Tag Archives: Exercise

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

IMG_8348rt5x7bwFor some guidance, here is a nice summary from the New York Times of some recent research. . . .

Exercise has had a Goldilocks problem, with experts debating just how much exercise is too little, too much or just the right amount to improve health and longevity. Two new, impressively large-scale studies provide some clarity, suggesting that the ideal dose of exercise for a long life is a bit more than many of us currently believe we should get, but less than many of us might expect. The studies also found that prolonged or intense exercise is unlikely to be harmful and could add years to people’s lives. Click here for the full article.

The conclusions?

1. The recommended weekly does of 150 minutes of exercise is a good starting point, but those who are able should strive for more, up to an hour a day of moderate exercise (such as steady walking)

2. Adding more intense exercise for short periods (jogging or brisk walking) is even more beneficial.

3. While more intense training, such as distance running, may not be harmful, the overall benefit on longevity is questionable. This should not stop those who are able from pursuing vigorous exercise,

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

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!

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.

A great prescription

BW ARA labcoatWe have written and posted about the heart health benefits of exercise at HeartHealthDocs – including programs like Cardiac Rehabilitation (Rehab)

heart to start book. In the book Heart to Start, Dr. James Beckerman, a cardiologist who lives in Portland, Oregon, writes a detailed prescription for anyone to use to start living heart healthy. The gut-check forward “What’s your legacy?” written by David Watkins is followed by patient examples, vignettes, and Beckerman’s own personal reasons for the book. The Warm Up, Work Out, Cool Down sections echo a training session, and take the reader through the paces – the what, why, how, for fitness assessment and growth toward heart & circulation health.

The chapter Cardiac Reboot asks “Got Rehab?” and points out the current reality that if you (the patient) don’t bring up cardiac rehab, “it is possible no one else will.” This relates to the low numbers (20-30%) of eligible patients being referred to cardiac rehab, and of those only 40% actually completing this effective treatment regimen.

Beckerman goes on to provide readers a toolkit for being active, while showing how an active lifestyle can be habit forming – and be maintained for years (ie. how not to get injured). The book will get you to your 5K and its finish & beyond, and will teach how nutrition, training, and balance (ie. strength conditioning in addition to walking/running) work together.

Dr. Beckerman gives powerful examples of what motivates him – for the book, and for his practice which includes the PlaySmart heart screening program. The proceeds from the sale of his book will support free heart screenings for kids.  The book will help anyone learn about and apply practical, inspiring information for exercise and heart health. A great way to multitask.

Asian Americans Face Greater Risk for Stroke and Hypertension

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. . . .

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

HeartHealth Docs Road Show. . .Promoting healthy kids

The HH Docs spent this past weekend in Indianapolis, presenting original research from Riverside Hospital. We performed a study analyzing the accuracy of cardiac ultrasound to detect a certain type of cardiac abnormality that may cause sudden death with exertion. Dr. Kyle Feldman, who collaborated on the study, presented the findings to over 300 attendees.

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For more information and a video on promoting heart health for athletes and active teenagers, see this article.