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The health risks of being a skinny old person – and how to stay strong in your 70s and beyond

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The health risks of being a skinny old person – and how to stay strong in your 70s and beyond

Build up the length of your walks slowly 

Walking is the starting point for someone who wants to strengthen their heart and lungs. Quinn advises against high intensity. “If anyone’s going to suffer a cardiovascular episode, an arrhythmia or atrial fibrillation, it will be someone in that older age bracket – the heart is ageing as well. I prefer duration and frequency rather than intensity.” 

Walking is underrated, adds Mallace. “It helps strength in your legs and your balance. Walk fairly briskly. Get a stopwatch, go out for a walk and time how long you walk before you want to stop. Note the time. If it’s 10 minutes that’s your baseline, increase really slowly and do 11 minutes the next time and build until you can walk half an hour at a reasonable speed.” She recommends walking every other day until you’re able to keep going for 25 minutes then you can do it every day.”

A study carried out by an Oklahoma-based team said that “walking briskly for 30 minutes per day for five days can reduce the risk of several age-associated diseases. Additionally, low-intensity physical exercise, including walking, exerts anti-ageing effects and helps prevent age-related diseases”.

Have milk in your coffee or cheese with your wine

The array of fashionable superfoods that catch our eye every now again is not the answer, according to Prof Mary Hickson of the dietetics department of Plymouth University. She says that appetite can diminish in our 70s and 80s partly because our sense of taste and smell is less sensitive. This means every meal needs to be nutrition-packed as it could well be smaller than those we enjoyed in the past. “An ideal plate would be half vegetables, a quarter protein and a quarter carbohydrate.” 

How much protein older people need is not entirely clear currently. “There is some debate about protein and older people and there seems to be a consensus slowly emerging that older people do need more.” A study by the University of Sheffield found that many older adults do not eat sufficient protein. “More than half of older adults aren’t consuming enough protein to reach national recommendations.”

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Prof Hickson says: “The recommendation for younger adults is 0.8 grams of protein per kilogram of body weight per day, and for older people it may go up as high as 1.2 grams per kg of body weight, as we age.” A 90-gram chicken breast contains 24 grams of protein but Prof Hickson reminds us lots of foods contain small amounts of protein adding to your total score – a slice of toast will have 2.5 grams, for example.

The carbohydrate element is important especially if you are active. “Complex carbohydrates are the best because they are broken down more slowly rather than sugar which gives you a spike of glucose,” Prof Hickson adds. “Whole-grain bread, cereals and pasta are all good choices, and you should have some at every meal.”  

If life with brown rice and chicken breasts feels a little spartan, Prof Hickson says coffee within the two-to-three cups a day limit is fine, some sweet treats are permitted if they are appropriately infrequent. She is also comfortable with alcohol within the 14 units a week but warns about dehydration. “The proportion of water in the body is less for older people so it’s easy to become dehydrated, so alcohol will have more of an effect.” Have milk in your coffee or cheese with your wine. Bone health calcium is important, and guidelines from the British Dietetic Association recommend three portions of milk-based products per day.

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World Fitness Bodies Release Study Supporting Exercise’s Impact on GLP-1s

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World Fitness Bodies Release Study Supporting Exercise’s Impact on GLP-1s
Fitness trade organizations from the U.S., U.K., Australia, New Zealand and Canada collaborated on a study revealing numerous benefits of an integrated care model that combines weight-loss drugs with exercise, especially strength training

Major international health and fitness organizations have joined forces to study the long-term impact exercise can have on GLP-1 users, with the findings showing optimistic results.

The white paper, which emerged from the collaboration of trade organizations including the U.S.-based Health & Fitness Association, U.K.-based ukactive, Australia-based AUSactive, Exercise New Zealand and Fitness Industry Council of Canada, finds that pairing GLP-1 therapy with regular structured exercise has multiple downstream benefits. Those include improved long-term health outcomes, reduced subsequent costs and positive economic returns across multiple countries.

The study dove into whether structured exercise can improve the long-term clinical and economic value of GLP-1 treatment by comparing the impacts of GLP-1 therapy as a standalone obesity treatment versus GLP-1 therapy combined with exercise, utilizing a health-economic model across Australia, Canada, New Zealand, the U.K. and the U.S.

The financial component of the study found:

  • U.K.: £2.7 billion in economic and societal value over 10 years and a 164% return on investment, rising to 717% and £13 billion over 30 years.
  • U.S.: $120 billion in economic and societal value over 10 years and a 496% return on investment, rising to 1,572% and $393 billion over 30 years.
  • Australia: AU$182 million in economic and societal value over 10 years and a 59% return on investment, rising to 457% and AU$1.4 billion over 30 years.
  • Canada: CA$3.5 billion in economic and societal value over 10 years and a 105% return on investment, rising to 526% and CA $17.9 billion over 30 years.
  • New Zealand: NZ$51 million in economic and societal value over 10 years and a 27% return on investment, rising to 306% and NZ$592 million over 30 years.

Meanwhile, the addition of structured exercise to a GLP-1 treatment plan had numerous positive health impacts, including:

  • Preserving muscle during weight loss
  • Maintaining strength, mobility and bone health
  • Keeping more weight off over time
  • Reducing weight regain after stopping medication
  • Lowering the risk of costly health events later on.

Additionally, the paper highlighted a reduction in acute cardiovascular events and joint replacements; improved patient longevity and quality of life; and reduced spending on medical costs and productivity losses.

Based on those results, the bodies are once again urging for the deeper integration of physical activity and strength training in GLP-1 treatment, after releasing a statement earlier this year calling on governments, health systems and international institutions to ensure that as drugs like Ozempic and Wegovy continue to dominate obesity treatment, they’re supported by lifestyle interventions including physical activity and nutrition.

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“GLP-1 medications are rapidly changing obesity treatment, but weight loss alone is not the full measure of success,” said HFA president and interim CEO Greta Wagner. 

From those results, the bodies have come up with a plan for how best to implement fitness-forward practices into a systemic treatment plan for GLP-1 users. They propose the following roadmap for policymakers, payers and healthcare systems:

  1. Recognise structured exercise, especially strength training, as an essential part of obesity care
  2. Embed exercise support into GLP-1 care models
  3. Build referral pathways between healthcare providers and qualified exercise professionals and fitness facilities
  4. Support patient access to qualified exercise professionals and fitness facilities
  5. Measure outcomes beyond weight loss, including long-term health and economic value.

The organizations also suggested policy shifts such as reimbursement, coverage, tax-preferred treatment or subsidy models that lower financial barriers to structured exercise for GLP-1 users, making exercise more widely recognized as a crucial component of GLP-1 therapy.

“The health and fitness industry has long known that lasting wellness requires more than a number on a scale, it requires strength, function and sustainable healthy life habits,” Wagner added. “This research confirms that exercise, especially strength training, helps patients sustain the benefits of GLP-1 treatment over time. It sends a clear message that exercise belongs at the center of GLP-1 care.”

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Adding Exercise to GLP‑1 Therapy Improves Long-Term Benefits, Multinational Study Finds – Health & Fitness Association

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Adding Exercise to GLP‑1 Therapy Improves Long-Term Benefits, Multinational Study Finds – Health & Fitness Association

The combination could save billions in healthcare costs, leading fitness organizations to call for deeper integration of structured exercise in GLP-1 treatment.

Pairing GLP-1 therapy with regular structured exercise would improve long-term health outcomes, reduce downstream costs, and generate positive economic returns across multiple countries, according to new multinational research by the Health & Fitness Association developed by FTI Consulting’s Center for Healthcare Economics and Policy. 

Released as a white paper entitled From Weight Loss to Lasting Value: Structured Exercise and the Economics of GLP-1 Therapy, the research compares impacts of GLP-1 therapy as a standalone obesity treatment with GLP-1 therapy combined with exercise in five countries. 

The research was developed in collaboration with the HFA Foundation and four fitness industry federations: AUSactive, Exercise New Zealand, Fitness Industry Council of Canada, and ukactive.

The white paper provides some of the strongest evidence to date that exercise significantly enhances the value of GLP-1 treatment for patients, healthcare systems, employers, and society as a whole.

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Across all five countries studied, the analysis found that a combined approach supports improved long-term health outcomes, reduced healthcare costs, and produced positive economic returns.

Combining regular exercise with GLP-1 therapy is estimated to generate:

  • United States: US$120 billion in economic and societal value over 10 years and a 496% return on investment, rising to 1,572% and US$393 billion over 30 years.
  • Australia: A$182 million in economic and societal value over 10 years and a 59% return on investment, rising to 457% and A$1.4 billion over 30 years.
  • Canada: C$3.5 billion in economic and societal  value over 10 years and a 105% return on investment, rising to 526% and C$17.9 billion over 30 years.
  • New Zealand: NZ$51 million in economic and societal  value over 10 years and a 27% return on investment, rising to 306% and NZ$592 million over 30 years.
  • United Kingdom: £2.7 billion in economic and societal  value over 10 years and a 164% return on investment, rising to 717% and £13 billion over 30 years.

The findings demonstrate that as GLP-1 use expands, exercise should play an essential role in helping patients and health systems maximize the long-term value from new generations of weight-loss drugs.

The fitness industry has an unprecedented opportunity to be part of the solution as GLP-1 usage continues to grow. 

“GLP-1 medications are rapidly changing obesity treatment, but weight loss alone is not the full measure of success,” says Greta Wagner, interim president and CEO of the Health & Fitness Association and president of the HFA Foundation. “The health and fitness industry has long known that lasting wellness requires more than a number on a scale; it requires strength, function, and sustainable healthy life habits. This research confirms that exercise, especially strength training, helps patients sustain the benefits of GLP-1 treatment over time. It sends a clear message that exercise belongs at the center of GLP-1 care.”

Based on this data, HFA, HFA Foundation, AUSactive, Exercise New Zealand, Fitness Industry Council of Canada, and ukactive are calling on policymakers, payers, and healthcare systems to integrate structured exercise into GLP-1 treatment pathways. 

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Specifically, the groups are asking that: 

  1. Structured exercise, including strength training, be recognized as an essential part of obesity care;
  2. GLP-1 care models include exercise support;
  3. Referral pathways are established between healthcare providers and qualified exercise professionals;
  4. Patient access to qualified exercise professionals and fitness facilities be supported; and
  5. Outcomes beyond weight loss be measured, including long-term health and economic value.

This call to action builds on a recent joint position statement signed by the participating fitness industry groups, the World Obesity Federation (WOF), and the World Federation of the Sporting Goods Industry (WFSGI), which emphasized the urgency of ensuring physical activity and nutrition are central to systems supporting the global roll-out of obesity medications. 

Download the complimentary full report to see how structured exercise can help unlock the full promise of GLP-1 therapy.

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From Weight Loss to Lasting Value: Structured Exercise and the Economics of GLP-1 Therapy – Health & Fitness Association

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From Weight Loss to Lasting Value: Structured Exercise and the Economics of GLP-1 Therapy – Health & Fitness Association

This white paper is complimentary.

GLP-1 medications are reshaping obesity care and creating new opportunities to improve long-term health outcomes. But weight loss alone is not the full measure of success. As use of these medications grows, policymakers, payers, healthcare providers, and patients face an important question: what helps ensure that the benefits of GLP-1 therapy are sustained over time?

This first-of-its kind multi-country research examines the health and economic value of combining GLP-1 therapy with structured exercise. The findings make clear that structured exercise help protect and extend the investment being made in GLP-1 treatment by supporting more sustainable health outcomes, reducing costly downstream medical events, and generating substantial economic value.

Across all five studied markets, the research projects that combining structured exercise with GLP-1 therapy can generate substantial health, economic, and societal value compared with GLP-1 therapy alone:

  • United States: US$120 billion in economic and societal value over 10 years and a 496% return on investment, rising to 1,572% and US$393 billion over 30 years.
  • Australia: A$182 million in economic and societal value over 10 years and a 59% return on investment, rising to 457% and A$1.4 billion over 30 years.
  • Canada: C$3.5 billion in economic and societal value over 10 years and a 105% return on investment, rising to 526% and C$17.9 billion over 30 years.
  • New Zealand: NZ$51 million in economic and societal value over 10 years and a 27% return on investment, rising to 306% and NZ$592 million over 30 years.
  • United Kingdom: £2.7 billion in economic and societal value over 10 years and a 164% return on investment, rising to 717% and £13 billion over 30 years.

If public and private payers are investing in GLP-1 therapy, they should also be asking what helps that investment produce more sustainable health and economic returns. Structured exercise is one of the clearest answers.

Methodology

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The research was conducted by by FTI Consulting’s Center for Healthcare Economics and Policy in partnership with a multinational coalition of fitness sector organizations, including the Health & Fitness Association, the HFA Foundation, AUSactive, Exercise New Zealand, Fitness Industry Council of Canada, and ukactive. 

Drawing on the existing body of research on GLP-1 therapy, weight loss, physical activity, and related health outcomes, the analysis modeled the incremental health and economic impact of adding structured exercise to GLP-1 therapy across participating markets. The model compares combined treatment against GLP-1 therapy alone over 10-year and 30-year horizons.

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