Category Archives: Exercise

Physical Activity Lowers Women’s Heart RIsks

This week is National Women’s Health Week, and in recognition of this important week today’s post will look at a study in older women, examining the effect of physical activity on coronary heart disease.

A research group performed a prospective cohort study from subjects participating in the Women’s Health Initiative. Nearly 6000 women with an average age of 78 1/2 were enrolled, and were followed for up to five years. These were women without a history of heart attack or stroke.

The activity level of the women was measured by the use of a accelerometer that was worn on the right hip. This device is designed to capture measures of subject activity and mobility. Researchers found that light physical activity was associated with a dose-responsive reduced risk of cardiovascular disease and coronary heart disease in this cohort of older women. The results were considered to be statistically significant.

The group with the highest quartile of light physical activity was associated with a 42% reduced risk of heart attack or coronary death, compared to the group with the lowest quartile of light physical activity. Similarly, there was a 22% reduced risk of cardiovascular events in the highest quartile of light physical activity, compared to the lowest quartile of light physical activity group.

This was a well-designed study among a group of older women, a group that is often neglected in medical research. This was also a diverse population, including substantial numbers of black (33.5%) and Hispanic (17.6%) women. It is impressive that encouraging more activity, even of the “light” variety, yielded some very substantial results.

“If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.”– Hippocrates

(Source- JAMA Network Open, 2019, 2(3))

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Exercise and Weight Loss Good for Diabetes

With the New Year now here, it is a great time to consider resolutions for exercise and weight loss for 2018.

A small study published in 2015 shows some of the benefits of exercise and weight loss, even over a short period of time. In this study, completed at the University of Vermont, patients were enrolled that had recently been diagnosed with Type 2 diabetes. These patients were typical of what is seen in a primary care setting, with HbA1c readings between 6.5-8.0%, and BMI from 27-40 Kg/M2. 

The patients engaged in exercise 5-6 days each week, including walking and supervised exercise. In addition, participants engaged in weekly group counseling sessions led by a registered dietician. It is important to note that participants were not on diabetes medications during the six month study.

At completion of the six month study, the majority of the participants went into at least partial remission of their diabetes, with the mean HbA1c dropping from 6.8 to 6.2, while one individual achieved what was termed a “total remission” with an HbA1c=5.6%. Mean weight loss amongst the group was 21+ pounds, and peak aerobic activity increased by 18%. Other cardiac risk factors such as CRP, fasting insulin and triglyceride levels all improved. Women made up the majority of those enrolled.

This study shows what is possible with directed efforts towards diet and exercise modifications. The authors suggest that no medication similarly used in this patient population would have provided such “broad reaching preventative efforts”, and perhaps that is true.

To be sure, this was a small study with only 12 patients enrolled and ten who completed. However, given the robust results, a more extensive study certainly seems warranted. Particularly for those patients who are very early in their diabetes disease process a diet and exercise regimen seems worthy of consideration. Combined with medication when appropriate, this intervention would likely yield even more profound results.

(Source- Journal of Cardiopulmonary Rehabilitation and Prevention, Vol 35(3), May/June 2015)

This blog is a review of medical and scientific literature and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Diet, Exercise and Metformin Help Prevent Diabetes

 Today is American Diabetes Association Alert Day, and in recognition today’s posts will be covering topics in diabetes.

Diabetes Mellitus Type II (DM2) is common in the U.S. and worldwide and it’s incidence and prevalence are increasing. The implications of DM2 are serious and widespread, including kidney and eye disease, heart and blood vessel disease, and neuropathies.

Because of the large numbers of people with DM2, there has been much research looking at ways to prevent or forestall its development. A landmark study in this area was published in 2002, and was conducted at George Washington University and 27 affiliated centers.

Over three thousand participants with elevated fasting and post-load plasma glucose concentrations were included in the study. Subjects were randomly assigned to a lifestyle modification plus metformin group (850 mg twice a day), a lifestyle modification plus placebo group, or a program of intense lifestyle modifications. The goals for the intensive lifestyle modification group were to maintain a 7% weight reduction and engage in moderate physical activity for at least 150 minutes each week. The average follow-up period was 2.8 years.

The primary outcome measure of this preventative study was the development of diabetes. The incidence of diabetes was 58% lower in the intensive lifestyle intervention group compared to the placebo group, while the incidence of diabetes in the metformin group was 31% lower than the placebo group.

Comparing the intensive lifestyle-modification group to the metformin group shows the incidence of diabetes was 39% lower in the intensive lifestyle modification group.

One of the important features of the study design were that substantial numbers of female subjects were enrolled (68% female, 32% male), and that a large percentage of African-American, Hispanic, Indian American and Asian-American individuals were enrolled, which supports the generalizeability of these results to a broad heterogeneous population such as seen in the U.S.

This study demonstrates that substantial lifestyle modifications including weight loss and increased exercise may have a profound impact in preventing or delaying the development of DM2 in those at risk. Given the serious health implications of DM2 perhaps those who are in the pre-diabetic stage may want to consider incorporating improved diet, exercise and weight loss in to their daily regimen.

 

(Source- New England Journal of Medicine, Vol. 346, No. 6)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Run For Your Life

Running1

As the Rio Olympics wind down, track and field events have entered center stage. Therefore today’s post will look at the relationship between running and cardiovascular risk.

Research published in the Journal of the American College of Cardiology shows the health benefits of running, even at slow speeds and at short distances, on cardiovascular health and mortality.

The study looked at over 55,000 adults, both men and women, ages 18 to 100 years, with an average age of 44 years. The amount of exercise in the study group was assessed by a medical history questionnaire, with a mean follow-up period of 15 years.

Runners were found to have lower risk of mortality including cardiovascular mortality compared to non-runners. Runners had 30% lower risk for all-cause mortality, and 45% lower risk for cardiovascular mortality.

Interestingly, even modest amounts of running such as 5-10 minutes/day and at slow speeds (greater than 10 minutes/mile) yielded significant mortality benefits. Not surprisingly, for those runners who were persistent in their efforts there was a stronger association with reduced mortality.

Given these health benefits, perhaps you may consider adding some running or jogging to your exercise routine.

Source- Journal of the American College of Cardiology, Vol. 64, No. 5, 2014)

“Running! If there’s any activity happier, more exhilarating, more nourishing to the imagination, I can’t think of what it might be. In running the mind flees with the body, the mysterious efflorescence of language seems to pulse in the brain, in rhythm with our feet and the swinging of our arms.”          Joyce Carol Oates

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

You Have Time To Exercise

cycling1

Every four years the Olympics inspire not only a new generation of athletes to pursue their Olympic dreams, but also gives encouragement to the less physically active to incorporate some exercise into the daily schedule. Unfortunately already overloaded schedules and time commitments end up causing many if not most to quit the new exercise or activity, or even discourages them from starting in the first place.

Can you spare 30 minutes a week for exercise? This is 30 minutes per week total, broken up into ten minute sessions, three times each week? Even the busiest of us can probably find 30 minutes in the course of a week to commit to exercise.

Researchers from McMaster University in Canada enrolled sedentary men ages 19-37 and placed them into one of three different groups- a sprint interval training (SIT) group, a moderate intensity continuous training (MICT) group, and a control group.

The training protocols were straightforward. The sprint interval training protocol involved a two-minute warm-up on the stationary exercise bike, followed by three “all out” cycling efforts of twenty seconds each, separated by two minutes of low intensity cycling, and finally a two-minute cool-down, for a total of ten minutes. This was done three times each week.

The moderate intensity continuous training protocol consisted of a two-minute warm-up on the exercise bike, followed by 45 minutes of continuous cycling at 70% of maximum heart rate, and finally a three-minute cool-down, for a total of 50 minutes. This was also done three times each week.

A 12 week training program then followed. Researchers measured plasma glucose and insulin, and performed muscle analysis, among other measures.

What the researchers discovered was profound- the sprint interval training group (aka the 30 minute per week group) had comparable improvements in cardiopulmonary fitness, insulin sensitivity, and skeletal muscle mitochondrial content to the moderate intensity continuous training group (aka the 150 minute per week group) over the 12 week training program.

Another way to consider this is that the sprint interval group, with only 1/5 of the time commitment of the moderate intensity group, had equal cardiometabolic benefits.

McMaster University in Hamilton Ontario is one of the leading centers of research in High Intensity Interval Training (HIIT). This recent paper adds to the growing body of research on this topic.

So you can you spare 30 minutes a week?

 

(Source- PLOS ONE, April 26, 2016)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone, Discuss any health concerns with your personal physician.

Swimming Improves Cholesterol in Women

swimming3

As we say goodbye to the swimming events for the Rio Olympics we will have one more post on the benefits of swimming.

A group of researchers from Pusan National University in South Korea designed a study to examine the effect of swimming on physical strength as well as lipid profile. Participants were women, ages 40-60, who were either in a swimming group or a control group of non-swimmers.

The swimming group swam for sixty minutes, three times/week, for a total of 12 weeks. Physical composition, strength and blood lipid measurements were taken upon entry to the study as well as at the conclusion at 12 weeks.

At the end of the 12 week study the swimming group showed improvements in total cholesterol, HDL, and triglycerides. On the other hand, the control group (non-swimmers) showed no significant change.

This small study shows the possible benefits of a simple intervention, in this case swimming three times per week, may have upon lipids parameters. It would be interesting to see if these same results would be found in a group of men.

(Source- Journal of Exercise Rehabilitation 2015; 11(5); 266-271)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Swimming and Cycling Help With Symptoms of Osteoarthritis

swimming4

In honor of the Rio Olympics today’s post will examine research on the benefits of swimming or cycling on the symptoms of osteoarthritis.

Osteoarthritis is a progressive disease that leads to damage of the underlying bone and cartilage. It is very common, and it is estimated that osteoarthritis affects approximately 30 million in the U.S. and perhaps 250 million worldwide. Symptoms of osteoarthritis often progress leading to increasing joint pain and decreased function.

A group of researchers from the University of Texas at Austin enrolled a group of 48 participants into the study, including both men and women, with an average age of about 60 years. Subjects had mild to moderate signs of osteoarthritis on x-ray, and in addition were symptomatic with joint pain and decreased function.

Subjects were randomized to a swimming group or a cycling group. They started with 20-30 minutes of exercise 3 days/week at an exercise intensity of 40-50% of heart rate reserve. As fitness improved, participants moved to a goal of 40-50 minutes of exercise/day, 3 days/week at 60-70% of reserve. Swimmers used the breaststroke, freestyle or a combination of the two strokes, while the cyclists used a stationary bike. Both swimming and cycling groups were followed for 12 weeks.

Participants were tested upon entry into the study, and again after 12 weeks of either cycling or swimming. Participants in both the swimming and cycling groups showed reductions in joint pain and stiffness, with improvements in function. There was also significant improvement in a six-minute walk test in both groups. Body mass, as well as hip and waist circumference decreased in both swimmers and cyclists.

This study is important in that it may be the first to look at swimming (not water aerobics) as an intervention for osteoarthritis symptoms. The active cycling control group showed similar improvements to the swimming group, thus giving another possible treatment method for patients with osteoarthritis. It would be interesting to see if the improvement in function and decreases in joint pain would continue if the swimming or cycling continued beyond 12 weeks. Swimming and cycling are low risk activities that may yield large benefits for those suffering with osteoarthritis.

 (Source- The Journal of Rheumatology 2016; 43:3)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Acupuncture May Improve Exercise Performance and Recovery

Keep-Calm-white

For some, seeing Michael Phelps and other swimmers on the starting blocks this week with the distinctive circular bruises left by cupping may have been their first exposure to this alternative health practice. However cupping in one form or the other has been in practice for thousands of years, and there are references in ancient Egyptian, Greek, Chinese and Persian texts regarding this technique. In honor of the Rio Olympics today’s post will examine another ancient health practice, acupuncture, specifically the use of acupuncture to enhance  both exercise performance, as well as post-exercise recovery.

Australian researchers reviewed data from four different acupuncture studies, three of which looked at its effect on exercise performance, while one study examined the effect of acupuncture on post-exercise recovery. There were 84 total participants in the four studies, both men and women. As the design of each study was varied (such as different treatment protocols, different outcome measures, different placebo controls, etc.) the Australian researchers did not pool the data from the four studies but instead examined each study on its own merits. One thing all four studies did have in common was the use of a cycle ergometer as the exercise method.

The Australian research group noted that one study (Li et al.) showed significantly increased peak power output in the acupuncture group versus the control group. On the other hand two studies (Dhillon et al. and Karvelas et al.) did not show benefit.

Also, in the  study that examined post-exercise recovery (Lin et al.) it was demonstrated that acupuncture needles inserted prior to exercise significantly lowers the blood lactate level sixty minutes after exercise.

Taken in whole the four studies show some possible benefits for acupuncture treatment, both for exercise performance as well as post-exercise recovery. What are now needed are additional well designed studies with larger numbers of participants to determine if these treatment effects are real. Acupuncture is a generally well tolerated treatment modality with a good safety profile, and may offer benefits to athletes and those that exercise.

(Source- The Journal of Alternative and Complementary Medicine, Volume 19, Number 1, 2013).

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.