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Category: Exercise

Published on Leave a comment on Aerobic Exercise, Thinking Skills, and the Brain

Once again a study found benefits from exercise - specifically that regular exercise is better for the brain and for thinking skills (for "executive function"). Executive function is a person's ability to regulate his or her own behavior, pay attention, manage new information and unexpected challenges, to plan, organize, and achieve goals. Executive functioning can decline in older adults - "age-related declines". So it's definitely beneficial to prevent or slow down a decline in thinking skills.

In this study 132 individuals (aged 20 to 67 years) living in New York City were either randomly assigned to a stretching group or an aerobic exercise group for 6 months. They were given a number of tests (at the start, at 3 mos, and at 6 mos.) to measure executive function, memory, IQ, etc. After 6 months the aerobic exercise group had a number of benefits (compared to the stretching group): they reduced their BMI (body mass index), they increased the cortical thickness in a part of their brain (this is good), and they had improved executive function thinking. The researchers found that the aerobic exercise showed more benefit to older adults than the younger adults.

How much did the aerobic group exercise? The individuals had 4 sessions a week of aerobic exercise (stationary cycling, treadmill, elliptical machine) which consisted of 10 to 15 minutes of warm-up/cool down, and 30 to 40 minutes of exercise. Note that at the start of the study all persons were healthy, sedentary non-exercisers - with "below median aerobic capacity". Meaning that there is hope for all of us to benefit from regular exercise whether a young adult or over 60.

For those persons that dread going to a gym or spend money for exercise equipment  - you don't need it! Just get out and walk briskly, or ride a bicycle, climb stairs regularly - in other words, move! The goal is to get your heart pumping. From Science Daily -

Exercise may improve thinking skills in people as young as 20

Regular aerobic exercise such as walking, cycling or climbing stairs may improve thinking skills not only in older people but in young people as well, according to a study published in the January 30, 2019, online issue of Neurology®, the medical journal of the American Academy of Neurology. ...continue reading "Aerobic Exercise, Thinking Skills, and the Brain"

Published on Leave a comment on Can Exercise and Dietary Changes Help Older Adults With Thinking Problems?

Another study finding more benefits of exercise was recently published in the journal Neurology. The study by researchers at Duke University found that in older adults who were already experiencing  cognitive (thinking) problems, but did not have dementia - that after just 6 months of exercise they showed improvements in thinking. What were their original thinking problems? The individuals had difficulty concentrating, making decisions, or remembering, but it was not severe enough to be diagnosed as dementia. However, these persons were considered at risk for progressing to dementia.

The 160 individuals in the study were 55 years or older (mean age 65), mainly women, evenly divided between whites and minorities, were sedentary (didn't exercise), and had heart (cardiovascular) disease or were at risk for heart disease. They were randomly assigned to one of 4 groups: 1) aerobic exercise (with no dietary changes), 2) DASH diet (with no exercise), 3) DASH diet plus exercise, and 4) the control group, who had no dietary or exercise changes - they just received some educational phone calls. The study lasted 6 months, and there were no drop outs.

In the study, the aerobic exercises were done 3 times per week: 10 minutes of warm up exercises followed by 35 minutes of continuous walking or stationary cycling. The Dietary Approaches to Stop Hypertension or DASH diet is a heart healthy diet that emphasizes eating fruits, vegetables, whole grains, as well as fish, poultry, beans, and nuts. It stresses lowering the intake of salt (sodium), sweets, sugar sweetened beverages, and fatty foods (both trans fats and saturated fats). [Note that in many ways it's similar to the Mediterranean diet with its emphasis on fruits, vegetables, whole grains, legumes, seeds, nuts, and lowering intake of meat. Studies find cognitive benefits from the Mediterranean diet.]

The six months of exercising improved thinking skills called executive function - in both the exercise alone or exercise + DASH diet group. The largest improvements were in the exercise + DASH diet group (as compared to the control group, which actually showed decline in functioning). Executive function is a person's ability to regulate their own behavior, pay attention, organize and achieve goals, and was measured in this study with a group of cognitive tests (a "standard battery of neurocognitive tests"). These executive function improvements did not occur in the DASH diet alone group or the control group. The study found no improvement in memory or language fluency in any of the groups. The exercise alone, DASH diet alone, and the combined exercise and DASH group had other health benefits by the end of the study, for example they lowered their risk factors for heart disease. Other improvements: the exercise groups had improvements in insulin levels, and the DASH groups decreased their intake of blood pressure medicines.

To illustrate how amazing these results are: at the start of the study (baseline) all participants scored as if they were in their early 90s on cognitive tests - as if they were on average about 28 years older than their actual chronological age! Then at the end of 6 months, the persons in the exercise + DASH diet showed an improvement of almost 9 years on the tests. In contrast, the control group showed an approximately 6 month worsening performance. When researchers looked at physical markers of the exercisers, they found that physical improvements and improvements in heart disease risk factors (e.g. losing weight, lowering blood pressure) were correlated with executive functioning improvements.

Other studies have found related findings, such as higher physical activity and a Mediterranean diet is associated with lower levels of dementia. The researchers point out that there is growing evidence that combining several lifestyle factors (e.g., exercise, not smoking, a healthy diet, lowering salt intake) and not just exercise alone, has the best results for better cognitive functioning among older adults. Bottom line: eat a diet rich in fruits, vegetables, whole grains, seeds, nuts and get exercise. Walking briskly, gardening, housework, walking up stairs - it all counts.  ...continue reading "Can Exercise and Dietary Changes Help Older Adults With Thinking Problems?"

Published on Leave a comment on Could Physical Activity Reduce Stroke Severity?

The results of a recent study suggested that walking 4 hours or more a week or 2 to 3 hours of moderate physical activity may have a (slight) protective effect of reducing stroke severity in persons who get a stroke. The study, which was conducted in Sweden, found that persons who were physically more active before their stroke and were younger in age were more likely to have a mild stroke (rather than a moderate or severe stroke). This finding was an association (didn't prove it).

But ...the majority of persons participating in the study - whether they exercised or not before the stroke - had mild strokes, and a minority in all of the groups had moderate or severe strokes. 73% of physically inactive people, 85% of those with light physical activity, and 89% of  those who had engaged in moderate physical activity before their strokes had mild strokes. Researchers found that light (walking or a similar activity for at least 4 hours per week) and moderate physical activity (2 to 3 hours per week) were equally beneficial. 

From Medical Xpress: People who walk just 35 minutes a day may have less severe strokes

People who participate in light to moderate physical activity, such as walking at least four hours a week or swimming two to three hours a week, may have less severe strokes than people who are physically inactive, according to a study published in the September 19, 2018, online issue of Neurology, the medical journal of the American Academy of Neurology. 

...continue reading "Could Physical Activity Reduce Stroke Severity?"

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Published on 2 Comments on Sitting For Long Periods and Reduced Blood Flow To the Brain

Nice study that explains why sitting for long periods is so unhealthy - it reduces blood flow to the brain (cerebral blood flow) . The results from a study conducted in the United Kingdom (UK) found that prolonged, uninterrupted sitting (4 hours in the study) in healthy office workers reduced cerebral blood flow. However this was offset when frequent, short-duration walking breaks were taken - about 2 minutes of walking every 30 minutes. However, taking a 8 minute walking break every 2 hours did not have the same positive effect - even though that was the same amount of walking over the 4 hour period.

Maintaining good blood flow to the brain is a great reason to stretch your legs and walk a few minutes whenever possible, preferably at least every 30 minutes - whether at work or at home. From Medical Xpress:

Sitting for long hours found to reduce blood flow to the brain

A team of researchers with Liverpool John Moores University in the U.K. has found evidence of reduced blood flow to the brain in people who sit for long periods of time. In their paper published in the Journal of Applied Physiology, the group outlines the experiments they carried out with volunteers and what they found.  ...continue reading "Sitting For Long Periods and Reduced Blood Flow To the Brain"

Published on Leave a comment on Walking At a Brisk Pace Is Best For Health

Walk, walk, walk for health - and the faster, the better. The message from a  large study (in Britain and Scotland) is that walking is associated with healthier, longer lives - but if you walk at a fast pace (brisk walking), the effects are even better. Walking at an average or brisk pace reduced death (from any cause) by 20% to 24% - as compared to those walking slowly. Heart disease deaths were reduced by  21% to 24% at an average or brisk pace - when compared to those walking at a slow pace.

Bottom line: average walking pace is good, but getting your heart rate up (and getting a little sweaty) while walking briskly is better. By the wayr, the researchers did not find any effect of walking speed on cancer deaths.  ...continue reading "Walking At a Brisk Pace Is Best For Health"

Published on Leave a comment on Ultra-Processed Foods and Alzheimer’s?

The last post dealt with the link between highly processed food and increased risk of cancer. Now an interesting article written by Dr. Lisa Mosconi (Associate Director of the Alzheimer’s Prevention Clinic at Weill Cornell Medical College/New York -Presbyterian Hospital) refers to that study when discussing research about lifestyles (and especially diet) and later Alzheimer's disease.

It'll be interesting to see how this research plays out - is her approach stressing diet (and avoiding ultra-processed food and trans fats) and lifestyle correct or not? Much of what she says definitely makes sense and is supported by research, such as the negative health effects of chronic inflammation, and how eating actual, real foods has beneficial health effects. On the other hand, vitamin, mineral, and fish oil supplements generally don't show those health benefits (as she discusses here).

Currently there are a number of theories about causes of Alzheimer's disease (including the role of microbes), as well as a number of drug treatments that so far have gone nowhere. If Dr. Mosconi's research interests you, then read the interview she did in 2017. [In the interview she talks about the importance of exercise, intellectual stimulation, social networks, and the benefits of eating real foods rather than supplements. She recommends: drink water, eat fish, eat vegetables and fruit, eat glucose rich foods, and don't eat highly processed and fast foods.]  From Quartz:

The road to Alzheimer’s disease is lined with processed foods

Dementia haunts the United States. There’s no one without a personal story about how dementia has touched someone they care for. But beyond personal stories, the broader narrative is staggering: By 2050, we are on track to have almost 15 million Alzheimer’s patients in the US alone. ... It’s an epidemic that’s already underway—but we don’t recognize it as such. The popular conception of Alzheimer’s is as an inevitable outcome of aging, bad genes, or both.  ...continue reading "Ultra-Processed Foods and Alzheimer’s?"

Published on Leave a comment on Chronic Diseases Raise Cancer Risk, and Exercise Lowers It

A new observational study from Taiwan found that having one of eight chronic diseases, such as heart disease or diabetes, or their markers (e.g. high cholesterol levels as a marker for heart disease), also significantly raises the person's odds of developing cancer or dying from cancer. The study estimated that these diseases or markers accounted for about 20% of all new cancers and 39% of all cancer deaths. That's about the risk of 5 lifestyle factors combined (smoking, alcohol consumption, obesity, unhealthy diet, and lack of exercise) contributing to cancer development and death.

The eight chronic diseases and markers were: cardiovascular disease (markers for which include blood pressure, total cholesterol, and heart rate), diabetes, chronic kidney disease (markers for which include proteinuria and glomerular filtration rate), pulmonary disease, and gouty arthritis (for which uric acid is a marker). The higher the chronic disease and marker score, the higher the risk of developing cancer and cancer death (a dose-response). Chronic diseases and markers were associated with a shortened lifespan -  about 13.3 years in men and 15.9 years in women.

But the good news is that regular physical exercise lowers the risk of developing cancer by about 48% and the risk of cancer death by 27%. That's huge!  So physical exercise and activity could be viewed as "cancer prevention" strategies. The researchers pointed out that additional cancer prevention strategies are avoiding smoking (very important), avoiding excessive alcohol consumption, maintaining healthy weight, and a healthy diet. From Science Daily:

Substantial impact of chronic diseases on cancer risk

Several common chronic diseases together account for more than a fifth of new cancer cases and more than a third of cancer deaths, finds a study published by The BMJ today. The findings show that the cancer risks from common chronic diseases, such as heart disease and diabetes, are as important as those from five major lifestyle factors combined.

A team of researchers based in the US and Taiwan therefore set out to investigate the combined effect of eight common chronic diseases or disease markers (for example, high blood pressure as a marker of heart disease) on cancer risk compared with lifestyle factors. They also explored whether physical activity could reduce the cancer risk associated with chronic diseases and disease markers. The study involved 405,878 men and women in Taiwan with no history of cancer .... underwent a series of medical tests between 1996 and 2007. .... Participants were followed for an average of 8.7 years.

The researchers found that cardiovascular disease markers, diabetes, chronic kidney disease markers, pulmonary disease, and gouty arthritis marker were individually associated with risk of developing cancer or cancer death. Higher chronic disease risk scores based on these diseases or markers were linked with an increased risk of developing cancer and cancer death, with the highest level associated with a more than twofold increase in risk of developing cancer and a fourfold increase in risk of cancer death.

High chronic disease risk scores were also associated with substantial reduction in life span. The highest scores were associated with 13.3 years of life lost in men and 15.9 years of life lost in women. Together, these chronic diseases and markers accounted for more than one fifth of all new cancers and more than one third of all cancer deaths in this study population, which was similar to the contribution of five major lifestyle risk factors combined -- smoking, insufficient physical activity, insufficient fruit and vegetable intake, alcohol consumption, and obesity.

The researchers also found that physical activity was associated with a nearly 40% reduction in the excess risks of cancer and cancer death associated with chronic diseases and markers. [Original study.]

Published on Leave a comment on Low Fitness Is Associated With Larger Waist Size and Higher Levels of Inflammation

A new study's results actually made me ask - this was a surprise? Of course more fit people have lower levels of chronic inflammation and smaller waist size, no matter their Body Mass Index (BMI) - which includes their weight. And the reverse is also true (lower fitness levels are associated with greater waist size and higher levels of chronic inflammation, no matter the BMI). Which means that being fit, no matter the weight, has health benefits. From Medical Xpress:

Low fitness is associated with larger waist size and higher degree of inflammation

Low fitness is associated with a larger waist size and a higher degree of inflammation, according to a study published January 17, 2018 in the open-access journal PLOS ONE by Anne-Sophie Wedell-Neergaard from the University of Copenhagen, Denmark, and colleagues.

Waist circumference can indicate the amount of excess fat found around the abdomen and previous studies have shown excess abdominal fat may increase the risk of chronic system inflammation and metabolic diseases. The authors of the present study sought to investigate the association between fitness and waist circumference as well as the association between fitness and low-grade inflammation, and whether there was a correlation with Body Mass Index (BMI).

The researchers analyzed the previously collected data of 10,976 individuals from The Danish National Health Examination Survey 2007-2008. These individuals took a maximal oxygen uptake (VO2max) test to assess their physical fitness. Their waist circumference, weight and height were measured, and blood samples were taken to measure their level of C-reactive protein, a nonspecific biomarker of low-grade inflammation.

The researchers found that higher levels of fitness were associated with a smaller waist circumference and a lower degree of inflammation independently of BMI. The researchers acknowledge that there are possible limitations that may affect the findings of the study, but overall the results suggest that increased fitness has the potential to reduce abdominal fat mass and inflammation which may improve metabolic health irrespective of BMI. 

Published on Leave a comment on Can Exercise Reverse The Effects of A Sedentary Lifestyle On the Heart?

A recent study's results give hope to those who haven't really exercised or been physically active as they've gone through middle-age (it's viewed as "sedentary aging") and wonder if this dooms them in some way. Is it too late to get benefits from starting to exercise now? Studies show that being sedentary (that is, not being physically active or exercising weekly) and in "poor physical fitness" in middle-age is a risk factor for later heart failure. This is because a consequence of "sedentary aging" is stiffness of the heart, specifically the left ventricle (thus a loss of "cardiac plasticity").

But the study found that after 2 years of an exercise program in (formerly) sedentary middle-aged adults, they improved their maximal oxygen uptake, decreased the heart's stiffness, and improved overall fitness. All good, even though it was a small study (only 53 people completed the study). So the bottom line is: No, it's not too late to start exercising. The heart has elasticity and can remodel itself if the exercise is started before age 65 and is done 4 to 5 times a week. The adults studied were both male and female, between the ages of 45 and 64,  and exercised or were physically active for a total of 150 to 180 minutes a week, which meant at least 30 minutes 4 or 5 times a week.

Looking at the study's exercise regimen, it's clear that a variety of exercises or physical activities (low, moderate, and high intensity) is necessary. Some of the time one should be active or exercise to a point of breaking a sweat and feeling the heart pump. This meant that over time the participants increased their exercise frequency, duration, and intensity. Think about it - as you get more fit, it takes more to get your heart pumping and to break a sweat, and you can handle more exercise. 

Unfortunately the "control group", who did a combination of yoga, balance, and strength training 3 times a week for 2 years did not show improvements in heart plasticity, maximal oxygen uptake, or in overall fitness.Yikes. Sooo...the study clearly shows it is worth getting off your butt and making the effort to exercise. Perhaps view it as brushing your teeth - a daily nuisance, but necessary for health. The researchers themselves stated "Exercise is medicine." From Science Daily:

Proper exercise can reverse damage from heart aging

Exercise can reverse damage to sedentary, aging hearts and help prevent risk of future heart failure -- if it's enough exercise, and if it's begun in time, according to a new study by cardiologists at UT Southwestern and Texas Health Resources. To reap the most benefit, the exercise regimen should begin by late middle age (before age 65), when the heart apparently retains some plasticity and ability to remodel itself, according to the findings by researchers at the Institute for Exercise and Environmental Medicine (IEEM), which is a collaboration between UT Southwestern Medical Center and Texas Health Presbyterian Hospital Dallas.

And the exercise needs to be performed four to five times a week. Two to three times a week was not enough, the researchers found in an earlier study..... The regimen included exercising four to five times a week, generally in 30-minute sessions, plus warmup and cool-down: One of the weekly sessions included a high-intensity 30-minute workout, such as aerobic interval sessions in which heart rate tops 95 percent of peak rate for 4 minutes, with 3 minutes of recovery, repeated four times (a so-called "4 x 4"). Each interval session was followed by a recovery session performed at relatively low intensity. One day's session lasted an hour and was of moderate intensity. (As a "prescription for life," Levine said this longer session could be a fun activity such as tennis, aerobic dancing, walking, or biking.) One or two other sessions were performed each week at a moderate intensity, meaning the participant would break a sweat, be a little short of breath, but still be able to carry on a conversation -- the "talk test.".... One or two weekly strength training sessions using weights or exercise machines were included on a separate day, or after an endurance session.

The more than 50 participants in the study were divided into two groups, one of which received two years of supervised exercise training and the other group, a control group, which participated in yoga and balance training.A t the end of the two-year study, those who had exercised showed an 18 percent improvement in their maximum oxygen intake during exercise and a more than 25 percent improvement in compliance, or elasticity, of the left ventricular muscle of the heart, Dr. Levine noted. He compared the change in the heart to a stretchy, new rubber band versus one that has gotten stiff sitting in a drawer. Sedentary aging can lead to a stiffening of the muscle in the heart's left ventricle, the chamber that pumps oxygen-rich blood back out to the body, he explained.

"When the muscle stiffens, you get high pressure and the heart chamber doesn't fill as well with blood. In its most severe form, blood can back up into the lungs. That's when heart failure develops," said Dr. Levine, who holds the S. Finley Ewing Chair for Wellness at Texas Health Dallas and the Harry S. Moss Heart Chair for Cardiovascular Research. Earlier research by UT Southwestern cardiologists showed that left ventricular stiffening often shows up in middle age in people who don't exercise and aren't fit, leaving them with small, stiff chambers that can't pump blood as well. [Original study.]

Published on Leave a comment on Lifestyle Linked to One Third of Cancer Deaths

For those who need convincing that lifestyle can contribute to development of cancer or its prevention, new medical research has once again supported the importance of lifestyle choices. A report from Australian researchers (with similar findings as a study in the US) stated: an estimated 38% of cancer deaths and 33% of cancer diagnoses could have been prevented with healthy lifestyle choices.

And what were the lifestyle choices that are linked to cancer?  The researchers list 20 separate things (in 8 broad groups) that are known to cause or are linked to cancer. They are: tobacco smoke (smoking or second-hand smoke), dietary factors (low-intake of fruit, non-starchy vegetables, and dietary fiber; and high intake of red and processed meat), overweight/obesity, alcohol, physical inactivity, solar ultraviolet radiation, certain infections (they list 7 infections, such as human papillomavirus, hepatitis B, hepatitis C), and reproductive factors (lack of breastfeeding, menopausal hormone therapy use, combined oral contraceptive use). Note that they found that the #1 most important lifestyle factor is tobacco smoke - and it accounted for about 23% of all preventable cancer deaths in Australia. From Medscape:

One Third of Cancer Deaths Could Be Prevented by Lifestyle

As we head into the festive season, many are looking forward to the tradition of "Eat, drink, and be merry." But as another research paper shows that more than a third of cancer deaths could be prevented by lifestyle, maybe a qualifier should be added:"celebration in moderation." The latest statistics come from Australia, where researchers note that 44,004 cancer deaths occurred in 2013. But an estimated 38% of these deaths and 33% of cancer diagnoses could have been prevented with healthy lifestyle choices, says a research team led by Louise Wilson, MEpi, at the QIMR Berghofer Medical Research Institute and the University of Queensland, Brisbane.

These cancer diagnoses and deaths were seen in Australians of all ages and are directly attributable to 20 known modifiable risk factors within eight categories that are established causes of cancer, the study authors say. The report is published in the February 2018 issue of the International Journal of Cancer.

Smoking was the leading cause of preventable cancer death in Australia in 2013 and accounted for 23% of all cancer deaths. ...Three other categories of modifiable risk factors — poor diet, overweight/obesity, and infections — accounted for 5% of cancer deaths each. In a fifth category, alcohol-related cancer accounted for 2.4% of deaths. Physical inactivity factors were responsible for 0.8% of cancer deaths, overexposure to ultraviolet radiation for 3.2% of cancer deaths, and, in the eighth category, reproductive or hormonal factors were linked to 0.4% of cancer deaths.

In the diet category, risk factors include low intake of fruit, nonstarchy vegetables, and dietary fiber and high intake of red and processed meat. In the infection category, seven cancer-causing agents, including human papillomavirus (associated with cancer of the vulva, vagina, penis, anus, oral cavity, and oropharynx) and Helicobacter pylori (noncardia stomach cancer), are included. Lack of breastfeeding, use of menopausal hormone therapy, and use of combined oral contraceptive use (breast and cervical cancer) are listed as preventable risk factors in the reproductive category.

These findings are in keeping with other research on the role of modifiable lifestyle-related risk factors in cancer prevention. As previously reported by Medscape Medical News, results from a large cohort study in the United States led researchers to conclude that 20% to 40% of cancer cases and related mortality could be prevented by not smoking, maintaining a healthy weight, and exercising regularly. In another report, results from a national online survey undertaken by the American Society of Clinical Oncology showed that, like their Australian counterparts, most US adults don't know alcohol and obesity are major risk factors for cancer. [Original study.]

A dividing lung cancer cell. Lung cancer is associated with smoking. Credit: National Institute of Health (NIH).