Exercise

Posted on Cardiovascular disease, Diabetes, Exercise

Heart health tip for older adults in 2023: Step it up a bit

Ongoing research shows significant cardiovascular benefits at 6,000 daily walking steps at any pace

Lead author

Amanda Paluch is an assistant professor of kinesiology in the UMass Amherst School of Public Health and Health SciencesCREDIT John Solem/UMass Amherst

The evidence-based health benefits of walking continue to accumulate, according to ongoing research by a University of Massachusetts Amherst physical activity epidemiologist, who leads an international consortium known as the Steps for Health Collaborative. 

Findings from the latest study led by Amanda Paluch, assistant professor of kinesiology in the School of Public Health and Health Sciences, show that older adults who walked between 6,000 and 9,000 steps per day had a 40-50% reduced risk of a cardiovascular event, such as a heart attack or stroke, compared to those who walked 2,000 steps per day. 

“We found for adults over 60, there was a strikingly lower risk of a cardiovascular event or disease over an average follow-up of six years,” says Paluch, whose team’s research was published this week in the journal Circulation. “When accumulating more steps per day, there was a progressively lower risk.”

Earlier this year, research by Paluch and the Steps for Health Collaborative showed that more movement, even below the highly touted but unscientific “10,000 steps per day,” was associated with longevity benefits. The meta-analysis of 15 studies involving nearly 50,000 people from four continents found that walking between 6,000 and 8,000 steps per day was linked with a lower risk of death from all causes among older adults.

Following those findings, Paluch and team wanted to tackle the less-charted territory of steps per day and cardiovascular disease. The results were similar, in terms of the most beneficial range of steps. 

While there appears to be a continual additional benefit for those who walk more than 6,000 steps, Paluch says, encouraging the least-active older adults to take more steps is perhaps the most important public health message.

“The people who are the least active have the most to gain,” she says. “For those who are at 2,000 or 3,000 steps a day, doing a little bit more can mean a lot for their heart health. If you’re at 6,000 steps, getting to 7,000 and then to 8,000 also is beneficial, it’s just a smaller, incremental improvement.”

The meta-analysis of eight studies involved more than 20,000 people from the U.S. and 42 other countries. For younger adults, no link between steps per day and cardiovascular risk was detected. 

“This is because cardiovascular disease is a disease of aging and often doesn’t come to fruition until we’re at older ages,” says Paluch, whose project was supported by the Centers for Disease Control and Prevention (CDC). “You’re not going to see many people develop cardiovascular disease after six years of follow-up in young to middle adulthood.”

Future research involving younger adults and steps per day would focus on the precursors of cardiovascular disease, including high blood pressure, obesity and type 2 diabetes. “Those conditions develop in younger adults and are important for early prevention,” Paluch says.

Four of the eight studies the researchers analyzed included data about walking intensity, or how fast the steps were taken. “We’re interpreting these results with caution, but we did not find any striking association with walking intensity,” she says. “There was no additional benefit with how fast you’re walking, beyond the total number of steps that you accumulated.”

Paluch is among the researchers working to build a firm evidence base to guide public health recommendations for simple, accessible physical activity, such as walking. 

Posted on Exercise

Short bursts of vigorous activity linked with increased longevity

Two-minute bursts of vigorous activity totalling 15 minutes a week are associated with a reduced risk of death, according to research published today in European Heart Journal, a journal of the European Society of Cardiology

Dubai and exercise

 

Two minute bursts of vigorous activity totalling 15 minutes a week are associated with a reduced risk of death, according to research published today in European Heart Journal, a journal of the European Society of Cardiology (ESC).1

“The results indicate that accumulating vigorous activity in short bouts across the week can help us live longer,” said study author Dr. Matthew N. Ahmadi of the University of Sydney, Australia. “Given that lack of time is the most commonly reported barrier to regular physical activity, accruing small amounts sporadically during the day may be a particularly attractive option for busy people.”

A second study, also published today in EHJ, found that for a given amount of physical activity, increasing the intensity was associated with a reduced likelihood of cardiovascular disease.2 “Our study shows that it’s not just the amount of activity, but also the intensity, that is important for cardiovascular health,” said study author Dr. Paddy C. Dempsey of the University of Leicester and University of Cambridge, UK, and the Baker Heart and Diabetes Institute, Melbourne, Australia.

Both studies included adults aged 40 to 69 years from the UK Biobank. Participants wore an activity tracker on their wrists for seven consecutive days. This is an objective way to measure motion and particularly sporadic activity of different intensities during the day.

The first study enrolled 71,893 adults without cardiovascular disease or cancer. The median age was 62.5 years, and 56% were women. The investigators measured the total amount of weekly vigorous activity and the frequency of bouts lasting two minutes or less. Participants were followed for an average of 6.9 years. The investigators analysed the associations of volume and frequency of vigorous activity with death (all-cause, cardiovascular disease and cancer) and incidence of cardiovascular disease and cancer after excluding events occurring in the first year.

The risk of all five adverse outcomes reduced as the volume and frequency of vigorous activity increased, with benefits seen even with small amounts. For example, participants with no vigorous activity had a 4% risk of dying within five years. The risk was halved to 2% with less than 10 minutes of weekly vigorous activity and fell to 1% with 60 minutes or more.

Compared with just two minutes of vigorous activity per week, 15 minutes was associated with an 18% lower risk of death and a 15% lower likelihood of cardiovascular disease, while 12 minutes was associated with a 17% reduced risk of cancer. Further gains were observed with greater amounts of vigorous activity. For instance, approximately 53 minutes a week was associated with a 36% lower risk of death from any cause.

Regarding frequency, accumulating short bouts (up to two minutes) of vigorous activity on average four times a day was associated with a 27% lower risk of death. But health benefits were observed at even lower frequencies: 10 short bouts a week were associated with 16% and 17% lower risks of cardiovascular disease and cancer, respectively.

The second study included 88,412 adults free of cardiovascular disease. The average age was 62 years, and 58% were women. The investigators estimated the volume and intensity of physical activity, and then analysed their associations with incident cardiovascular disease (ischaemic heart disease or cerebrovascular disease). Participants were followed for a median 6.8 years.

The researchers found that higher amounts and greater intensity were associated with lower rates of incident cardiovascular disease. Increasing the intensity led to greater reductions in cardiovascular disease for the same volume of exercise. For example, the rate of cardiovascular disease was 14% lower when moderate-to-vigorous activity accounted for 20% rather than 10% of activity, converting a 14-minute stroll into a brisk seven-minute walk.

Dr. Dempsey said: “Our results suggest that increasing the total volume of physical activity is not the only way to reduce the likelihood of developing cardiovascular disease. Raising the intensity was also particularly important while increasing both was optimal. This indicates that boosting the intensity of your activities is good for heart health. For example, picking up the pace on your daily walk to the bus stop or completing household chores more quickly.”

Posted on Exercise, Obesity

Exercise and obesity have the opposite impact on muscle, fat tissues; researchers demonstrate

New insight into how excess belly fat may increase cancer risk

 Exercise training is a well-known means of maintaining and restoring good health; however, the molecular mechanisms underlying the benefits of exercise are not yet completely understood. A new paper by researchers at Joslin Diabetes Center in Cell Metabolismsheds light on the complex physiological response to exercise.

Taking advantage of recent single-cell technologies and advancements in computational biology, a team led by Laurie J. Goodyear, PhD, senior investigator of Integrative Physiology and Metabolism at Joslin Diabetes Center, launched a collaboration with a computational biology and artificial intelligence lab at Massachusetts Institute of Technology led by Manolis Kellis, PhD, to investigate how three metabolic tissues respond to exercise and to high-fat diet-induced obesity at single-cell resolution. These first-of-their-kind results provide a reference atlas of the single-cell changes induced by the exercise and obesity in two different types of fat and muscle. The investigators determined that there are opposite responses to exercise and obesity across all three tissues and highlight prominent molecular pathways modulated by exercise and obesity.

“Regular physical exercise is a well-established intervention for prevention and treatment of obesity and diabetes, and our goal is to set the foundation for understanding the molecular changes and cell types mediating the systemic effects of exercise and obesity in different tissues throughout the body,” said Goodyear, also a professor of medicine at Harvard Medical School. “The results of this study are going to serve as a tremendous resource that can lead to so much other work – not just from our laboratory but from other labs, too – that could eventually lead to the discovery of novel therapeutic options for obesity and other chronic metabolic diseases.”

Goodyear and colleagues focused the current investigation on two kinds of white adipose tissue – or fat – and skeletal muscle taken from mice which were either trained or sedentary, and fed either a healthful chow diet or fed a high-fat diet (HFD) intended to mimic the typical Western diet. This effectively provided four groups of mice; chow-fed/sedentary, chow-fed/active, HFD/sedentary and HFD/active. Diet treatments were for six weeks, and exercise training was done by housing mice with free access to a running wheel for three weeks.

After three weeks of the exercise intervention, the animals’ tissues were analyzed with single-cell RNA sequencing, providing the researchers with a plethora of new data. Among the most striking findings, the scientists observed that genes governing extracellular modelling (ECM) and circadian rhythm were regulated by both exercise and obesity across all three tissue types. Obesity up-regulated ECM-related pathways, while exercise down-regulated them. Conversely, exercise up-regulated circadian-related pathways, and obesity down-regulated them.

“With respect to the circadian rhythm, we saw very quiet cells that weren’t metabolically active with the high-fat diet group,” said co-first author Pasquale Nigro, PhD, a senior member of the Goodyear lab at Joslin and an instructor in medicine at Harvard Medical School. “We discovered that exercise reversed this. It seemed that, when the circadian system is upregulated, cells become re-activated.”

“As one of the most effective strategies to maintain a healthy body and mind, exercise is increasingly understood to induce tissue-specific and shared adaptations in the context of many other diseases beyond obesity,” said co-first author Maria Vamvini, MD, staff physician at Joslin and instructor in medicine at Harvard Medical School. “By combining our knowledge as physiologists with the computational biology skills of the Kellis lab at MIT, we’ve been able to develop a single-cell atlas with more than 200,000 cells and 53 annotated cell types. This resource has the potential to help our research team as well as others reveal fundamental exercise-induced changes in a diverse set of diseases and physiological contexts such as cancer and aging.  This teamwork stands out as a model for what we can accomplish through collaboration.”

Posted on Exercise

Dogs with more active owners may get more exercise

A dog and its owner exercising together

Compared to inactive owners, active dog owners report exercising their dogs more and report their dogs’ weight as healthier CREDIT Diego Perez-Lopez, PLOS, CC-BY 4.0

A new, international study suggests that dog owners who spend more time exercising themselves tend to exercise their dogs more, and more active owners are also more likely to perceive their dog’s body weight as being ideal. Sydney Banton of the University of Guelph in Ontario, Canada, and colleagues present these findings in the open-access journal PLOS ONE on August 24, 2022.

Obese dogs may face a number of health problems, such as diabetes and cardiac disease, and concerns about dog obesity are increasing worldwide. Earlier research has identified associations between dogs’ body weight and diet, exercise, and sociodemographic factors. However, those studies tended to be small and focused on individual countries.

For a broader, international perspective, Banton and colleagues analyzed results from a survey of 3,298 dog owners living in France, Germany, the United Kingdom, Canada and the United States. The survey included questions about both owners’ and dogs’ diet and exercise routines, and each owner’s perception of their dog’s body weight.

Analysis of the survey responses showed that dogs were more likely to get more exercise if their owners spent more time exercising themselves. More active owners were also more likely to perceive their dog as having an ideal body weight. Compared to owners in other countries, owners in Germany tended to exercise their dogs for a longer time, were more likely to perceive their dog’s body weight as ideal, and were less likely to report having been told that their dog was overweight.

Among dogs who were 5 years old and older, owners were less likely to perceive their dog as having an ideal body weight if they had been told their dog was overweight, if they reported attempting to control their dog’s weight by limiting food intake, and if they reported giving dogs other foods, such as treats, every day.

The findings suggest that many owners may attempt to control dogs’ body weight through diet, but not through exercise. The researchers therefore call for veterinarians to be given more resources to help owners develop exercise routines to avoid weight gain in dogs.

Sydney Banton adds: “Results from the survey revealed that feeding practices play a main role in owner perception of their dog being overweight, while exercise practices play a main role in owner perception of their dog being an ideal weight. While many weight loss strategies for dogs focus on feeding, this data highlights the need to incorporate exercise into weight loss regimens.”

Posted on Exercise

Survey finds nearly 1 in 5 Americans experience pain with exercise and continue to work out rather than resting to heal

Exam


George Eldayrie, MD, examines Jen Jordon at Orlando Health Jewett Orthopedic Institute. Jordon has had progressing knee pain over the past few years, and was relieved to hear that she did not need surgery and could help heal her injury by strengthening and stretching specific supporting muscles. CREDIT Orlando Health Jewett Orthopedic Institute

It’s not uncommon to have a lingering injury or nagging pain. In fact, a new national survey by Orlando Health finds nearly one in five Americans (18%) often experience pain while working out and the same number of people (18%) work through the pain rather than resting to heal.

Sports medicine physicians and orthopedic surgeons at the Orlando Health Jewett Orthopedic Institute say identifying the source of pain is the first step toward feeling better, and new advancements offer a range of options before surgery is part of the discussion. However, delaying treatment often leads to further damage and a higher likelihood that surgery will be needed to repair it.

“There’s the saying, ‘No pain, no gain.’ But there’s different types of pain that you feel during workouts, and sharp, stabbing pain that’s very uncomfortable is not typically normal,” said George Eldayrie, MD, a sports medicine physician at Orlando Health Jewett Orthopedic Institute. “The pain may be coming from an underlying problem and if you continue to push through it you can make that problem worse.”

Fitness class

Jen Jordon teaches a fitness class at the YMCA. Jordon finally addressed a lingering knee injury after years of progressing pain, something that’s very common according to a new national survey by Orlando Health that found nearly one in five Americans works out through pain rather than resting to heal. CREDIT Orlando Health Jewett Orthopedic Institute

Non-surgical options may include physical therapy to stretch and strengthen specific muscles and tendons. It may also involve injections that reduce inflammation and promote healing, such as corticosteroids and platelet-rich plasma, which are delivered precisely to the right area using ultrasound technology.

“Rehabilitation is a powerful tool, but it’s important to see a professional who can really key in on the right diagnosis so a therapist can develop a treatment plan focused to the right area,” saiid Dr. Eldayrie. “Platelet-rich plasma has also been shown to be very effective for chronic tendinopathies, things like tennis elbow or golfer’s elbow. But it typically works better the earlier it is administered, before the injury progresses.”

Jen Jordon, 39, lived with increasing pain in her left knee for years before finally making an appointment with Dr. Eldayrie to address it. 

“I would go into a lunge and just feel a sharp pain and then it would just continuously hurt throughout the day,” said Jordon. “It just kept getting a little bit worse and affecting me a little bit more during workouts and while I was on my feet at work, so I decided it was time to go get it checked out.”

Exercise is a daily part of Jordon’s life and something she relies on to maintain her physical and mental health. She put off treatment for fear she would be sidelined for a long period of time, or worse, would be told she needed surgery.

“Surgery is definitely a fear of mine. One of the reasons I work out is to stay healthy and prevent the need for surgery as I get older,” Jordon said. “Part of me didn’t really want to know what was going on because I didn’t want to have to take time off or have a procedure that was going to take weeks or months of recovery.”

Dr. Eldayrie examined Jen’s knee using x-rays and ultrasound to show her in real time where her tendons were strained and where degradation was occurring.  

“He was able to just point to the affected area and show me exactly what the issue was on his tablet. It was really informational and empowering to see the problem and learn how to take action to fix it,” Jordan said. 

Jen was also relieved to learn that she does not need surgery at this time, and will likely be able to solve her knee pain by adding exercises to better support the affected area. This will not only heal her knee, but also her fear of dealing with injuries.

“I am so glad that I went and had Dr. Eldayrie look at it, and I think it will help me prevent anything worse from happening in the future,” said Jordon. “After suffering for so many years and learning that simple stretching could have prevented the pain for all this time, I will definitely go in as soon as something starts hurting next time.” 

While there are a lot of non-surgical options, surgery is often the best course of action for injuries that require repair or reconstruction and will not heal on their own. However, that is not as scary as many patients believe. Advancements in robotic and laparoscopic procedures have made many surgeries less invasive and recovery shorter and easier than ever.