Dr Lis Boulton: movement, the importance of staying physically active throughout our lives

Most people know that physical activity is good for us, and this doesn’t change as we age – staying active is essential to health and wellbeing as we age. Take Five’s Move action area is all about finding enjoyable ways to move. Dr. Lis Boulton from Age UK is passionate about the power of movement, and we spoke to her about the latest research and her top tips for Move.

Could you tell me a bit about why you are supporting Take Five to Age Well and how you got involved?

We know from research that we can do things to positively impact our health and if we can take action now in our 40s, 50s, 60s, or even younger, we will improve our health later on and this can enable us to just to stay as well and active for as long as possible. Take Five is part of that – it can help identify action to take and help people make those behavioural changes.

So, will you be signing up personally? And if so, what's your area of action?

Yes. As you would expect for somebody who's passionate about healthy ageing, I try to do some things already, but I know I could move more. I don’t get a lot of vigorous exercise; I’m waiting for some foot surgery so it's not easy, but I think I could probably increase my heart rate more without pounding the pavement. So, I'm going to commit to getting my heart rate a little bit higher, I just need to find the right exercise.

You’ve hit a really good point, because as we age, there can be curveballs, for instance injuries that life may throw at us that can derail the physical activity that we're used to doing. And it can be difficult, physically and emotionally – how have you found this?

Yeah, it's not easy and I think beyond injury, there are other things, for instance, I'm a carer for my dad and that takes up a huge amount of my time. So actually, fitting in the time to be physically active is really challenging. So, you know, it can be any kind of life event that that derails you and it's easy in those periods where you can't do much to get low and feel quite miserable. In these times, Take Five might be really useful because it can give you and lots of suggestions for different ways to move or to take on any of the any of the other actions that can help you feeling healthy in other ways.

When we talk about move, what do we mean by movement or physical activity?

Firstly, we need to be really clear that any amount is good; people will have very difference starting points and therefore have different capabilities and movement preferences. It may be standing up every hour or so or it might be going to a swim – there are so many ways to move. We know there are huge benefits from moving more, in 2019 the Chief Medical Officers from each of the four UK nations published physical activity guidelines and in so doing highlighted the ‘magic pill’ that exercise offers, "if physical activity were a drug, we would refer to it as a miracle cure, due to the great many illnesses it can prevent and help treat.” It reduces risk of many of the big killers such as cancer, heart disease, dementia and stroke.  We know from our stakeholders at Age UK that staying independent is a huge driver for people to be healthy; nobody wants to be dependent on their children or end up in a care home and physical activity will improve your chances of staying independent for longer. And on top of that, movement releases endorphins and so it also impacts wellbeing. Research has shown that people have even been able to come off antidepressant medication or anti-anxiety medication with physical activity and this is something that can now be prescribed as a first line treatment for low mood.

That's very compelling. But we all know that it’s not always easy to find the motivation to move. What would you say are your top tips to getting moving? 

The most important thing is to find something you enjoy. Because if it's a chore, then it requires high amounts of willpower to make yourself do it and willpower is a finite resource. If you're a sociable person, look for activities with others, if you like music, find something that involves moving to music. Secondly, don't set yourself unachievable targets. Remember that anything is better than nothing and when we aren’t in the mood, but still do the action, even if much less than hoped, we should be really proud as these things are effortful.

Great top tips, thank you. But we also do know that for some people it is easier to do these things than others. We don't all have equal opportunities. Could you talk a bit about the wider determinants of health and how they impact on someone's opportunity to engage in physical activity?

Yes, as a society, we're not ageing equally. There are huge inequalities between different parts of the population. At Age UK we're trying to get away from using age as an indicator of what people are capable of because you could have somebody who's in their 70s who's living in good health on a decent pension who is going to be experiencing older age very differently to somebody who's spent their life living in an area of deprivation. On a low income, you've not got the disposable income to join a gym, perhaps your living conditions might not be great, for instance a small flat with little or no access to green space and perhaps you don’t feel it's safe to go out and walk alone, particularly after dark. This is the reality for many midlife and older adults across the UK resulting in fewer opportunities to be active.

How can we better facilitate people who are living in poverty to engage with physical activity? What are the policy levers and the interventions that might support people to age better through physical activity?

I think that's a great question; what can we do better as policymakers or service providers to enable people who are living in poverty to age better. I don't think it's easy. I think services are not always great at getting into communities that that are seldom heard and underserved. That's not that's not the fault of people living in those communities, it’s about how we communicate with them and how we better give the messages in a way which will and be engaging. And one of the things that's really important is working in partnership – there are plenty of third sector organisations that are already out there, working in those communities so it’s important to work with the third sector in order to reach particular communities.

What interesting facts from the research would you like to share with the Take Five community?

One thing is around falls prevention; in order to prevent falls as we get older, we really need to improve our strength and our balance. These are very specific activities; for improving your balance, you need to be reducing your base of support. So, if you think about standing with your feet kind of hip width apart or wider you know you're really steady, if somebody gives you a nudge you're not going to move. But if you start to put your feet closer together and if you put them side by side and somebody gives you a nudge you're going to wobble. If you put one foot in front of the other, you're going to wobble even more. And if you stand on one leg, you're going to wobble a lot. So, it might sound counterintuitive, but you want to minimise your base of support as and much as possible so that you are wobbling, this is when you're going to be training your balance. Now I would never recommend anybody just to go and start standing on one leg without some support around them. You've got to work out where your wobble starts and then to train your balance you need to be progressively challenging yourself. This is absolutely crucial. We know from so much research that the ability to maintain your balance is highly correlated with being able to stay independent as you get older. The other thing you need to do is build up strength in your legs as well. So, the type of exercises which we talk about there are squatting or lunging, but you don't have to start with that. If you're starting from right at the beginning, then there's one which is really easy to do, but you'll be surprised how challenging it can be.  When you sit back down in your chair after standing up, just try and sit down really slowly and you'll feel it in your thigh muscles. And when you're standing up, try and do that really, slowly as well. There are other things such as strengthening ankles. Having that lower body strength and stability is really crucial as we get older because our muscle mass and balance both start declining from age 30. There are now many falls prevention classes and sessions all over the country so if you don’t already go to one and think you would benefit look up and falls prevention class in your area.

Thank you. Some really good tips in there, I'm going to start trying to lower myself into my seat more slowly. Why do you think people sign up for Take Five to Age Well?

Taking part in Take Five is an investment in your future. If you think about yourself in the future, what would you wish that you'd done to stay as healthy as you can. Would you be annoyed with yourself that you'd not done something simple when you could? At Age UK often when we talk to older people, they wish they’d done more when they were younger. Take Five celebrates the small, daily actions that can be done, things that are manageable for you. And if the idea of future me is not a strong enough motivation, think about the benefits that you'll get now. Within a very short space of time, you can feel stronger, fitter, like you've got more energy and actually you can be really proud of yourself.

Brilliant, thank you. Worth saying that and other actions are available. It doesn't have to be physical activity. Eat, Drink, Connect and Engage and Think are other areas that are all good for you!

THANK YOU FOR READING

Thanks to The Centre for Ageing Better for the images in this article.