getting to know my readers more and it also helps with content development.
On to the roundup.
Is my butt dead?
About a month ago, I was on the tail end of a six-mile neighborhood run with friends and we were going up a long hill. I usually walk/run but was feeling good, so I kept running.
I felt a strain in my upper left hamstring but kept going because we were almost done. As I finished and noted this tight feeling, I thought I’d take a rest from running for a few days.
I did gym workouts, and when it came time for my Friday tennis lesson, I really felt my hamstring when running after the ball. I thought to myself…. well this isn’t good.
My 2-week vacation was coming up, so after more rest, I thought I’d try to run just two miles with my crew. Although the first mile was okay, the second mile I could feel it.
Following my two-week hiatus, I was happy I could run three miles and play tennis, experiencing only a slight twinge in my hamstring. But then two days later, attempting 4 miles, the pain started right around mile three.
I’ve done a good job of avoiding injuries all these years. Until now, I've never had to take a break from running to recover.
With so much contradictory info online, I made an appointment for physical therapy. After an examination, the physical therapist told me that my hamstrings were compensating for my weak glutes. This is also what’s behind my iliotibial (IT) band on and off hip pain I’ve had for 25 years.
Our gluteal muscles are the largest muscles in the body and when we don't fully engage them, other less equiped muscles like the hamstrings take over. But the job is too big for them, so overuse ensues and they become strained.
This can also be the reason for back, ankle, and knee issues.
Looking this up, I discovered the term “dead butt syndrome.” It’s also the result of too much sitting or a combo of being active and then sitting all day.
At my gym we don’t always directly work the glutes and I need to change this. I've committed to following PT's advice completely because I gave up once I started feeling better in the past.
But I’m determined to engage my glutes and use proper form so I can avoid injury because it sucks and I’m so glad to have a clear answer.
More on this in the future, including interviews with experts who can help us all avoid injury.
Any injury stories to share?
Bad press on fish oil
Have you heard the reports of a new study on fish oil? If not, here are some headlines:
Fish oil supplements may cause harm, study finds (CNN)
Why fish oil supplement scan be dangerous for the heart (Time)
Fish Oil Supplements May Raise Your Risk of Heart Disease and Stroke If You’re Healthy (Healthline)
This was all based on the UK Biobank study with half a million people. The study found that people taking fish oil without cardiovascular disease had a 13% increased risk of Atrial fibrillation (A fib) and 5% increase of stroke.
It also found that people who developed heart disease and used fish oil supplements had a reduced risk of atrial fibrillation turning into major cardiovascular events, including heart attack and heart failure.
Other studies have found this fish oil A Fib link, including the STRENGTH study, where high-risk participants were taking very high amounts of fish oil (4 g/day), to lower triglycerides.
Users of fish oil had a higher risk of atrial fibrillation events, by about 25%, according to a meta-analysis of seven randomized controlled trials. High doses (>1g) were more significant.
This may be why the Vital trial which included lower amounts of fish oil (840mg) did not show a relationship with A Fib. And another study looking at levels of omega-3 in 54,799 individuals from 17 cohorts and 13 years follow-up, showed higher levels of EPA/DHA were associated with lower risk of A Fib.
I turned to Dr. Bill Harris, PhD from the fatty Acid Research Institute (FARI) who has been studying omega-3 fatty acids for 40 years. In this video, he goes into detail about the data taken from the UK Biobank and discusses the research on omega-3 and health.
He reminds of the science showing benefits of fish oil, including reducing the development of type 2 diabetes, fractures, dementia, primary liver cancer and total mortality. And yes, researchers have found that the main negative effect in some studies is A fib.
“Is it a worry? It’s something that not being a medical doctor or a cardiologist, I can’t give advice on” Harris said in this podcast. “It’s something (A Fib) nobody really wants to have, but if it protects you about against 15 other adverse outcomes, then you take 1% increase in absolute risk. It might be worth the balance.”
In my Biomarker Guide, I suggest getting tested and using both diet and fish oil to meet the >8% omega-3 index. I also don’t think we should compare over-the-counter amounts of fish oil with prescription high dose fish oil used as a treatment for heart disease patients—as they are two different things.
As women transition through menopause, they make less DHA from non-marine food sources, so it’s important to make sure we’re meeting our needs. This is a watch out, but not cause for alarm, in my opinion.
Heavy resistance training in older adults
Another study I got alerted to on Instagram was about heavy resistance training in older adults.
This was a randomized control trial with 451 retirement age individuals. The researchers assigned them to one of three groups for a year: heavy resistance training (HRT), moderate resistance training (MIT), and a non-exercising control (CON).
I’m calling this “the other HRT.”
The HRT group used machines like leg and chest presses at a fitness center three times a week. The MIT group did body weight-type exercises (i.e., pushups and squats) and bands. They trained in a facility once a week and two times at home.
The researchers tracked 369 participants (mean age 71, 61% women) at year four and observed that only the HRT group maintained leg strength, whereas leg strength decreased in the MIT and CON groups.
Even when there were decreases in leg mass, the HRT group-maintained strength, which is thought to be because of neural adaptations in response to resistance training, as noted in the report:
This is in line with a recent report showing that prolonged training across the lifespan is associated with permanently elevated acetylcholine receptors and improved neuromuscular function.22 Resistance training may, therefore, be beneficial for function beyond the influence of muscle size itself.
You can see the benefits shoot up at the 1-year mark and this is when the intervention ends, so it’s not clear who continued and not. But although MIT was less, it still had an effect. Starting where you are and gradually progressing is the most effective strategy.
“Heavy resistance” in this study just meant using machines or free weights for less than 12 reps. And even if you don’t see muscles develop (ha ha), you are gaining strength, which is the most important for function as we age.
I’m in the middle of a transition with my strength strategy, which I’ll be talking about in an upcoming video.
Interesting articles and podcasts
The New York Times had a couple of midlife focused articles.
First one: Is Delaying Menopause the Key to Longevity? Researchers are working on ways to extend ovarian life to see if it boosts women’s health. And I wonder, would you want to stay fertile in your 60s?
Next is a general midlife article, How Your Body and Mind Change at Midlife, gives a general overview.
A friend sent me Dr. Mary Claire Haver on the Huberman podcast about how to navigate perimenopause and menopause. It’s an excellent overview and eye opener about how few OB-GYNs understand menopause. My only nitpick is it oversells HRT a bit, but overall, a well-rounded piece.
Does any of this resonate with you? Let me know in the comments.
I’ve been struggling with IT band syndrome for several years, was way late addressing it because for a long time I thought I just needed a firmer mattress, better shoes, to stretch more, to foam roll more. When none of that worked, I started looking for exercise-based solutions. What has helped more than anything is suffering through squats and lunges. My glutes were weak too and with the collagen loss from menopause, the tendons got very overstressed. For a while, just squats (and leg presses on a machine) were all I felt comfortable doing; the hip was too painful to feel stable doing lunges. However I finally worked my way up to doing lunges as well and the hip pain, while not completely gone, is about 80% better. The improvement is in line with the squatting. Yes squats can be misery but on the upside, you will one day catch a glimpse of your bum and it will be about two inches higher than you remember, and a lot rounder.