Two Fitness Tests Your Doctor Might Do Soon (start now!): Fitness is a Vital Sign

Coming soon to a doctor near you in your next doctor visit, maybe fitness testing. Yes. So no kidding, here's the deal. There are a lot of people out there and physicians included who believe that fitness should be a vital sign. So what can you do in the short and limited time that you have to discuss anything at all with your physician? Well, I have two ideas and I'm gonna include them here. Just recently taught to a group of physicians. So yes, I have an insider track to the fact that physicians are getting wiser about the need based on the authority and credentials they have and the influence that they could have on your strong future. Here we go. You're in perimenopause, menopause, or postmenopause, and you're not slowing down. You're just getting started. But the old rules don't apply anymore. The workouts that worked before, they're working against you now. The advice you've been given, incomplete at best. I'm Debra Atkinson, and I'm the founder of Flipping 50, the pioneer in fitness for women in midlife. For more than 40 years, I've been in the trenches with women just like you, and for the last 12, right here on this podcast, and, and the founder of Flipping 50: The Stronger Way. And membership. Welcome to Flipping 50 the Stronger Way, where science meets strength, where you'll find the tools, research, and real talk to build the body and the life you want in your second half. Each week you'll get evidence-based exercise and nutrition strategies, conversations with leading experts, and honest answers to the questions your doctor didn't get answers to in medical school and doesn't have time to answer in an appointment. This is your show. Let's get stronger. If you're listening carefully, and I don't just mean to this podcast, by the way, I mean collectively to the world at large. And yes, I suppose social media, but really we're talking news, scientific-based, evidence-based news. We don't have a fat problem, we have a muscle problem, and we have a frailty, fragility, At risk of falls problem. With greater strength, power, VO2 max entering menopause, women have fewer vasomotor issues, less chance of developing dementia and heart disease. And until fitness is truly treated as a vital sign, exercise may still feel to so many, too many, optional. So it's defined, by the way, Low muscle mass, or sarcopenia, is defined as significant loss of muscle and strength. And I want to let you know a little secret. Until fitness is designed and treated as a vital sign, like your blood pressure, your heart rate, it still may feel optimal even to you. It may feel like it's extracurricular and you're getting ahead, as you well may be. But exercise absolutely is better than nothing, any exercise. But if you really want it to do something for you, you have a specific goal, a way you want to live when you're 80 or 85, then measuring if it's working is really necessary, which is after all why they're doing blood pressure, right? There is a healthy norm versus Not so much. Same with cholesterol or any other routine test done. In May, I taught a brief demonstration to physicians about how to administer two fitness assessments that could be done and interpreted, both of them, in less than 3 minutes. And these are directly related to sarcopenia, again defined as significant loss of muscle. And strength. Important, right? So some of these functional tests that I'll describe have a stronger relationship with your longevity than your blood pressure, which is never missed. I mean, have you ever not had your blood pressure taken? If you've gone into the doctor for anything, you went in because you think you have a virus or aren't sure if it's viral or bacterial and can they do something for you, right? They'll take your blood pressure. And so here I'm suggesting this will become the doctor's visit of the future because of the weight that a doctor carries. We go and see them, we expect that they know things about our health that we don't know. Shouldn't they know this? Shouldn't they be tracking this? Because we know so much more about the positive power that our own daily habits and weekly habits have on our now health and our future health. Don't we all wish just a little bit, "I wish I would've known the benefit of exercise toward my healthy future self when I was 30 or when I was 40, when I actually could've gotten ahead of the hot flashes, night sweats, belly fat, weight gain. And yes, I know for some of you, you're listening and you've been active and still experience some of those things, but I want to point something out. If you experience some of those signs and symptoms still, even though you're exercising, potentially you have sailed through better than you would have having not exercised at all. And we now know This is the exact reason to measure because it's not just an 'anything works' better than nothing. And I hesitate to say that because if you're listening right now and you are one of those struggling to get or stay started, keep the habit going, I don't want to discourage you from doing something and getting started. However, we have to see that if we want really specific results and they're intended to help us decrease our to lower the risk of symptoms, to age better, we want to be measuring the right thing so that we know the activity is actually having the right result. And that is the one place where so many of us for years weren't. We were measuring using a scale. It didn't tell us what the weight composition was made of. And unfortunately, many of us lost weight, went down that cycle of Lost weight, but yet a large percent of that was muscle. We regained weight because a large percent of that was muscle. Our metabolism slows. We go through that vicious cycle too many times and we have higher fat weight than we have muscle weight. We can no longer afford to play that game and we have to be much more careful if we want to lose weight. We don't really— we want to lose fat, we want to maintain muscle, and the truth Be told might be we want to gain muscle, period, end of story. We wanna gain strength. Maybe it's that we don't end up gaining muscle, we gain quality of muscle. Within that muscle, the mitochondria production, that's your energy central, by the way, every— everybody's got it, is better. And that's what will determine our longevity. So don't fear gaining mass. You're not gonna get bigger and bulkier. However, you may gain muscle tone and definition that you didn't know you had, but you won't gain muscle mass and strength and avoid sarcopenia by chasing muscle tone, thinking 4,800 reps, you know, and all of this quote-unquote toning. Go for the strength. You're going to prevent yourself from wear and tear on those joints and gain something that will keep you alive, thriving longer. So if your doctor's visits get an upgrade, to the pace of science, truly keeping you thriving, this is what it would look like. So given the time you spend with a physician is often really short, I chose these two tests to teach the physicians because they predict so much and they don't take much time at all. They give you real feedback about the value of your exercise toward the value of your future life. And energy. And I want them in your hands. And by the way, when you find out what these two tests are, this is pun intended because one involves your hands. So you can essentially take the pre-test and you can ace the quiz should your doctor ever start. All right. And if not, you can take matters into your own hands right now. So let's go. And I'm gonna start though with a quiz. So there are two functional tests I will give you, But I'm gonna give you this one, and if you happen to be driving or maybe you're hiking, use your fingers to keep track of your score. There are not a lot of questions, but there are enough where you're gonna have to tally this. And spoiler alert, I'll give you this, it's like golf, you want fewer points at the end of the game, okay? So this is called the SARC-F, S-A-R-C dash F, SARC-F screen for sarcopenia. So it's component question scoring. So with each question I ask you, I will say, if you say this is 0, or this is 1, or this is 2, just so you know how it's going to go. The questions are easy. You have the answers. Okay. This episode is sponsored by the Flipping 50 Menopause Fitness Specialist. It is the framework that we designed our entire membership and program based on. Since 2013, I've been developing that. After 30 years of working with women in midlife, that was born. And in 2018, we rolled out the Menopause Fitness Specialist to train other fitness and health pros on how to actually prescribe exercise. Here's where we're going next, in case you wanna get started now, that we're actually training physicians on exercise prescription, knowing they get very little of it in medical school. And hoping that it also bridges the gap for you who may be a fitness or health professional, or want to be, who works with women in menopause, because there is so much demand and so much room for you right now. If you are working with women in menopause, but not getting all the results, don't have a reliable, predictable framework that gets you results over and over that people know, like, and trust, come and talk to us. We'll put the link in the show notes for today. That's the Flipping 50 Menopause Fitness Specialist. And if you want to head on over to fitnessmarketingacademy.com, it's where we have all of the content dedicated to you, health and fitness pros. So first of all, strength. How much difficulty would you have in lifting and carrying 10 pounds? No problem whatsoever? Give yourself zero. You're good to go here. You had a little trouble with 10 pounds, give yourself 1 point. Or you'd have a lot, or you'd be unable to do that right now, give yourself 2. Next question, assistance in walking. How much difficulty do you have walking across a room? No difficulty, 0 points. You have some difficulty doing that, 1 point. You have a lot of difficulty, or you use aids or are unable to, give yourself 2 points. And I want you to answer this and realize these questions, you might have to come back to it. Let's say right now you're in the hospital recovering from something like a surgery on your lower body. You're going to probably struggle with these and your answers are not going to be great. Come back and do it again in a month or 2 months after rehab, okay? Next question, rise from a chair. How much difficulty do you have transferring from a chair or from a bed, getting up and out of bed? No problem whatsoever, 0. Some, 1 point. A lot or you're unable to do this without help, give yourself 2 points. Climb stairs. How much difficulty do you have climbing a flight of 10 stairs? No trouble, 0. Some, 1. A lot or you're unstable, 2. Next question, falls. How many times in the past year, so full year, okay, have you fallen? No falls, give yourself a 0. Less than 3 falls, give yourself 1 point. 4 or more falls, give yourself 2 points. Data suggests that from your score, end of quiz by the way, you can put your pencils down. Or your fingers, but no, hold your fingers up, what was your score? 4 or more predicts the need for further, more comprehensive evaluation, meaning we're a little worried about that, okay? So if that describes you right now, and again, let's say you just had a hip replacement and you're in post-rehab, you may have to think more about getting up and out of a chair, moving across the room could be a problem. You maybe didn't have that hip replacement because of a fall, you had it planned, so you're okay there. But if you have greater than 4 points or even 4, a need to, to do further evaluation. So we'd be a little concerned about that. All right, let's go on and look at 2 functional tests. Now, one of these is as simple as it sounds. The first one, you need a regular chair. And if, in case you don't know this, a little trivia, a standard height chair is about 17 inches high. So the seat is that— a dining room chair, your regular kitchen table chair. Now, if you have a bar stool at your kitchen counter, totally different, and you're not going to be able to use that one. Okay, but somewhere in your house you probably have a standard height chair. So I happen to be sitting in my office. I have a swivel chair on rollers. This one would not work, okay? Even if I adjusted it, not ideal because if I got it to the right height, it still is movable. It's not a great test. This is called a 5-time chair stand. And there are a lot of sit-to-stand tests, by the way. So we can make it a 5, we could make it a 10, or we can make it a timed test where we'd say, all right, I want you to do a 30-second or a 1-minute. And for anybody unable to do a timed test, in that length because they just don't have the endurance, we'd cut it down to 10. And now that more likely is somebody with a neurological disease or who's got really low muscle mass and strength and probably an older adult compromised. We know they're probably not gonna do well. But if I were to give you this 5-time chair stand, number one, it's really easy to do. It takes 5 seconds. We could do that. Or probably takes a little bit longer, maybe though up to 15 seconds, and then I'm gonna be worried about you anyway. Spoiler alert on that one. So we start you feet flat on the floor. You're sitting in the middle of that chair, not back against it. There's no problem doing that, but it's a disadvantage for you. And then you're gonna take your hands, cross them over your shoulders to the opposite side. They're across your chest and you're gonna rise. On the go, you stand and sit 5 times. When after your 5th stand, your butt hits the chair, that's time. Boom. So we start the timer. You have somebody do that for you, or you hit it on your watch or your phone. And when your butt hits the chair, done. Okay. So you measure basically how quickly a person can stand from your seated position 5 times without using your arms, a time greater than 15 seconds indicates probable sarcopenia, and a time of between 12 to 15 seconds suggests a greater risk of fall. So see how you did. Most generally, if you were here, you are high functioning unless you have some kind of neurological compromise. Maybe this is really also testing your balance. What it tests is power. So combining two things, strength and speed, because I'm asking you to do 5 times and we're putting you on a timer, I'm asking you to do it under speed duress, basically. That's an indication of power. And you may take that for granted right now thinking, really, that's not very powerful. It's not like asking you to do an explosive squat jump or move a weight with a lot of speed. But when you're 80 or 85 or 90, you're going to say, ah, yes, this takes a little power to get up from go to zero to everything all at once. So again, test yourself 5 times and do that under time. What is your time? And say 12 to 15 seconds, I'm a little more at risk for falls. Over 15 seconds, indicative of sarcopenia. So you and I potentially are still in an age range where we may have aging parents. Give this test to your aging parents or parent. Second test is a hand grip strength test. Now for this one, you do have to have a tool, a dynamometer. I will put the one I like in the show notes, so you can also get there by going to flipping50.com/resources or on the website. It's under Debra's Favorites, and my Amazon store is listed. You're gonna go there, and I have a one called Fitness Tools, and you'll see the one I have. So I believe it's Handexer. It's a dynamometer, and depending on what Amazon does on a given day, it's about $30, $35. So really easy, everybody in your house can do it. I take them to retreats. We'll have everybody in the group do them. We have a little discussion about about the value of the test and what it means. And when I occasionally, very occasionally meet with a person one-on-one, whether they come to my home or I'm in theirs, I will take this and we'll do this. So you do a hand test by flexing your arm at 90 degrees. You hold onto the dynamometer, set it on, say, okay, start. And you would do the best of 3 tests. So you take the average of that. Or if you were, if you were an athlete, what you would do is say, let's just do 3 trials and let's take the best of those because we want this one-time wonder. We want to see what your max is and we'll take that. But the reason we would do the average of 3, if you are just a mere mortal like you and I, probably really fit into that category, is you can have a fluke. And do really well, or that sometimes that first one— what I've noticed is both for myself and for clients, that first one you're kind of weak and you're kind of like, "What is this like? What am I doing here?" And then you shake it out and recover, and when you're ready, you do it again and you actually do better. So the second one almost always is peak, not necessarily, but we're going to take the average of those 3. So there's no I was really weak the first time, didn't know what was going on. And this, there might be also a, this is a fluke, like you did really, really well and let's just, maybe there's room for error there. So average of 3 for normal mere mortals. And if you're really an athlete and we wanna see what is your biggest powerful potential, we would just take the best, absolute best. All right? So let me give you the scores in case you've got a dynamometer. Cut-offs for probable sarcopenia are, for males, I'll give it to you both, it's 59.5 pounds or 27 kilograms. Those are equivalent. For men, that is. For women, the cutoff for sarcopenia where we'd start to say, "Hmm, is less than 35.2 pounds or 16 kilograms for women. So again, we want to look at that. And here's why this is important. And I always say this, I'm a broken record, so if you've heard me say it, I apologize, but then not, not really. So I don't want you walking around the house squeezing tennis balls or racquetballs thinking, "This is how I'm getting my grip strength ready for my next No, no, and no. Your grip strength gets better by doing weight training. So what studies have proven over time is that looking at men and women, different age groups, we look at total body strength. And if we were gonna take you really into the gym to do it, we would do anywhere between a 1 rep or a 3 rep or a 10 reps of rep— I'm sorry, maximum— and have you do, say, a bench press or a leg press and say, what is your maximum? That really is indicative of your total body strength. And what we know about hand grip strength tests is they tell us the prediction. There's a correlation there. Your hand grip strength tells us how your total body strength is. So if you're doing strength training, your grip strength is getting better. You are getting better at holding on, but your biceps, your chest, your leg strength shows up in your hands. So I want you to really fully understand why that test is done. It is easier and safer than having you do, say, a 10-rep or definitely a 3-rep. We're getting really heavy there. Max test. So with young male athletes, I guarantee you everybody shows up for football camp at a college, a Division I school in the fall. They're gonna take them into the gym and find out what is it. And they're gonna probably test them before they leave in the spring and say, hey, here's what I want you to be doing over the summer. Get yourself into a gym. You better be lifting cuz we want you to show up here in the fall. With this kind of a mark, right? So that is definitely happening. Young athletes who are used to really going hard and heavy, and it's a little bit safer to test them like that. For you and I, or someone who had stepped away from strength and wasn't doing it, we don't necessarily believe that it is the— in your best interest to do a 1-rep max test. Certainly, we err on the conservative side with most individuals and do a 3-rep so we can predict your 1-rep max. Or a 10-rep, even safer yet. But that is the importance of it. A hand grip strength test is not just showing you what your hands can do. It's total body strength is reflected in that. If you want and are curious about overall your fitness level for longevity, There are a multitude in about 6 areas where your fitness really shows up as it pertains to your longevity and/or mortality, depending on how you wanna think about things. I'm gonna go for longevity. And your mortality risk will increase if your balance is not great, your stability isn't good, your strength isn't good, your power isn't where it could be. And here we are potentially exercising intentionally for a result or outcome But I'm going to say this for myself. Left to our own devices, what are we thinking about? We're thinking about how we look, right? Aren't we? How we look in the mirror naked, even to ourselves, matters. Still does. And there's nothing wrong with that, but it doesn't give you enough evidence. Getting on a smart scale is way better than getting on a normal, dumb scale. Weight only does not tell you what that weight is made of. However, that is still not quite enough. What is your power like? Will you be able to get out of a chair? If we're going to struggle with it now, I guarantee you in 20 years we're going to struggle with it. And your 20-year-from-now self is going to say, "What were you doing while you were putting in all those steps and going to the gym all the time? And it's not paying off for me now." Why did you do that? So I'm pretty much thinking that's what you're gonna think. And I wanna tell you something. This becomes really important when life somehow gets away from you and you thought you were in control and you thought you were eating well, drinking well, sleeping well, had a pretty good life as far as health goes. And then something happens, a routine surgery for a joint that just has gone through wear and tear it doesn't go so well. Maybe there's an infection. Maybe you have to go through things you didn't know. The more fit you are, the more power, the more strength, the more VO2 you have on your side and in that corner. If those things happen, the better you will come out the other side, because if there's bed rest, the stronger you are going in. Those days you have to be at bed rest because you've got an infection, you've got things and complications going on, the better off you're going to be on the other side. So realize that sometimes what we're doing is not just preparing ourselves for the 85-year-old self that we will be and wanna be, and hopefully still be able to travel and choose to do that and be active. And hold the grandchildren, but not just hold them and have somebody put them in your lap in the rocking chair, but go get them and get them from the floor and play with them in the swimming pool. You also have to prepare for those things that we don't know are coming. And I share this with you to share— I've got a family member going through that right now, and until last week he was the healthiest of, of one of my siblings. And you just don't know. And so be prepared. Prepare yourself as well as you possibly possibly can. And when you prepare yourself physically, I think you're also preparing yourself mentally. I think it's an insult. I think it will still hit us like, are you kidding me? Like, I did all that for to be here and have that happen that you couldn't control. And in a way, the answer to that is yes, you did. You prepared yourself because going into it like this means you'll come out of it better like that, no matter what. And so look at what you can. In the resources, I'm going to put the Longevity Fitness Scorecard. It's a PDF, it's free. You, you do have to pay for it with your email, and I will email you and follow up because I want to make sure you're doing this. So yes, and if you really despise those gatekept things, there's a reason, because I know it's really easy to put off fitness. So We do, we communicate with you and I will. And if that makes you angry, it's okay. Don't opt in to do it. Okay. And next I'm going to share with you the 10-Day Hot Numb Other Challenge. If you're listening in May of 2026, we're preparing the next one. You're open now until the 31st, because once we start, we don't want you to come in and miss part of it. You can't catch up during 10 days. You can't make up day 1, 2, and 3. If you join in 3. It doesn't work like that. So you'll get access to everything the sooner you register and sign up. If you miss this one, you can click on the link and see. You may find out you get on a notifications list, or you may be lucky and the next one is open up. I'm gonna link to that hand grip, the Dynamometer. It is a mouthful to say that. There are a lot of M's in that word, but I will link to that. And again, if you're looking for a reasonable investment to make for your health, that would be it. I would say smart scale and then this. And there are a couple smart scales I like. Those are also in my Amazon store, and you'll see them in all different price ranges. I'm about to check out another one, and I'll share all the results with you from that. If you are a 'prove it to me science' girl, the science is also in the show, and I love that. I hope that you understand science is only as good as your ability to interpret the science and understand what are random controlled studies, what is the difference or the similarity between you and the subjects that were studied, and realize that you also are a study of one. So every study out there may not completely apply to you, but it's good to know and start with a framework. And that's how we use studies. We use studies and then we work with real people to prove, do they work for that real person or don't they? And We've done so for the last 12 years, and thank you for honoring me with your time today. You can get all the details here from the show notes for today. And if your doctor is already fitness testing, I want to hear from you. Tell me about it. The information shared on Flipping 50 the Stronger Way is for educational and informational purposes only and not intended as a substitute for medical advice, diagnosis, or treatment. Always consult your physician or qualified health healthcare provider before beginning any exercise program, making changes to your diet, or adjusting any medications or supplements. Individual results may vary. Debra Atkinson and Flipping 50 are not responsible for any injury or adverse outcomes resulting from information presented on this podcast.