Category Archives: exercise

More benefit to physical activity~ Prevents Heart Failure

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Physicians talk about patients with heart failure (HF) when describing someone with shortness of breath, inability to exert physically without having shortness of breath, or also experiencing fluid retention (leg swelling, increased waist size).

 

Non-physicians (my husband for example) hear about ‘heart failure’ and imagine death, or heart stopping like in sudden cardiac death. The terms could be better, but for now are used as above for physicians and for HeartHealth Doctors followers: Heart Failure refers to symptoms of shortness of breath (dyspnea) or fluid retention either due to reduced (r) heart pumping function (also termed Ejection Fraction or EF) (HFrEF) or preserved (p) EF but ineffective heart pumping function (HFpEF).

 

Heart failure is one of the most common reasons for hospitalization and is more common as people get older.   In the US more than 6 million adults have HF.

 

HeartHealth Doctors blog has information regarding the benefits of exercise and heart healthy lifestyle as powerful ways to prevent symptoms from heart issues.

 

For the first time, the Women’s Health Initiative program (WHI) has reported benefit of physical activity specifically walking, for post menopausal women to prevent HF.

Physical Activity and Incidence of Heart Failure in Postmenopausal Women (J Am Coll Cardiol HF 2018;6:983–95) reports findings from WHI that support regular physical activity – reported as recreational physical activity by participants – as a powerful means of reducing Heart Failure risk (both HFrEF and HFpEF).

The findings again support exercise (physical activity) as medicine – without potential side effects, and with a good dose response (more activity time, less chance to develop Heart Failure).

The study looked prospectively at the women, and the following list are possible ways physical activity impacts risks for developing heart failure. As HeartHealth Doctors have outlined, physical activity improves risk factors for heart disease, and as pointed out in the Clinical Research Study, for Heart Failure-

 

Exercise or physical activity helps prevent or manage:

Obesity

Blood pressure

Glucose / blood sugar regulation

Inflammation and Oxidative stress

Left ventricular compliance (heart pumping/relaxing function)

Arterial function

Aerobic capacity

Skeletal muscle function

Coronary Heart Disease

Diabetes

Atrial fibrillation

 

The researchers removed participants who were unable to walk 1 block prior to enrollment.

They included post menopausal women age ~50-79 years at start of the study and followed the group for 15 years with surveys.

The study highlights new benefit to heart healthy habits of exercise and physical activity; still the best way to multi task for your heart health.

How much physical activity is enough?

The study suggests volume of activity is a good focus rather than intensity – just walk for example work toward the authors’ goal of ‘brisk walking (3.3 mph on level ground) with the target of achieving 30 min/day on 5 or more days of the week.’

Benefit was shown with regular walking pretty much in line with current guidelines of 150 minutes per week; which can be 10 minutes twice a day or 30 minutes 5 days per week ~ now a big study shows one more of so many reasons to be physically active.

 

Physical Activity and Incidence of Heart Failure in Postmenopausal Women (JACC: Heart Failure December 2018)

J Am Coll Cardiol HF 2018;6:983–95

Exercise can make your body feel younger. . . and (maybe) actually make it younger?

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IMG_8348rt5x7bwAs we prepare for Thanksgiving (and in my case, the Thanksgiving Day Turkey Trot!) there is some good news on exercise and aging.  We know that lifelong regular exercise can reverse many of the effects of aging – at least in “elite” or professional lifelong athletes. But what about “regular people” who commit to a lifestyle of regular activity? Can their bodies become “younger” too?

A recent study (link to full study here) tried to answer this question – by studying the Running Turkeybodies (specifically, muscle tissue) of older individuals who had remained active though regular leisurely activities. The main findings, according to this article in the New York Times summarizing the study:

“The muscles of the older exercisers resembled those of the young people, with as many capillaries and enzymes as theirs, and far more than in the muscles of the sedentary elderly.

The active elderly group did have lower aerobic capacities than the young people, but their capacities were about 40 percent higher than those of their inactive peers.

In fact, when the researchers compared the active older people’s aerobic capacities to those of established data about “normal” capacities at different ages, they calculated that the aged, active group had the cardiovascular health of people 30 years younger than themselves.”

What does this mean?

  1. Committing to an active lifestyle can slow, or even eliminate” many of the changes in our muscles that we consider “normal aging”
  2. Even though our overall exercise capacity does diminish over age, these changes are slowed significantly in those who remain active, compared to less active older individuals.
  3. In the words of one of the researchers, “exercise could help us to build a reserve of good health now that might enable us to slow or evade physical frailty later”

So this is more evidence for all of us to stay active – here is our overview of physical activity and its benefits on heart health, and here are more articles on exercise:

Exercise News: Delay Dementia, and Never Too Late to Start!

Is Running Risky? Lets check the science. . . .

Can 1 Minute of Exercise Possibly be Useful?

What is the “right dose” of exercise for a long and healthy life?

 

 

Can 1 Minute of Exercise Possibly be Useful?

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IMG_8348rt5x7bwYou may have noticed (or perhaps soon will) this article from the NY Times earlier today with an enticing headline: Only a single minute of high intensity exercise  can replace 45 minutes of moderate exercise. This seems like good news for those of us who are always pressed for time to find time for exercise. But we need to delve into the details of this study before drawing broad conclusions about the optimal duration of exercise.

The study in question showed that an exercise routine using high intensity exercise for one minute of total duration (in a routine that took 10 minutes total including warmup and rest periods) had similar benefits to a longer routine of moderate exercise in this study group of 25 subjects. It suggests that incorporating intervals of high intensity exercise can shorten the amount of time needed to obtain long-lasting health benefits.

I do think this is an enticing concept and it is a very good reminder that adding interval trainingrunning shoes can be quite beneficial to our health and our fitness goals. But we need to remember why we advocate for physical activity for wellness and disease prevention. Exercise should not be a “bitter medicine” taken as quickly as possible, but should be considered a desired component of our day-to-day lifestyle. Therefore I think that moderate exercise, such as brisk or sustained walking, as well as light jogging, can have much broader benefits, such as improving our mental state, helping concentration and sleep, and of course improving our long-term health and disease prevention.

This article is certainly a useful reminder that adding intervals to exercise, for those of us who are physically able, can help us reach our fitness goals quicker and more successfully.  However, these type of programs can also increase the risk of injury or worsen underlying medical conditions.  Therefore, high intensity exercise regimens should only be undertaken with the guidance of a fitness professional, and for those with chronic heart or other medical conditions, with the approval of our personal physician or health care provider.

Here is the link to full article.

Another Reason to “Stand Up” to Heart Disease!

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IMG_8348rt5x7bwIn case you need another excuse to get off the couch (and think about a treadmill desk). . . it appears “too much sitting” may in itself contribute to the progression of heart plaque. . .

Too Much Sitting May Up Risk of Coronary Artery Calcification

Marlene Busko

SAN DIEGO, CA — Each added hour spent sitting was associated with a 14% increase in coronary artery calcium (CAC) score, independent of traditional risk factors, including physical activity, in a study of middle-aged subjects without cardiovascular disease[1].

“Our study contributes to the growing body of evidence whereby health consequences of ‘sitting too much’ appear to be distinct from those of ‘too little exercise,’ and [it] suggests that increased subclinical atherosclerosis may be one of the mechanisms through which sedentary behavior increases CV risk,” Dr Jacquelyn Kulinski (Medical College of Wisconsin, Milwaukee) told heartwire from Medscape.

The researchers examined data from 2031 participants in theDallas Heart Study who were aged 20 to 76, with a mean age of 50. Just over half (62%) were women, and about 50% were black.

Participants had a CT scan to measure CAC; a CAC score above 10 was deemed positive and a score below 10 was deemed negative. In addition, the participants wore a watch accelerometer for at least 4 days to measure body movements, which were classed as sedentary, light activity (nonexercise), or moderate to vigorous physical activity.

On average, participants were sedentary for 5.1 hours a day, but this ranged from 1.1 to 11.6 hours a day. Older people, those with a higher body-mass index (BMI), and those with diabetes or hypertension were more likely to spend more time sitting.

After adjustment for BMI, systolic blood pressure, total cholesterol, HDL cholesterol, statin use, type 2 diabetes, smoking, household income, education, marital status, employment, and moderate to vigorous physical activity, each hour of sedentary time was associated with a 10% higher odds of having CAC (adjusted odds ratio 1.10, 95% CI, 1.01–1.21; P=0.035).

Moderate to vigorous physical activity was modestly associated with CAC in models adjusted only for age, gender, and ethnicity, but the association disappeared after adjustment for traditional cardiovascular risk factors, including smoking, diabetes, BMI, cholesterol, and blood pressure, Kulinski added. Even though study participants exercised only an average of 6 minutes a day, other studies in marathon runners have also reported that exercise was not associated with CAC, she noted.

LINK TO FULL ARTICLE:

Too Much’ Sitting May Worsen Coronary Calcification, Regardless of Exercise
Heartwire from Medscape, 2015-03-11

Heart Health News. . . You Can Use

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IMG_8348rt5x7bwHere are some quick links to useful items in the news recently that reflect new findings on prevention and heart health:

Could drinking alcohol actually affect the way you exercise? Some new research described here suggests that could be the case – and in a positive way. 

The upshot? Because exercise and alcohol intake affect similar “pleasure” centers in our brain, you may actually be tempted to drink more in days you exercise – but people who drink moderate amounts of exercise also tend to exercise more regularly. . . and seem to be healthier. (see our earlier article about wine and heart health).

Is coffee good or bad for you? A new study described here looked at coffee intake and risk of death from various causes.

The upshot? Keep bringing on the java (and consider buying Starbucks stock!)

Can you be “too old” to exercise. . or get its benefits? Not according to new research. 

The upshot? Even in those over age 75, regular walking can reduce your risk of heart attack and stroke. So keep moving!

This article describes research into the link between weekend sleep and weekday sleep.

The upshot? Sleeping in late on weekends may feel good, but may have negative health consequences.

Remember. . only your doctor can give you specific health care advice. . so always check with your health provider if these articles (and the advice they contain) apply to you and your health situation. 

 

VIDEO: Which Exercise is Best for Preventing Heart Disease?

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IMG_8348rt5x7bwRecently, I was asked by the online video blog, VIDOYEN, about the best exercise for heart prevention. Here is my 3 minute answer:

Cardiologist and Heart Health Advocate Kanny S. Grewal, MD answers Which Exercise is Best for Preventing Heart Disease? (3 minutes) – VIDOYEN.

 

Is “Too Much” Exercise Harmful? Some New Information. . .

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IMG_8348rt5x7bwWe have known for some time that physically active individuals have a longer life span and are overall healthier than those who are sedentary.  This certainly extends to heart disease, where exercise clearly has a beneficial effect for both prevention and therapy. But more recent research into “extreme” levels of exercise, especially endurance running, is raising questions about whether it is possible to exercise too much. This is becoming a controversial and heavily debated topic in the world of sports medicine.

Recently, a new study was released which adds important information to this debate. This was a veryrunning shoes detailed study in Europe of individuals over many years to try to link the degree of jogging with overall mortality and cardiovascular health.  Called the Copenhagen Heart Study, this particular analysis identified over 1000 active joggers and followed them for over 12 years. Not surprisingly, those who exercise either mild or moderate amounts were healthier and lived longer than their sedentary counterparts. What was most interesting however, is that those who ran the most vigorously (defined as 4 or more sessions weekly, or high intensity sessions) actually did not have improved survival compared to the sedentary non-runners.  This suggests that perhaps more extreme levels of running may actually be harmful. In fact, other studies have suggested a similar connection, such as a higher risk of irregular heart rhythms in those who participate in extreme sports.  The study did have some limitations as it did not address other types of exercise, the participants were not randomized,  and the limited number of participants prevented detailed analysis and comparisons.

So, for overall wellness and heart health, what level of exercise should we recommend? Here are some guidelines:

1. Remember, always check with your physician or other health provider to determine whether physical activity is appropriate for your specific medical condition.

2. This study adds to the evidence that light and moderate exercise is clearly beneficial.  The current recommendation by the American Heart Association is 150 minutes a week of moderate exercise. That could include brisk walking, light or moderate jogging, or many other types of aerobic activity. However, as we previously reported, even very short sessions of exercise can be beneficial.

3. High-intensity exercise, defined as 4 or more sessions a week, or frequent sessions of very high intensity activity (for example, running > 7 MPH) , may not be optimal for long-term health and survival. There is still minimal evidence that this level of exercise is actually harmful, but the benefit may not be as high as for those that stick to moderate exercise.

4. For those who elect to perform higher intensity exercise, it may be reasonable to cycle the periods of high activity with “down time”or cross-training with other less-intense types of exercise. There is still really no evidence that any particular type of aerobic exercise is best, so an active lifestyle that focuses on a mix of activities may be optimal.

Other than perhaps diet, an active lifestyle is still the single most effective way to prolong our lives and prevent disease. We hope you will join the HeartHealth Docs in participating in the upcoming Capital City Half Marathon and the New Albany Walking Classic.

Here is a reference to the study mentioned and this article.

Here is our overview of exercise, and an additional article on the benefits of exercise.

Exercise can make you feel younger. . . and function younger!

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IMG_8348rt5x7bwMost of us are well aware of the benefits of regular exercise (certainly, regular readers of this blog should be!)  While there is plenty of evidence of the the benefits of exercise for our heart and circulatory health, an interesting new study has taken this concept a bit further – it showed that older adults who are regular exercisers were not only healthier, but essentially “younger” – in other words, their bodies had the physiologic and mental attributes of someone who was younger. And, this not only included their athletic endurance, but things like mental acuity and reflexes. This study was in an unusual group of elderly folks who were fairly vigorous cyclists, but there is a good chance these findings would apply to all active elderly adults.

So while some aspects of normal “aging” may be inevitable, studies such as this show that staying Runningactive may not only make our bodies and minds feel younger, but possibly function younger! Here is a link to a nice summary of the study in the New York Times:

For some of our tips about starting and maintaining an exercise program see our previous article. And always remember, you should always check with your doctor to make sure that an exercise program is safe and beneficial for your specific health conditions.

Asian Americans Face Greater Risk for Stroke and Hypertension

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Asian Americans are at higher risk for stroke and hypertension compared to whites, according to a study examining U.S. death records from 2003–2010.

IMG_8348rt5x7bwAlthough heart disease is the No. 1 killer of all Americans, certain races and ethnic groups face higher cardiovascular risk than others. Asian Americans are the fastest growing racial/ethnic group in the United States, yet little is known about heart risks in distinct subgroups of the Asian American population.

Published in the Journal of the American College of Cardiology, a recent study analyzed death records for the six largest Asian-American subgroups: Asian Indian, Chinese, Filipino, Japanese, Korean and Vietnamese. Together, these subgroups make up 84% of the Asians in the United States.

After comparing U.S. death rates from 2003–2010, researchers found that stroke and high blood pressure was more common among every Asian American subgroup compared to non-Hispanic whites. Compared to whites, Asian Indians and Filipino men also had greater mortality from coronary artery disease—a condition that occurs when the heart’s arteries narrow, often due to the plaque build-up on the arterial walls. (text taken from http://www.cardiosmart.com)

Until further studies clarify the specific reasons for elevated risk in Asian Americans, the goals for prevention in this population are similar to all adults, with a few areas of emphasis:

1. Blood Pressure Control – monitoring blood pressure – .and prompt treatment of elevated readings – it is important for all adults, but in Asian American’s we may need to emphasize more thorough monitoring, and consider intervention ( either lifestyle changes or medications) at an earlier age or with lower blood pressure targets. Here is more information.

2. Manage Your Cholesterol – in recent years we have certainly learned more about specific changes of cholesterol in the Asian population. For example, here is an article I co-authored which looked at specific cholesterol findings in Indian Americans.  Even though the spectrum of specific cholesterol abnormalities vary among the various agents are groups, the lifestyle advice to minimize the impact is universal: Reduce intake of saturated fats, processed grains, and minimize wheat based carbohydrates. Here is more information.

3. Stop smoking and minimize tobacco exposure. Hopefully the impact here is self-explanatory. Here is additional information.

4. Monitor Blood Sugar – Type 2 (or “adult onset”) diabetes is far more common in certain Asian populations (such as Indians), especially those that have moved to Western countries that eat highly processed diets. In many Asians, diabetes can develop even in the absence of the usual weight gain (e.g. abdominal fat) typical in other populations. Ask your physician about screening recommendations for those at risk of diabetes.

4. Stay Active! Regular readers of our blog should be well versed in the many benefits of the ultimate medical therapy: Regular exercise. Here is an overview of the benefits of exercise, and here is even more information.

For now, the screening recommendations for prevention of heart disease and stroke in Asian Americans are no different from the population at large. However, there is some evidence that certain screening tools may benefit certain populations. These include advanced blood testing and imaging to screen for early coronary plaque. If you are concerned about your risk, you should ask your physician whether additional screening may be useful. or even consider calculating your very own “Heart Age”.  In the meantime, clinical studies are providing more and more information about cardiovascular risk in this growing segment of Americans.

Is Running Risky? Lets check the science. . . .

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IMG_8348rt5x7bwIf you follow the medical and popular media, you know that there is an ongoing debate as to the benefit and/or possible risk of more extreme physician activities, specifically running. Some studies have suggested that running may actually be harmful, or does not protect against heart disease. Recently, a new study was published which looked in more detail at the relationship of running and longevity. This was a very detailed study of over 55,000 adults who were followed over 15 years.

A synopsis of the study is shown below, but here are some key take away points:Running

1. Adults who run regularly have about 30% less risk of dying from any cause compared to non-runners.

2. This benefit exists regardless of the duration, intensity, or specific type of running. It was the same for men and women.

3. Most importantly, even though surrounding for as little as 5 minutes a day had the same benefit compared to non-runners.

4. Also of note, the runners who did the most vigorous activity had a similar benefit, which suggests that there is no adverse effect of more intense running (but possibly no benefit either!)

So what is the take-home message? For most adults, even minimal amounts of running have a long-term benefit, and for those who do more intense running, there is little evidence of any significant harm. Although the study did not look and other types of exercise, other studies have shown that just moderate exercise such as brisk walking probably has a similar positive effect. So this is even more evidence to make sure we keep moving!

Here is more information on exercise and heart disease.

Also see: Does Running Really Help your Heart . . . . and Your Spouse’s Too?

 

Running five minutes daily can reduce risk of cardiovascular disease related death

JULY 28, 2014

WASHINGTON (July 28, 2014) — Running for only a few minutes a day or at slow speeds may significantly reduce a person’s risk of death from cardiovascular disease compared to someone who does not run, according to a study published today in the Journal of the American College of Cardiology.

Researchers studied 55,137 adults between the ages of 18 and 100 over a 15-year period to determine whether there is a relationship between running and longevity. Data was drawn from the Aerobics Center Longitudinal Study, where participants were asked to complete a questionnaire about their running habits. In the study period, 3,413 participants died, including 1,217 whose deaths were related to cardiovascular disease. In this population, 24 percent of the participants reported running as part of their leisure-time exercise.

Compared with non-runners, the runners had a 30 percent lower risk of death from all causes and a 45 percent lower risk of death from heart disease or stroke. Runners on average lived three years longer compared to non-runners. Also, to reduce mortality risk at a population level from a public health perspective, the authors concluded that promoting running is as important as preventing smoking, obesity or hypertension. The benefits were the same no matter how long, far, frequently or fast participants reported running. Benefits were also the same regardless of sex, age, body mass index, health conditions, smoking status or alcohol use.

The study showed that participants who ran less than 51 minutes, fewer than 6 miles, slower than 6 miles per hour, or only one to two times per week had a lower risk of dying compared to those who did not run.
DC (Duck-chul) Lee, Ph.D., lead author of the study and an assistant professor in the Iowa State University Kinesiology Department in Ames, Iowa, said they found that runners who ran less than an hour per week have the same mortality benefits compared to runners who ran more than three hours per week. Thus, it is possible that the more may not be the better in relation to running and longevity.

Researchers also looked at running behavior patterns and found that those who persistently ran over a period of six years on average had the most significant benefits, with a 29 percent lower risk of death for any reason and 50 percent lower risk of death from heart disease or stroke.

“Since time is one of the strongest barriers to participate in physical activity, the study may motivate more people to start running and continue to run as an attainable health goal for mortality benefits,” Lee said. “Running may be a better exercise option than more moderate intensity exercises for healthy but sedentary people since it produces similar, if not greater, mortality benefits in five to 10 minutes compared to the 15 to 20 minutes per day of moderate intensity activity that many find too time consuming.”

CONTACT: Nicole Napoli, 202-375-6523