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Hey everyone, Mikki here. You are listening to another Mini Mikkipedia Monday. And this week I'm integrating a bit of a personal story with hopefully some practical tips and information on supplements for older people. So back in December last year, my husband and I, were in Queenstown doing a bit of running

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of the Not the Wild event. And when we got back from a run, I noticed that I'd had a couple of missed calls from my sister, which was not unusual, but I, you know, wasn't quite sure what was going on. So I gave her a call and she told me that my dad or our dad was in A and E. And this was pretty like shocking to me actually at the time. So my dad, I

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is 70 and he's really robust. You know, he out of both of my parents, he would definitely be the most resilient one. Like he still works, he works as a cleaner, he has a house that he maintains, he walks all the time. Well, he tells me he walks all the time. I don't know whether he's just telling me that or if it's actually true. But he's fairly fit, you know, and he's healthy and out of both of my parents, for the majority of my adult

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He has been the one that's been interested in health and well-being and trying to keep himself as fit as possible And this is I don't mean to be disrespectful to my mum or anything like that because she too is is now quite interested in that but For a long time it was really you know, dad was the one who was always super interested in it So when I got the details from my sister, it turns out that dad had had COVID for about 10 days before going into hospital

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And it wasn't the COVID that was the catalyst for his going into hospital. However, he was also at the time and has for a number of years, has sort of dermatitis, psoriasis. So little sores on his skin that doesn't heal well. And actually, I have been telling him for years that dairy and gluten free is actually one of the best things that he can do for that.

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because that skin irritation is in fact sort of an inflammatory response to something. And when you pull out the major dietary triggers, which would be dairy and gluten, a lot of that inflammation can subside. But it hadn't really been a topic of conversation between us. And I took truthfully over the last few years, he had mentioned it, I'd sort of forgotten about it, you know, we just went about our way. But in December last year, dad got COVID

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He was bedridden for like 10 days and he couldn't, like he said that he was, like subsequently he had said that he was super tired, really uninterested in doing any of his hobbies which is reading and listening to music and watching YouTube about music. He said he was really uninterested in any of that, didn't eat hardly anything, particularly in a week of that sort of bed rest that he had. And some of those souls that he had had.

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actually were, they ended up being like wounds actually, so he needed to dress them and he didn't have the energy or inclination to do that either and one in particular on his knee started swelling up, looking really inflamed and angry and actually his whole knee had swollen up to the point that on the Sunday my sister called me, she had gone around to see him,

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to see him because the Covids and they were following the rules, even though this was December last year. And then saw him and he was in incredible pain because the wound was literally like festering on his knee. And the only thing really for them to do was to take him to A&E. So he went into A&E, but of course, because he was still testing positive for Covid quite strongly too.

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infection and the COVID meant that he was still very, it was still like a strong positive. He had to go into an isolation room and no one could see him. But then of course, dad being dad, his phone had died like, you know, probably days earlier. And so no one could actually contact him. And it was, like I say, it was a pretty worrying experience to hear

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this is what's going on with your parent and you had no information, essentially. So over the next few days, dad in the hospital care, they dressed his wound. He had cellulitis actually in his knee and there was some concern that it had traveled to his joint and that would have required a surgical intervention. But thankfully that didn't happen. So they were able to take care of the wound and essentially he

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had to remain off his knee. And in fact, this was the case for him for a good four weeks post-hospital visit. And so a week after he was in hospital and had to come back from hospital, so he got out and I ended up traveling back down to Dunedin and just spending a bit of time at home with him, just making sure he was sorted with all of the things that he needed to do in his real life, because he couldn't have done anything.

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He was not supposed to weight bear on that knee because it was just going to impede on his recovery. And I mean, the knee was double the size of his other knee. In part, of course, this was due to the bed rest that he had to undertake because of COVID. This is well before he went into hospital actually. And if you had listened to my episode with Professor Brendan Egan about exercise

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sort of older adults or exercise in aging, you will probably remember Brendan saying that you can lose a decade's worth of muscle mass in 10 days. And that is what I saw had happened to Dad. He was very thin. And Dad and I have a very similar physique. So he doesn't have very big bones. He has like, he's like quite lean, limbed and things like that. So he's always been the, soon quite lean.

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Other than, you know, we need eight to many cheese toasties back in about Maybe 208 and I had to do an intervention and get him to lose that six kilos but other than that very lean so To see him so thin was also really worrying because the thing that really sort of accelerates mortality in Older adults is bedrest

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And that's why fractures are such a critical and is such a bit of a catastrophe really for an older adult because they then are unable to be mobile. They then lose the muscle mass and that is what leads to early mortality in an older adult. And in fact, I believe the statistics are that if we're thinking about fractures, 30% of people who have a fracture over the age of 65 actually end up passing the same test

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within a year, which is a pretty scary statistic. So seeing dad, but also knowing that usually he's really fit and robust, but that he went downhill so quickly, really just made me think we need to put in some dietary interventions here as well to ensure that when he does get back up and running and able to, well, metaphorically running, able to move around and be mobile, we need to make sure he's got the nutrients he needs

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help support that and help rescue any of that muscle mass that he has lost. And let me tell you, it is super difficult to do that in an older adult. That is why if you are not an older adult and you're currently in this pre-contemplation phase of strength training, you just better do it, to be honest. There is no, make no bones about it. You actually are accelerating.

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years of poor health now if you don't do something about that and it is well within your control and Hubster if you think I'm talking directly to you well you're not wrong well being a little bit facetious but actually anyone listening to this you know how I feel about this anyway so I just wanted to chat to you actually about sort of set the scene of the situation that dad was in which is

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and then tell you what I've done to sort of intervene. So first and foremost, let me hit that psoriasis. As a condition that sort of is provoked by inflammation, I then, I just doubled down on that dairy and gluten free actually. And I said, dad, you just have to suck this up and you just cannot eat cheese. You cannot consume dairy. And you are way better off being gluten free.

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and he was actually totally fine with that. So, you know, prior to an earlier intervention on this, he was a huge dairy lover. And look, dairy is super healthy. So I'm certainly not saying dairy is not a healthy and nutritious sort of source of nutrients, calcium, B vitamins, protein, things like that. But if you have inflammation, the casein protein in dairy can provoke additional

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and Cal's dairy contains casein. So we switched dad to an A2 milk, which is casein free, so it's removing that beta A1 casein. And we got rid of the dairy yogurt and we switched that out for a plant-based yogurt. And in addition to that, we got dad having almond milk, which is fortified with calcium. Now,

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This happens quite a bit actually so I did just want to bring it up is that I'm currently at Dad's house on my way back from a trip that I had in Queenstown just for funsies. It was fun actually and I saw he had lactose free milk in his fridge and not a two milk and that's actually quite common like people get a little bit confused by the thing they're supposed to avoid and they just go for what they see available. So it is you want to avoid the A1 caseine

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protein and you just want the A2. With regards to cheese, goat and sheep, cheese is actually free of casein so that's fine. Buffalo dairy though is 90% casein so you do want to avoid that. And same of course goes for goat milk or yogurt and sheep milk and yogurt. So we sort of address that dairy element and there are in fact other A2 cheeses that are around which are delicious.

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And the next thing of course was the gluten. So in addition to removing the high gluten, like just normal bread, dad sort of switched to a gluten-free loaf and also has sourdough, which has a low gluten load. Like dad is not celiac. It is more about removing that inflammatory response. So that's why the gluten was one of the things which we needed to,

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dropped that load on. But it isn't just in bread, you know, it's in it, you know, there's soy sauce, heats of other sauces, obviously crackers and biscuits, there'll be chocolate that has sort of gluten and dairy in it as well, there'll be shampoos and things that you put on your body that contain gluten too. So just being mindful of that, I think, when you're thinking about a gluten-free approach. So those are the two main dietary things that we did.

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And of course the next big dietary thing is that when your body is under trauma, much as it was for me and my bone injury, you do need to eat more calories. And Dad did not have an appetite during COVID and didn't have much of an appetite, obviously in hospital and then coming out of hospital. So we just did our best to make sure that we gave him lots of really good fats in his

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when he had toast, he'd have like butter and peanut butter and a bit of honey and banana and things like that, just to really stock up on calories in a way that was easy to consume. Because a lot of older people, and it feels strange to put my dad in that camp, but I mean that is who he is. They don't really have a great appetite. And that is one of the reasons why we get this accelerated bone and muscle mass is because you're competing with the, your caloric requirements.

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with this fact that you just don't want to eat. So finding solutions for that, like extra added fats and sneaking sort of nuts and seeds and oils and coconut cream, nut butters, things which are fairly easy to consume and even potentially over consume so you're getting in good calories there. And you may remember this from a blog about my bone health

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situation and also the podcast, your caloric requirements during sort of trauma might go up by 20%. So you need 1.2x the number of calories that you think you do. So we just made sure that there were plenty of opportunities for Dad to eat energy-dense and nutrient-dense foods that took up less stomach space. So he reduced down the vegetables on his plate as well. He's like me.

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And the next thing we did was of course think about the protein element and not just the protein that he gets from food, but you know, dad as dad being dad, you know, we had like a lot of people I think that I talked to they they described this is that they spend years in there sort of throughout their adulthood hood when times are a little leaner and they can't buy essentially what they'd want to buy.

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have to think about how much money you spend on food. Now, dad is working full time still and he also has a pension. So in actual fact, like the pension doubled dad's income. And so in terms of his income, he's way better off now than what he was even 10 years ago. But we are talking about decades of habits, having to buy things on a budget because there

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the money to do it any other way. So things like meat, which are a lot more expensive, a typical serving size for Dad might be half of what I would suggest it be. So we had to have a bit of a discussion about that actually and me sort of just saying you do need to just prioritize this a little bit more. But also, you know, he actually, even though he couldn't have maybe afforded it 10 years ago, he probably can afford to do that now.

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in his brain that he has to think in a much more sort of restrictive way from a financial perspective. So anyway, we had a sort of conversation about that. I also, for his Christmas gift, gave him a first light sort of meat pack. So if you haven't had first light meat, it is delicious and I highly recommend it. And I also got him in a few of the Keto box, which is the company that I'm a part of, got in a few of those meals as well to make it easy

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their high fat, their high protein, their lower carb, they're actually great from a calories perspective. In addition to that though, I really doubled down on his protein in the morning. So we got him a couple of plant-based protein powders and also whey protein isolate. Now whey protein isolate protein powder is stripped of the casein and actually it doesn't mean that it's

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participant in one of my Monday's matter program, which I was really thankful for, because I thought that, you know, it was completely casein-free, but it's not. However, what I do know clinically is that people who get an inflammatory response to casein actually can tolerate WPI fairly well. Now, I just want to be mindful that there are so many different proteins out there. You can see a 100% whey. You can see a whey protein complete. You can see a whey protein isolate.

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concentrate and all of those protein powders will probably contain a whey protein isolate but you don't want any other than the WPI. You want it to be isolated from other sources of protein so WPI tends to be more refined, more expensive, much easier to digest actually and it's sort of gold standard protein. So that was one of my first options for him and the other of course was a fermented pea protein.

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protein which has a slightly lower loosing content than whey protein but is still easy to digest and absorb however. So we got him on that protein and I made sure they had a minimum of 30 grams of that in the morning. In addition to that protein though to make up for that 30 grams because he would have it in a muesli or in a porridge something like that with the coconut yoghurt or plant-based yoghurt that he uses but then I also got him to

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put collagen powder in addition to that. Now because of his wounds he needed that collagen and vitamin C so I got him the purez collagen powder that has the additional vitamin C in it. I got him that just to help support the synthesis of tissue endothelial tissue which we know is important for wound healing and to help him

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with the substrates he needed for that process. In addition to that, of course, it's super helpful for bone and muscle, we know this. And many people who have joint pain actually anecdotally say that they get a really good effect of putting collagen in their diet. But you do want the collagen with the vitamin C, that's essential for sort of collagen synthesis. So we got them on the collagen as well. Now, a lot of the time you'll hear that collagen isn't worthwhile

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because it doesn't have the leucine protein in there. And I have to respectfully disagree with this because leucine is one thing and it's super important for muscle protein synthesis, but we do still need the other amino acids. Collagen has glycine, proline, hydroxyproline, and these are amino acids that aren't essential so we can produce them ourselves, but we do go through periods of time

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These are conditionally essential, meaning that our requirements are more than what our body can produce. So in that sense, this is where collagen is super helpful. Whenever you've got a wound or you've got some sort of trauma or like me a bone issue, additional glycine, proline, hydroxyproline is not a bad thing. So we got them on 20 grams of collagen as well. So we've got the protein powder in the collagen. The next thing I did was get them

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on in essential amino acids, part of two, which is essentially when you make it up, looks a little bit like a corneal, it's sugar free though, and it has, as the name suggests, essential amino acids. So not just the branch chain, the leucine, isoleucine, and valine, but it also has the other nine amino acids, I'm sorry, the other six amino acids that the body cannot make and must be provided for in the diet. And this is a really good tool to use.

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whenever you're working with someone or you yourself is someone that can't stomach a lot of protein actually because if you have an amino acid drink alongside a meal that will then make a more robust or give you more loosing to make sure you get that robust muscle protein synthesis signal and we need that in the morning and the evening time. So I made sure that dad had that in the morning and the evening time because I knew that despite my

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waiting that he needed to eat more protein, he was probably just going to fall back into his old patterns and routines of decades old. So I just really wanted to sort of, I suppose, hedge my bets if you like to make sure that he would be getting enough of the essential amino acids. And in addition to that, we also got him some creatine. And creatine is just bloody amazing. I in fact just heard on a podcast today.

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dietary source of creatine is sardines. 100 grams of creatine will provide 4 grams of creatine. And when you dose it, I suggest dosing between 3 to 5 grams a day for your bones, for your muscle health, for your brain, cognitive function, works as an antioxidant. It's like a mood lifter in

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prevent low mood and depression. It is almost like this super amazing molecule and you can get it from diet of course but it's so safe and particularly in times of trauma where you have this sort of conditional increased requirement for things it is well worth taking as well and it is not as cheap as it was but it's still fairly cheap. So I got dad a bag of creatine and he's on that too. So from

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From a supplement perspective, we've got protein, we've got protein powder, we've got collagen powder, we've got essential amino acids and we've got creatine. Two other things which I think are really important which Dad also takes and has been taking actually prior to me intervening is omega 3 fats, really important for bone and muscle and brain and reducing inflammation.

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that episodes actually was with Dr. Stuart Gray and from the University of Glasgow. And we talked about the importance of omega-3 for bone and muscle. And it's an under-talked about subject, actually. So in addition to the ability to reduce inflammation, improve endothelial health, improve the blood flow through the body, it was also really important substrate to help protect muscle and bone. And actually, particularly in bed rest,

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really an interesting finding from one of the studies that Dr. Stuart Gray was involved in, in an older population. So omega-3s are really important for musculoskeletal health, in addition to the other functions that I just mentioned. Dad was already taking some omega-3s, so we just made sure that he was still on it. And then, of course, we made sure he was taking vitamin D, really important for bone and immunity. So those were the things

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for to, I'm sort of from a dietary intervention with dad. The last thing that we also did actually is we got him some resistance bands from Rebel Sport and he couldn't do anything obviously with his lower body initially but we got him doing some upper body movements like not press ups because he'd have to be on his knees but just some sort of against the wall chest presses, some sort of

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band, we did overhead press using the resistance band just to try to get a little bit more sort of functional movement in those areas which those resistance bands when used correctly they can actually help build muscle and they can help build strength as well. And from the place that dad was at he really needed both of those, any little bit helps. So that was in December last year.

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up to the end of March, beginning of April. And this is the first time I've seen dad actually since sort of mid January when we came down very briefly. And he's looking so much better. He's obviously his knee is looking like back to normal, which is great. So movement is back to normal, which is great. And he's also not looking nearly as fragile or frail, which is also really nice to see. Of course, I will talk to him about that lactose-free milk. But of course, I don't want to be

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to like ditch it because what a waste of milk. But I'll just say something to the effect of next time dad just remember it's A2 milk you want. You know like I have to try to remember not to be so dogmatic but to be fair I hate throwing things out so I would never tell him just to ditch it. And we've continued to sort of just stock up his stocks on his stock on his supplements and he's been super good about taking them and I will say what I do and what I encourage him to do as well is go to Sprintfield.

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go to the clearance section, find things that are on special which sort of fit the bill, which they might not be the best, most awesome, you know, sprinkled in unicorn dust type supplements that you can buy, but honestly, they are going to provide the substrates which we require. So he's getting his protein, has essential amino acids, and he's getting his protein,

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the creatine that he needs. So I think you've got to really be practical and realistic about recommendations as well. Anyway, gosh, that's almost half an hour and that was completely off the cuff. Hopefully you followed along alright and thanks for listening. Any questions, obviously just let me know otherwise. Obviously I'll see you Wednesday, not really see you, but you'll hear me Wednesday and catch you next week. See you later.