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Getting More Exercise than Guidelines Suggest May Further Lower Death Risk

Doubling to quadrupling the minimum amount of weekly physical activity recommended for U.S. adults may substantially lower the risk of dying from cardiovascular disease and other causes, new research finds.

The study, published in the American Heart Association journal Circulation, found people who followed the minimum guidelines for moderate or vigorous long-term, leisure physical activity lowered their risk of dying from any cause by as much as 21%. But adults who exercised two to four times the minimum might lower their mortality risk by as much as 31%.

“Our study provides evidence to guide individuals to choose the right amount and intensity of physical activity over their lifetime to maintain their overall health,” study author Dong Hoon Lee said in a news release. Lee is a research associate in the department of nutrition at the Harvard T.H. Chan School of Public Health in Boston.

“Our findings support the current national physical activity guidelines and further suggest that the maximum benefits may be achieved by performing medium to high levels of either moderate or vigorous activity or a combination.”

The American Heart Association recommends adults get at least 150 minutes per week of moderate-intensity aerobic exercise, 75 minutes per week of vigorous aerobic exercise, or a combination of both. That advice is based on federal guidelines for physical activity.

For the new research, a team analyzed 30 years of medical records and mortality data for over 100,000 adults enrolled in two large studies: the all-female Nurses’ Health Study and all-male Health Professionals Follow-Up Study. The data included self-reported measures of leisure time physical activity intensity and duration. Participants were an average 66 years old.

In the study, moderate physical activity was defined as walking, lower-intensity exercise, weightlifting and calisthenics. Vigorous activity included jogging, running, swimming, bicycling and other aerobic exercises.

Going above and beyond the recommended minimums reaped greater longevity rewards, especially for moderate physical activity. Extra moderate-intensity exercise – 300 to 600 minutes per week – was associated with a 26%-31% lower risk of death from any cause compared with almost no long-term moderate-intensity exercise. By comparison, people who hit just the minimum goals for moderate physical activity had a lower risk of 20%-21%.

For vigorous physical activity, getting 150 to 300 minutes a week was linked to a 21%-23% lower risk of death from any cause compared to getting none. That compared to a 19% lower risk for people who just met the minimum exercise target.

People who reported meeting the recommendation for moderate physical activity had a 22%-25% lower risk of dying from cardiovascular disease, while those who exercised two to four times the recommendation had a 28%-38% lower risk, the analysis found. Those reporting the recommended amount of vigorous physical activity were 31% less likely to die from cardiovascular disease, while those who doubled to quadrupled the recommended target had a 27%-33% lower risk.

Engaging in more than 300 weekly minutes of vigorous or 600 weekly minutes of moderate physical activity did not provide any further reduction in death risk, the study found. But it also did not harm cardiovascular health. Prior research has suggested long-term, high-intensity endurance activities – such as marathons, triathlons and long-distance bicycle races – may increase the risk for cardiovascular problems, including sudden cardiac death.

“This finding may reduce the concerns around the potential harmful effect of engaging in high levels of physical activity observed in several previous studies,” Lee said.

Donna K. Arnett, incoming executive vice president for academic affairs and provost at the University of South Carolina, said in the release that the findings fit with what is already known about the heart health benefits of regular physical activity.

“We have known for a long time that moderate and intense levels of physical exercise can reduce a person’s risk of both atherosclerotic cardiovascular disease and mortality,” said Arnett, who helped write guidelines for cardiovascular disease prevention from the AHA and American College of Cardiology. She was not involved in the new research.

“We have also seen that getting more than 300 minutes of moderate-intensity aerobic physical activity or more than 150 minutes of vigorous-intensity aerobic physical exercise each week may reduce a person’s risk of atherosclerotic cardiovascular disease even further, so it makes sense that getting those extra minutes of exercise may also decrease mortality,” she said.


Source: American Heart Association

An Hour of Weight Training Per Week Can Extend Your Life

Steven Reinberg wrote . . . . . . . . .

Adding regular strength training to your exercise routine may not only make you stronger, but let you live longer, too, researchers in Japan report.

Their new study says 30 to 60 minutes a week of muscle strengthening may reduce your risk of dying early from any cause, and from heart and blood vessel disease, diabetes or cancer by up to 20%.

“Doing muscle-strengthening activities has a health benefit independent of aerobic activities,” said lead researcher Haruki Momma, a lecturer in medicine and science in sports and exercise at Tohoku University Graduate School of Medicine in Sendai.

Strengthening exercises include lifting weights, using resistance bands and doing pushups, situps and squats. It can also include heavy gardening, such as digging and shoveling, researchers said.

“Although several physical activity guidelines recommend that adults perform muscle-strengthening activities based on musculoskeletal health benefits, our findings support this recommendation in terms of preventing premature death and major chronic diseases,” Momma said. “Also, our findings suggest that optimal doses of muscle-strengthening activities for the prevention of all-cause death, cardiovascular and cancer may exist.”

For the study, Momma and his colleagues pooled data from 16 published studies. The studies, which included both men and women, ranged in size from nearly 4,000 participants to almost 480,000.

The analysis found that muscle strengthening was linked with a 10% to 17% lower risk of premature death from any cause, as well as from heart and blood vessel disease, stroke, diabetes, lung cancer and cancer as a whole.

They found no link between muscle strengthening and any reduced risk of colon, kidney, bladder or pancreatic cancer.

The greatest benefit was seen when strength training was done up to an hour a week.

But more wasn’t necessarily better. After 60 minutes of strengthening exercise in a week, no further benefit in preventing premature death was seen.

Even better than strength training alone was combining it with aerobic exercise. (Aerobic exercises include swimming, cycling, walking and rowing.)

The combo reduced the risk of dying prematurely from any cause by 40%; heart and blood vessel disease by 46%, and cancer by 28%, the researchers found.

The findings were published online in the British Journal of Sports Medicine.

Dr. Russell Camhi, a sports medicine specialist at Northwell Health in Great Neck, N.Y., reviewed the new study.

“There’s good evidence that people should be incorporating strength training as part of their workout regimen,” Camhi said.

For men, strength training increases testosterone. For both men and women, it helps keep bone density up and decreases the risk of falls and fractures, he said.

“Strength training has also been shown to help with mental health and mood,” Camhi said. “There’s a lot of benefits that come from the muscular system being activated.”

Camhi recommends starting with weight-bearing exercise and gradually working up to using weights or other equipment. Weight-bearing exercises include walking, dancing and stair-climbing.

“Start with simple weight-bearing exercise, and then start adding in small weights as tolerated,” Camhi advised.

“You don’t want to go into strength training too quickly, because that can lead to some overuse and sometimes injury if not done correctly,” he added.

Camhi noted that videos and other instructional materials are easy to find online, and classes and personal trainers can also get you going.

It’s never too late to start a strength-training regimen, he said.

“There’s always benefits that can be gained. We cannot always undo all the loss from chronic disease, but there’s always benefit that can be gained from exercise,” Camhi said.


Source: HealthDay

Never Too Late: Starting Exercise in 70s Can Help the Heart

Steven Reinberg wrote . . . . . . . . .

Here are some numbers that could add up strongly in your favor.

If you’re in your 70s and get 20 minutes a day of moderate to vigorous exercise, you may ward off heart disease in your 80s, new Italian research suggests.

In the study of close to 3,000 Italians over 65, regular exercise was linked with a 52% lower risk of heart disease among men. Women also benefited.

The greatest benefit seemed to occur at age 70. Risk was only slightly lower at 75 and no lower in the early 80s, the study found.

“Engaging in physical exercises daily is of great importance even in late life, but at the same time, the sooner one starts, the better,” said lead researcher Dr. Claudio Barbiellini Amidei, of the University of Padua in Padova, Italy.

“These results reinforce the importance of promoting physical activity at all ages,” he added.

Researchers stressed that this study doesn’t prove that exercise alone prevents heart disease, only that there appears to be a connection.

Dr. Gianfranco Sinagra of the University of Trieste in Italy, who wrote an editorial that accompanied the findings, agreed.

“Even a small amount of physical activity confers beneficial effects in older people, however this benefit is mostly evident when an active lifestyle is present early in late life,” he said.

He said the beneficial effect of physical activity may be due to its ability to slow down atherosclerosis. Atherosclerosis is a disease in which cholesterol plaque builds up in arteries, obstructing blood flow.

“Movement is medicine also in late life,” Sinagra said, calling on health care providers to urge younger patients who are inactive to get moving and maintain adequate activity to obtain significant benefits to heart health and life expectancy.

“The routine assessment and promotion of physical activity should become a standard in health care,” he said.

For the study, Amidei’s team collected data on close to 3,100 Italian seniors who took part in a mid-1990s study. It began in 1995 and 1997, and follow-up was done four and seven years later. Participants answered questions about their physical activity levels at each assessment.

Moderate physical activity included walking, bowling and fishing. Vigorous physical activity included gardening, gym work outs, cycling, dancing and swimming. Those who exercised 20 or more minutes a day were defined as active and those who did less were considered inactive.

The researchers also gathered information on income, education, smoking and drinking. They tracked the health of all participants via hospital records and death certificates through the end of 2018.

In all, complete data were available for more than 2,700 participants, of whom 60% were women. Throughout the study, more than 1,000 participants were diagnosed with heart disease, heart failure or stroke.

Increasing levels of exercise and maintaining an active lifestyle were tied with lower risks of heart disease and death in both men and women, researchers found.

The biggest reduction was seen for coronary heart disease and heart failure in late old age. No significant link between physical activity and stroke was seen.

Dr. Gregg Fonarow, director of the Ahmanson-University of California, Los Angeles, Cardiomyopathy Center, reviewed the findings.

“Regular physical activity has been associated with improved cardiovascular health, including lower risk of [heart attack], heart failure, stroke and premature cardiovascular death,” he said. “Studies have shown these associated benefits are seen across the lifespan in both men and women.”

There are many ways physical activity can reduce the risk of heart disease and improve function, he said.

“These findings suggest that at every age, it is not too late to derive health benefits from physical activity,” Fonarow said.

The American Heart Association recommends:

  • At least 150 minutes a week of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity — or a combination of both, preferably spread throughout the week.
  • Moderate- to high-intensity muscle-strengthening activity, such as resistance or weights, at least two days per week.
  • Sitting less. Light-intensity activity can offset some of the risks of being sedentary.
  • Being active at least 300 minutes a week, for greater benefits.
  • Increasing the amount and intensity of exercise gradually over time.

The findings were published online in the journal Heart.


Source: HealthDay

How Regular Exercise Restructures the Brain

Ross Pomeroy wrote . . . . . . . . .

Physical activity can do wonders for the body. Exercise can trim weight, chisel muscles, and strengthen the lower back, among many other benefits. Less overt, but no less consequential, physical activity can also buff up your brain. Science is increasingly revealing that the brains of those who regularly work out can look very different compared to the brains of people who don’t.

Changes can start to occur in adolescence. Reviewing the scientific literature in 2018, researchers from the University of Southern California found that for teens aged 15-18, regular exercisers tended to have larger hippocampal volumes as well as larger rostral middle frontal volumes compared to healthy matched control teenagers. The hippocampus is most commonly associated with memory and spatial navigation, while the rostral middle frontal gyrus has been linked to emotion regulation and working memory. Studies suggest that these structural changes translate to improved cognitive performance and better academic outcomes.

Exercise’s brain augmenting qualities extend into adulthood, even though the brain tends to be less ‘plastic’ (easily changed) as we get older. Rutgers University scientists beautifully demonstrated this in a study published early last year:

The researchers recruited older African Americans, all previously sedentary, to complete twenty weeks of twice-weekly cardio-dance exercise classes held at local churches and senior centers. As compared to the control group comprised of community members of similar age and background who did not exercise, those in the program showed significant improvements in dynamic brain connectivity (or “neural flexibility”) in their hippocampus and surrounding medial temporal lobe, as measured using resting-state functional MRI.

In another study, published in August 2019, scientists looked at 45 sets of adult identical twins, who, within their pair, all differed greatly in physical activity levels. “More active co-twins showed larger gray matter volumes in striatal, prefrontal, and hippocampal regions, and smaller gray matter volumes in the anterior cingulate area than less active co-twins,” the researchers found.

The scientists also probed the twins’ cognitive abilities.

“More physical activity may expedite preconscious processing of visual stimuli and, in somatosensory domain, improve selective attentional processing by dampening the strength of unattended deviant somatosensory signals,” they added.

The brain alterations do appear beneficial, but current twin studies are too small, and the participants too young, to find whether exercise-induced changes can actually reduce the risk of cognitive disorders or improve outcomes such as education or income.

Researchers have also tried exercise interventions on much older adults, even those with Alzheimer’s disease, to see if physical activity could repair their stricken brains. In 2016, a team of scientists recruited 68 older individuals with probable Alzheimer’s disease to determine whether moving more could help with their symptoms. Some subjects aerobically exercised for 150 minutes per week while others underwent a less rigorous control regimen of stretching and toning for 26 weeks. Compared to the control group, the aerobic exercise group improved more on the Disability Assessment for Dementia at the study’s conclusion. Boosts to cardiorespiratory fitness were also linked to improvements in memory and reduced atrophy of the hippocampus.

Working out also augments the brains of otherwise healthy older adults. Getting thirty minutes of physical activity each day does seem to preserve brain volumes in adults over age 70 compared to sedentary individuals, according to a study published in August of last year. Moreover, higher cardiorespiratory fitness was linked to lower levels of brain atrophy in the research.

One way exercise can induce changes in the brain is by increasing levels of the protein brain-derived neurotrophic factor (BDNF) in the blood, which is linked to neurogenesis. More BDNF may mean more new neurons in the brain. Regular exercise also increases the growth of additional blood vessels in the brain and helps maintain current ones, leading to boosted blood flow for the oxygen-hungry organ. Lastly, physical activity seems to keep microglia in good working order. Microglia “constantly check the brain for potential threats from microbes or dying or damaged cells and clear any damage they find,” Áine Kelly, a Professor in Physiology at Trinity College Dublin wrote for The Conversation.

Regularly moving one’s body may be the closest thing there is to a health panacea, for both outside the skull and inside.


Source : Real Clear Science

Scientists Work Out How Exercise Saves Your Brain

Dennis Thompson wrote . . . . . . . . .

Exercise helps you stay fit, hale and hearty, and researchers say it may also help you stave off dementia and Alzheimer’s disease. Now they have a better understanding of the hidden benefits that aid the brain.

Older folks who are more physically active have higher levels of a protein that promotes better communication between the brain’s synapses, a new study reports.

“Synapses are these critical communicating junctions between nerve cells. They’re what sends the message from one nerve cell to another, and I think of them as where the magic happens when it comes to cognition,” said lead researcher Kaitlin Casaletto, an assistant professor of neurology with the University of California, San Francisco. “All of our thinking and memory occurs as a result of these synaptic communications.”

Even people in their 80s and 90s whose brains were riddled with amyloid plaques and tau tangles — the toxic hallmarks of Alzheimer’s — contained higher levels of these synaptic proteins if they were more active, researchers found.

The synaptic proteins are involved with the production and release of neurotransmitters, the biochemicals in the brain that promote communication between nerve cells, Casaletto said.

“We think having more of these proteins suggests that maybe you have more synapses and/or maybe your synapses are working a little bit better,” Casaletto said. “You’re getting more of that juice into the brain and facilitating communications.”

This study involved more than 400 elderly people who agreed to wear monitors that tracked their amount of daily physical activity. They were all participants in the Rush University Memory and Aging Project, a long-term effort to identify the causes of Alzheimer’s and dementia.

Researchers already had discovered that people within this group who had greater levels of physical activity also tended to have better cognitive performance and a reduced risk of dementia, Casaletto said.

The next step was to figure out why that was. Brain autopsies provided answers.

“We followed these adults until death. They donated their brains to the autopsy program, and we were able to look at the brain tissue after death,” Casaletto said. The average age of death among participants was 90.

Autopsies revealed higher levels of synaptic proteins in the brains of those who, while they lived, tended to move around more in their day-to-day lives, researchers said.

“We saw a pretty linear relationship. The more activity, the higher the synaptic protein levels. To me, this suggests every movement counts,” Casaletto said.

These levels were elevated even among people who had physical evidence of Alzheimer’s in their brains.

“The capacity of the elderly brain to mount this healthy response to activity might help buffer these age-related brain changes and help promote cognition,” Casaletto said.

Further, researchers found these elevated levels of synaptic proteins in six regions of the brain — not only in the memory center, but in other parts related to thought and reasoning as well.

“It suggests it’s more of a whole-brain phenomenon,” Casaletto said.

As people age, their brains tend to accumulate toxic proteins like amyloid beta and tau, the researchers said in background notes. As these proteins form clumps and tangles, they can interfere with synaptic communication between nerve cells and eventually cause the synapses and neurons to fall apart.

The findings suggest that physical activity can promote resilience in the brain, said Heather Snyder, vice president of medical and scientific relations at the Alzheimer’s Association.

A steady flow of neurotransmitters from these proteins might add up to better synaptic function for aging brains, maintaining communication between nerve cells despite the interference from toxic amyloid and tau.

“If you can keep brain cells healthy and communicating longer, you may slow the changes you would see in disease or you may be able to decrease the vulnerability of the brain to other injury or other insult,” Snyder said.

The study didn’t measure the vigor of each person’s physical activity, only how much they tended to move during the day, Casaletto said.

There are any number of activities you could pursue to promote brain health, Snyder said, such as ballroom dancing, neighborhood walks or riding a stationary bike at home.

“Find something that you’re going to enjoy, that you’re going to stick with and continue to do,” Snyder said, adding that seniors should check with their doctor before taking on a new activity.

The new study was published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.


Source: HealthDay

Balance Between Sleep and Exercise May be Key to Help Osteoarthritis Patients Manage Pain

Noah Fromson wrote . . . . . . . . .

It may shoot through the hands while typing or flare in the knees when getting out of the car. Wherever the pain, over 32 million Americans living with osteoarthritis experience it.

To reduce that pain, patients living with the degenerative joint disease are often told to exercise.

It sounds simple.

But people with osteoarthritis may experience pain when they start to move more, which can be a deterrent to taking up, or sticking with, an exercise program.

“Pain during movement is an important reason why this population isn’t more active, and we need to identify ways we can help to change this,” said Daniel Whibley, Ph.D., research assistant professor of physical medicine and rehabilitation at Michigan Medicine. “Otherwise, they may end up in a loop of pain and inactivity that we know can lead to disability later down the line.”

A growing body of research suggests that maintaining good sleep health – specifically good quality sleep for an appropriate duration – in patients with osteoarthritis may reduce pain. There is also strong evidence supporting links between sleep and being physically active.

“If you’re sleeping well, you’re more likely to be able to move more the next day or stick with a planned exercise program,” Whibley said. “And those who are physically active during the day are more likely to get a good night’s sleep.”

Whibley’s team looked to develop a new intervention that brought together insights from previous research that supports these relationships.

“There are many different physical activity or exercise programs for people with osteoarthritis, but they spend relatively little time on sleep,” he said. “Conversely, some researchers have started to investigate the effectiveness of cognitive behavioral therapy, the process of rooting out problematic thoughts and changing cognitive patterns, for insomnia as a way of reducing osteoarthritis-related pain.”

What hasn’t been investigated is whether intensively and simultaneously targeting both sleep and physical activity – and the optimal balance between them – results in better pain outcomes. Alongside a team of researchers, Whibley introduced the concept of a hybrid sleep-exercise program to two focus groups composed of people living with osteoarthritis-related pain and sleep disturbances.

The sleep improvement component involves an automated program called Sleepio, which delivers cognitive-behavioral therapy for insomnia over the internet, as well as components focused on sleep education and behavioral modifications to sleep routines. In tandem with the six-week Sleepio course, users complete an exercise program with remote weekly support from a program coach.

During the focus groups, researchers explained the outline plan for the hybrid program and encouraged discussion between participants about how best to adapt design and delivery plans. These discussions informed the development of prototype materials which were then shared and refined with the same study participants at a second round of focus groups held a month later.

The findings, published in the British Journal of Pain and supported through Versus Arthritis and the Dan Barry Research Program, reveal that motivational language, personal accountability and accessible educational materials are important features to include in a successful program for sleep and exercise for osteoarthritis-related pain.

“The participants wanted to be encouraged to stick to the sleep and exercise components of the program using terms void of negative associations that made it seem like punishment,” Whibley said. “They also wanted to share records of activity with health care professionals without feeling like they have no power in the dynamic.”

These features, however, also present parallel challenges.

Previous negative interactions with health care providers – like feeling patronized or underestimated – and being asked to excessively record sleep and daily physical activity may cause people using the program to feel disinterested or discouraged, said Anna Kratz, Ph.D., a co-investigator on the study and associate professor of physical medicine and rehabilitation at Michigan Medicine.

“Developing an understanding of what factors may present barriers to engaging with the program was a primary reason to conduct the focus groups,” Kratz said. “In response to our findings, we were then able to create intervention materials that would be more attractive to potential users, including a workbook that supports adaptation of intervention content for the individual using it – they can set their own activity or sleep goals and keep track of their progress.”

A test of the program’s feasibility is currently underway with a small group of people living with osteoarthritis. Once complete, the team will conduct a full trial. The results, Whibley hopes, will provide more insight into the relationship between sleep, physical activity and exercise, and how their balance can impact pain in this population.

“People living with osteoarthritis want to improve their sleep, physical activity and exercise behavior and reduce their pain – all of these are valued outcomes,” Whibley said. “I’m not saying this new program will be a magic bullet for everyone, but I think the hybrid approach holds great potential for the future of osteoarthritis-related pain management.”


Source: University of Michigan

Major Life Events Influence Level of Physical Activity, May Negatively Impact Heart Health

Starting a new school or a new job, having a baby or entering retirement are major life events that significantly affect a person’s physical activity level, which may lead to poorer heart health. Individuals and health care professionals need to be proactive in addressing this issue, according to guidance from a new American Heart Association Scientific Statement published today in the Association’s flagship journal Circulation. A scientific statement is an expert analysis of current research and may inform future guidelines.

The statement, entitled “Supporting Physical Activity in Patients and Populations During Life Events and Transitions,” focuses on the need to better understand how life changes affect physical activity levels and what can be done to help people maintain good heart health throughout life transitions. The statement writing group members note that because sedentary behavior is an emerging cardiovascular disease risk factor, it’s important to recognize how physical activity levels may impact health during major life events and transitions. The statement also provides guidance for health care professionals to identify, address and promote regular physical activity to patients experiencing significant changes in their lives. Options for community-level interventions to promote physical activity are also explored.

“Certain life events and transitions may mark the beginning and end of different phases of a person’s life, and these life changes may lead to periods of less physical activity and more sedentary lifestyle behaviors. Physical activity is an important heart-healthy behavior and too much sitting and inactivity is not good for you,” said the writing group Chair Abbi D. Lane-Cordova, Ph.D., FAHA, an assistant professor in exercise science at the Arnold School of Public Health at the University of South Carolina in Columbia South Carolina. “This is a particularly important topic right now because, in addition to life’s other major events, the COVID-19 pandemic is another disruption of everyone’s daily routines and activity levels.”

The American Heart Association recommends most adults participate in at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week. Children and adolescents 6-17 years old should get at least 60 minutes of moderate-to vigorous-intensity physical activity every day.

According to the U.S. Centers for Disease Control and Prevention’s Office of Disease Prevention and Health Promotion “Healthy People 2020” initiative, only 1 in 5 teens (20%) and about 1 in 4 adults (24%) in the U.S. routinely achieved the recommended levels of physical activity in recent years. While these rates are low across the board, data suggest these numbers could change significantly during a major life event or transition. The writing group examined data on 17 different life events or transitions, and found evidence of decreased activity levels during nine events:

Beginning a new school (elementary, middle, high school or college) – each distinct life events;

  • a first job or career change;
  • a marriage or civil union;
  • pregnancy;
  • parenting;
  • retirement; or
  • moving into a long-term care facility.

The writing group also assessed the effects of major life changes on various subgroups within the U.S. population to identify people most in need of support during life transitions. People most at risk for significantly lower physical activity during life changes include:

  • individuals with lower levels of education;
  • those who lived alone during the initial COVID-19 venue closings;
  • those who lacked safe access to outdoor space for exercise and physical activity; and
  • women during pregnancy and parenthood.

The “socioecological model,” which encompasses individual, social, environmental and policy contributors, was the framework used to examine numerous factors that affected levels of physical activity.

The analysis found that general factors affecting physical activity levels among youth (<18 years of age) at the individual level include:

  • gender;
  • age;
  • motor coordination;
  • time outside;
  • physical activity preferences
  • body image;
  • perceived barriers;
  • involvement in school sports; and
  • physical education.

At the interpersonal level, youth were influenced by their weight and physical activity levels, and by their parents’ education level. Environmental influencers for youth included neighborhood crime rates, perception of safety, walkability, proximity and access to school programs and recreational facilities. COVID-19–related restrictions and stay-at-home orders have also been related to changes in physical activity in youth and Lane-Cordova noted more data in this area will be important to consider.

The analysis of physical activity levels for adults (18+ year old) found individual influencers included:

  • the perceived health benefits of exercise;
  • history of and intention to exercise;
  • self-efficacy/confidence to achieve goals;
  • enjoyment; and
  • lower stress levels.

Social and cultural norms affected adults both negatively and positively, while environmental influencers included proximity and access to recreation facilities and greenspaces, transportation, neighborhood walkability and convenience.

Research specific to factors affecting physical activity during life transitions is less robust, so the statement suggests future efforts to identify socioecological factors that may help support routine exercise. Examples of these factors include safer streets for pedestrians and cyclists, rails-to-trails programs and park upgrades. The writing group proposes public health policies to implement these infrastructure changes would help ensure support for physical activity during major life events.

The statement also suggests practical strategies for health care professionals to support routine physical activity levels during major life events and transitions. Health care professionals can assess physical activity by asking a few questions as part of the collection of vital signs during a routine health visit. A brief screening tool of questions for individual patient responses may be a low-cost option in a clinical setting to assess physical activity levels and support needed. For daily patient use, the writing group suggests simple, commercially available wearable technology such as pedometers or accelerometers to monitor physical activity levels and changes. Simple metrics like adding 1,000 steps per day to increase daily physical activity levels may result in improved health benefits.

“It’s important to maintain or improve physical activity when major life events happen, which is often a time when exercise is most needed,” Lane-Cordova said. “There are so many ways people can do this. They could plan family activities that involve exercise, use free videos or websites to exercise at home or take standing breaks while at work. The most important things are to be aware of the positive health and cardiovascular impact of physical activity and make the effort to get moving.”

The statement suggests health care professionals have a big role to play when it comes to opening the conversation about physical activity levels with their patients. The writing group recommends health care professionals focus on compassion and understanding. Given that primary care physicians may lack the necessary time and resources for follow-up support, clinicians may look at expanding the roles of other members of the clinical care team, including nurses, medical assistants and health or lifestyle coaches.

The statement also mentions behavioral counseling as another means to provide support for physical activity during major life transitions or events. There are numerous mental and physical health benefits of starting and maintaining regular physical activity during major life events and transitions. Urging regular physical activity along with offering compassion and empathy supports physical and mental health during challenging times.

The statement writing group notes that health care professionals can be an important source of encouragement. Referring to past accomplishments may increase a patient’s confidence in their ability to incorporate regular physical activity into their daily routine. Motivational interviewing may be better received during life transitions and events than a more traditional educational approach during life transitions and events. And a variety of health care professionals, such as medical assistants and health or lifestyle coaches, can help provide physical activity counseling.

The writing group said it is crucial “to look beyond the health care setting and engage organizations, communities, workplaces, faith-based communities and assisted living facilities to promote physical activity.” The statement provides a list of resources for individuals and health care professionals, many of which are free and online.

Future areas of research should include improved surveillance efforts to assess physical activity, sedentary behavior and the corresponding overall health and wellness, particularly among at-risk and underserved populations, according to the writing group. More information is also needed to effectively characterize the impact of life events and transitions on sedentary behavior, especially given the growing body of evidence that too much sitting is associated with worse health outcomes. Finally, the statement highlights the need to develop and test interventions that specifically target life events and transitions linked to declines in physical activity levels.


Source: American Heart Association

All Those Steps Every Day Could Lead to Longer Life

Denise Mann wrote . . . . . . . . .

Miami publicist Robin Diamond is “step-obsessed.”

She aims for 10,000-plus steps every day using her Apple watch and even bought a treadmill during the COVID-19 quarantine to make sure she reaches her daily goal. The 43-year-old has lost 15 pounds since April 2019 and feels better than ever before.

“Walking saved my sanity and restored my body,” she said.

Now, a new study suggests that all those steps may also add years to her life.

Folks who took about 7,000 steps a day had a 50% to 70% lower risk of dying from all causes during after 11 years of follow-up when compared with people who took fewer steps each day. These findings held for Black and white middle-aged men and women.

And quicker steps weren’t necessarily any better, the study showed. Step intensity, or the number of steps per minute, didn’t influence the risk of dying.

The study, led by Amanda Paluch, an assistant professor at the University of Massachusetts’ department of kinesiology, appears in the journal JAMA Network Open.

“Step-counting devices can be useful tools for monitoring and promoting activity in the general public and for patient-clinician communication, Paluch said. “Steps per day is a simple, easy-to-monitor metric and getting more steps/day may be a good way to promote health.”

She added, “7,000 steps/day may be a great goal for many individuals who are currently not achieving this amount. We also found in our study that accumulating a greater number of steps/day was associated with an incremental lower risk of mortality until leveling off at approximately 10,000 steps/day.”

Two physicians with no ties to the study looked favorably at the findings.

“This is a very nice study with a great message: “Live longer, walk more,” said Dr. Guy Mintz, Northwell Health’s director of cardiovascular health at the Sandra Atlas Bass Heart Hospital in Manhasset, N.Y. “There’s no need to join a gym, no need to purchase equipment, just start walking.”

The research wasn’t designed to say how, or even if, taking more steps reduced the chances of dying.

But “exercise can reduce cardiovascular risk by improving blood pressure, reducing cholesterol, improvement of hyperglycemia [blood sugar] in diabetes, and contributing to weight reduction,” said Mintz.

Dr. Michael Massoomi is a big fan of step counting. He is a clinical assistant professor of medicine within the division of cardiology at the University of Florida in Gainesville.

There is no one-size-fits-all magic number, he said. “Instead of focusing on 10,000 steps per day, as many groups call for, focus on doing more than you did the day before,” he said. “If you get less than 5,000 steps a day, try to increase it to 6,000 in the next few weeks.”

This can mean adding a 20-minute walk into your daily schedule, said Massoomi.

You don’t need anything fancy or expensive to help count steps either, he said. There are many free apps for smartphones that work extremely well.

In an accompanying editorial, Nicole Spartano, a research assistant professor of medicine in endocrinology, diabetes, nutrition, and weight management at Boston University School of Medicine, pointed out that the step counter used in the new study isn’t commercially available.

“It is unclear the extent to which steps measured on these activity monitors compare with steps measured by common consumer devices, including smartwatches, pedometers and smartphone applications,” she wrote.

The new study looked at the risk of dying, but other outcomes matter, such as quality of life and mental health. “I hope to encourage investigators and research funders to focus on these understudied topics that will provide evidence to support a national step guideline,” Spartano wrote.


Source: HealthDay

Want to Avoid Sleep Apnea? Get Off the Sofa

Here’s yet another reason to limit screen time and get moving: Boosting your activity levels could reduce your risk of sleep apnea, according to a new study.

Compared to the most active people in the study, those who spent more than four hours a day sitting watching TV had a 78% higher risk of obstructive sleep apnea (OSA), and those with sedentary jobs had a 49% higher risk.

And that added risk was not due to their weight.

“We saw a clear relationship between levels of physical activity, sedentary behavior and OSA risk. People who followed the current World Health Organization physical activity guidelines of getting at least 150 minutes of moderate activity per week, and who spent less than four hours per day sitting watching TV, had substantially lower OSA risk,” said study leader Tianyi Huang, an assistant professor and associate epidemiologist at Brigham and Women’s Hospital and Harvard Medical School, in Boston.

People with this disorder stop and start breathing many times during sleep. Common symptoms include snoring, disrupted sleep and excessive tiredness. Poorly managed sleep apnea can increase the risk of high blood pressure, stroke, heart attack, irregular heartbeat and type 2 diabetes.

After accounting for risk factors such as obesity, age, smoking and drinking, the researchers found that people whose activity levels were equivalent to three hours of running a week had a 54% lower risk of sleep apnea than those whose activity levels were equivalent to two hours a week of walking at an average pace.

The study included more than 138,000 U.S. women and men without a diagnosis of sleep apnea. They were followed for 10 to 18 years. Over that time, more than 8,700 were diagnosed with the condition.

So are desk jockeys doomed? Not necessarily.

The researchers said folks with sedentary jobs could lower their risk by getting more exercise in their leisure time. Also, those who can’t do much physical activity due to physical limitations could lower their risk of sleep apnea by standing or doing other gentle activities more often.

The study was published in the European Respiratory Journal.

“Importantly, we saw that any additional increase in physical activity, and/or a reduction in sedentary hours, could have benefits that reduce the risk of developing OSA,” Huang explained in a journal news release.

The difference in risk between sedentary work and time spent sitting watching TV could be explained by other behaviors related to those activities, the researchers suggested.

“For example, snacking and drinking sugary drinks is more likely to go along with watching TV compared with being sedentary at work or elsewhere, such as sitting during traveling. This could lead to additional weight gain, which we know to be a risk factor for OSA,” Huang noted.

It’s estimated that 1 billion adults worldwide, aged 30 to 69, have mild to severe sleep apnea.

Anita Simonds, president of the European Respiratory Society, was not involved with the study but commented on the report. She said, “It is encouraging that even a small increase in physical activity or reduction in sedentary hours could reap potential benefits. It is therefore an important message to get across to our patients and their families in primary care and respiratory clinics.”


Source: HealthDay

Exercise Boosts Survival for People With Implanted Defibrillators

Just small amounts of exercise can benefit people with implanted heart defibrillators, new research shows.

An implantable cardioverter defibrillator (ICD) is a battery-powered device placed under the skin to detect abnormal heart rhythms and deliver an electric shock to restore a normal heartbeat.

The new study found that even slight increases in physical activity reduced the risk of hospitalization and early death after patients got an ICD. And that was true even if their fitness boost wasn’t from a formal rehabilitation program, according to findings published in the journal Circulation: Cardiovascular Quality and Outcomes.

“Cardiac rehabilitation programs offer patients a safe environment to increase physical activity after ICD implantation,” said study author Dr. Brett Atwater, director of electrophysiology at the Inova Heart and Vascular Institute in Fairfax, Va.

“Evidence has also shown cardiac rehab lessens the risk of additional hospitalization and death, but cardiac rehabilitation programs are underutilized, especially among women, the elderly, people from diverse racial and ethnic groups and those living in rural areas,” he said in a journal news release.

Atwater and his team examined data on nearly 42,000 Medicare patients (average age: 75) who got ICDs between 2014 and 2016.

Of those, 3% took part in a heart rehab program. During rehab, their physical activity rose by nearly 10 minutes a daily, compared to a minute-a-day drop off among patients not in rehab.

Those in a rehab program were 24% less likely to die within three years of getting their ICD than patients who were not in rehab.

The study also linked every 10 minutes of increased daily activity to a 1.1% reduction in death from all causes during that time span — whether patients were in a formal rehab program or not.

“Our study examined whether physical activity outside of a formal cardiac rehabilitation program could yield similar benefits, and we found it did,” Atwater said. “This suggests that additional options like home-based cardiac rehabilitation might help more patients realize the health benefits of increased physical activity.”


Source: HealthDay