Sports concussions increase injury risk

June 16, 2023

Science Daily/University of South Australia

Concussions are an unfortunate reality of contact sports at junior and senior levels. Now, sports experts at the University of South Australia are suggesting extended recovery times may be needed for youth athletes suffering from head trauma as new research shows a concussion can increase future injury risk by 50%.

Published in the Journal of Science and Medicine in Sport,the world-first study tracked and evaluated the long-term impact of concussion and subsequent injury risk of 1455 sub-elite junior Australian rules football players.

This builds on previous UniSA research that found an approximate 1.5-fold increased risk of injury of sub-elite Australian rules football players returning from an injury, compared to those with no injury.

Tracking injuries over a seven-season period, researchers found that football players who suffered a concussion were also about 1.5 times more likely to be reinjured in the future when compared to players who had never been injured. This increased risk was the same as players returning from upper and lower limb injuries.

The finding comes ahead of the Australian Senate's report into concussion injuries, and follows the AFL's announcement for a $25 million study into the long-term effects of concussions and head knocks.

In the AFL, concussions are one of the most common injuries, with an average of six concussions every 1000 hours played, which involve around 70 to 80 male players every year.

In junior elite football as well as AFL and AFLW, the guidelines for concussion say that the earliest a player can return to play post-concussion is 12 days after the injury, after following the graded progression through a return-to-play program.

Lead researcher, UniSA's Dr Hunter Bennett, says the significant and elevated risk of injury after a concussion may suggest a longer recovery time is required for some players to better recover before returning to play.

"The current recommendation of 12 days post-concussion may not be sufficient to allow full recovery in elite under-18 footballers," Dr Bennett says.

It may also indicate that the physical qualities impacted by concussion should be assessed more thoroughly before an athlete is cleared to return to the sport.

"Concussion is a common injury in Australian rules football that can lead to impairments in balance, coordination, reaction time, and decision making -- and these impairments can increase the risk of other injuries if an athlete returns to play before being fully recovered."

A recent consensus statement on concussion in sport also indicates that children and teenagers may take up to four-weeks to recover from a sport related concussion.

"Concussions are a unique injury that occur without muscle tissue damage, instead impacting aspects of motor control," Dr Bennett says.

"Recurrent injuries can significantly impact team success, player health, and career longevity.

"In elite sports, there is the potential for young athletes to overplay their readiness to return to sport after an injury, as they worry that missing games can exclude them from senior drafting or competition.

"When we know that athletes have a greater risk of another injury post a concussion, it suggests we need unique and careful rehabilitation strategies to monitor when an athlete is fully recovered and ready to return to play."

Researchers say that future research should seek to identify optimal rehabilitation and injury prevention strategies for athletes who suffer from concussions.

https://www.sciencedaily.com/releases/2023/06/230616161943.htm

Colorful fresh foods improve athletes' vision

Visual range is a critical asset for top athletes in almost any sport

June 8, 2023

Science Daily/University of Georgia

Nutrition is an important part of any top athlete's training program. And now, a new study by researchers from the University of Georgia proposes that supplementing the diet of athletes with colorful fruits and vegetables could improve their visual range.

The paper, which was published in Exercise and Sport Sciences Reviews, examines how a group of plant compounds that build up in the retina, known as macular pigments, work to improve eye health and functional vision.

Previous studies done by UGA researchers Billy R. Hammond and Lisa Renzi-Hammond have shown that eating foods like dark leafy greens or yellow and orange vegetables, which contain high levels of the plant compounds lutein and zeaxanthin, improves eye and brain health.

"A lot of the research into macular lutein and zeaxanthin has focused on health benefits, but from a functional perspective, higher concentrations of these plant pigments improve many aspects of visual and cognitive ability. In this paper, we discuss their ability to improve vision in the far distance or visual range," said lead author Jack Harth, a doctoral candidate in UGA's College of Public Health.

Visual range, or how well a person can see a target clearly over distance, is a critical asset for top athletes in almost any sport.

The reason why objects get harder to see and appear fuzzier the farther they are from our eyes is thanks in part to the effects of blue light.

"From a center fielder's perspective, if that ball's coming up in the air, it will be seen against a background of bright blue sky, or against a gray background if it's a cloudy day. Either way, the target is obscured by atmospheric interference coming into that path of the light," said Harth.

Many athletes already take measures to reduce the impact of blue light through eye black or blue blocker sunglasses, but eating more foods rich in lutein and zeaxanthin can improve the eye's natural ability to handle blue light exposure, said Harth.

When a person absorbs lutein and zeaxanthin, the compounds collect as yellow pigments in the retina and act as a filter to prevent blue light from entering the eye.

Previous work had been done testing the visual range ability of pilots in the 1980s, and Hammond and Renzi-Hammond have done more recent studies on how macular pigment density, or how much yellow pigment is built up in the retina, is linked to a number of measures of eye health and functional vision tests.

"In a long series of studies, we have shown that increasing amounts of lutein and zeaxanthin in the retina and brain decrease glare disability and discomfort and improve chromatic contrast and visual-motor reaction time, and supplementing these compounds facilitates executive functions like problem-solving and memory. All of these tasks are particularly important for athletes," said corresponding author Billy R. Hammond, a professor of psychology in the Behavior and Brain Sciences Program at UGA's Franklin College of Arts and Sciences.

This paper, Harth said, brings the research on these links between macular pigment and functional vision up to date and asks what the evidence suggests about optimizing athletic performance.

"We're at a point where we can say we've seen visual range differences in pilots that match the differences found in modeling, and now, we've also seen it in laboratory tests, and a future goal would be to actually bring people outside and to measure their ability to see contrast over distance through real blue haze and in outdoor environments," said Harth.

But before you start chowing down on kale in the hopes of improving your game, he cautions that everybody is different. That could mean the way our bodies absorb and use lutein and zeaxanthin varies, and it could take a while before you notice any improvements, if at all.

Still, the evidence of the overall health benefits of consuming more lutein and zeaxanthin are reason enough to add more color to your diet, say the authors.

"We have data from modeling and empirical studies showing that higher macular pigment in your retina will improve your ability to see over distance. The application for athletes is clear," said Harth.

https://www.sciencedaily.com/releases/2023/06/230608120930.htm

Your thoughts can harm your neck and back during lifting tasks

In lab, contradictory feedback linked to increased spine loading

May 25, 2023

Science Daily/Ohio State University

The mental distress of cognitive dissonance -- encountering information that conflicts with how we act or what we believe -- can lead to added pressure on the neck and low back during lifting and lowering tasks, new research suggests.

When study participants were told they were performing poorly in a precision lowering experiment in the lab, after initially being told they were doing well, their movements were linked to increased loads on vertebrae in their neck and low back.

Results showed that the higher the cognitive dissonance score, the greater the extent of loading on the upper and lower parts of the spine.

The finding suggests cognitive dissonance may be a previously unidentified risk factor for neck and low back pain, which could have implications for risk prevention in the workplace, according to researchers.

"This increased spine loading occurred under just one condition with a fairly light load -- you can imagine what this would be like with more complex tasks or higher loads," said senior author William Marras, executive director of the Spine Research Institute at The Ohio State University. "Basically, the study scratched the surface of showing there's something to this."

The research was published recently in the journal Ergonomics.

Marras' lab has been studying daily living and occupational forces on the spine for decades. About 20 years ago, he found that psychological stress could influence spine biomechanics, using a study design that involved having a fake argument with a graduate student in front of research participants.

"We found that in certain personality types, the loads in the spine increased by up to 35%," Marras said. "We ended up finding that when you're under that kind of psychosocial stress, what you tend to do is what we call co-activate muscles in your torso. It creates this tug of war in the muscles because you're always tense.

"In this study, to get at that mind-body connection, we decided to look at the way people think and, with cognitive dissonance, when people are disturbed by their thoughts."

Seventeen research participants -- nine men and eight women aged 19-44 -- completed three phases of an experiment in which they placed a light-weight box within a square on a surface that was moved left and right, up and down. After a short practice run, researchers gave almost exclusively positive feedback during the first of two 45-minute trial blocks. During the second, the feedback increasingly suggested participants were performing in an unsatisfactory way.

To arrive at a cognitive dissonance score for each participant, changes during the experiment to blood pressure and heart rate variability were combined with responses to two questionnaires assessing discomfort levels as well as positive and negative affect -- feeling strong and inspired versus distressed and ashamed.

Wearable sensors and motion-capture technology were used to detect peak spinal loads in the neck and low back: both compression of vertebrae and vertebral movement, or shear, from side to side (lateral) and forward and back (A/P).

Statistical modeling showed that, on average, peak spinal loads on cervical vertebrae in the neck were 11.1% higher in compression, 9.4% higher in A/P shear and 19.3% higher in lateral shear during the negative-feedback trial block compared to the baseline measures from the practice run. Peak loading in the lumbar region of the low back -- an area that bears the brunt of any spinal loading -- increased by 1.7% in compression and 2.2% in shear during the final trial block.

"Part of the motivation here was to see whether cognitive dissonance can manifest itself not only in the low back -- we thought we'd find it there, but we didn't know what we'd find in the neck. We did find a pretty strong response in the neck," said Marras, a professor of integrated systems engineering with College of Medicine academic appointments in neurosurgery, orthopaedics and physical medicine and rehabilitation.

"Our tolerance to shear is much, much lower than it is to compression, so that's why that's important," he said. "A small percentage of load is no big deal for one time. But think about when you're working day in and day out, and you're in a job where you're doing this 40 hours a week -- that could be significant, and be the difference between a disorder and not having a disorder."

Marras is also principal investigator on a federally funded multi-institution clinical trial assessing different treatments for low back pain that range from medication to exercise to cognitive behavioral therapy.

"We're trying to unravel this onion and understand all the different things that affect spine disorders because it's really, really complex," he said. "Just like the whole system has got to be right for a car to run correctly, we're learning that that's the way it is with the spine. You could be in physically great shape, but if you're not thinking correctly or appropriately, or you have all these mental irregularities, like cognitive dissonance, that will affect the system. And until you get that right, you're not going to be right.

"We're looking for causal pathways. And now we can say cognitive dissonance plays a role and here's how it works."

https://www.sciencedaily.com/releases/2023/05/230525141244.htm

Running throughout middle age keeps 'old' adult-born neurons 'wired'

'Mice on the run:' study reveals how exercise helps maintain memory function during aging

May 25, 2023

Science Daily/Florida Atlantic University

A new study provides novel insight into the benefits of exercise, which should motivate adults to keep moving throughout their lifetime, especially during middle age. Long-term exercise profoundly benefits the aging brain and may prevent aging-related memory function decline by increasing the survival and modifying the network of the adult-born neurons born during early adulthood, and thereby facilitating their participation in cognitive processes.

Aging often is accompanied by cognitive decline. Among the first structures of the brain affected are the hippocampus and adjacent cortices, areas essential for learning and memory. Deficits in cognitive ability are associated with reduced hippocampal volume and degradation of synaptic connectivity between the hippocampus and the (peri)-entorhinal cortex.

Increasing evidence indicates that physical activity can delay or prevent these structural and functional reductions in older adults. A new study by Florida Atlantic University and CINVESTAV, Mexico City, Mexico, provides novel insight into the benefits of exercise, which should motivate adults to keep moving throughout their lifetime, especially during middle age.

For the study, researchers focused on the effects of long-term running on a network of new hippocampal neurons that were generated in young adult mice, at middle age. These "mice on the run" demonstrate that running throughout middle age keeps old adult-born neurons wired, which may prevent or delay aging-related memory loss and neurodegeneration.

Adult-born neurons are thought to contribute to hippocampus-dependent memory function and are believed to be temporarily important, during the so-called 'critical period' at about three to six weeks of cell age, when they can fleetingly display increased synaptic plasticity. However, these new neurons do remain present for many months, but it was unclear whether those born in early adulthood remain integrated into neural networks and whether their circuitry is modifiable by physical activity in middle age.

To address these questions, researchers used a unique rabies virus-based circuit tracing approach with a long-time interval between the initial labeling of new neurons and subsequent analysis of their neural circuitry in rodents. More than six months after tagging of the adult-born neurons with a fluorescent reporter vector, they identified and quantified the direct afferent inputs to these adult-born neurons within the hippocampus and (sub)cortical areas, when the mice were middle-aged.

Results of the study, published in the journal eNeuro, show long-term running wires 'old' new neurons, born during early adulthood, into a network that is relevant to the maintenance of episodic memory encoding during aging.

"Long-term exercise profoundly benefits the aging brain and may prevent aging-related memory function decline by increasing the survival and modifying the network of the adult-born neurons born during early adulthood, and thereby facilitating their participation in cognitive processes," said Henriette van Praag, Ph.D., corresponding author, an associate professor of biomedical science in FAU's Schmidt College of Medicine and a member of the FAU Stiles-Nicholson Brain Institute.

Findings from the study showed long-term running significantly increased the number of adult-born neurons and enhanced the recruitment of presynaptic (sub)-cortical cells to their network.

"Long-term running may enhance pattern separation ability, our ability to distinguish between highly similar events and stimuli, a behavior closely linked to adult neurogenesis, which is among the first to display deficits indicative of age-related memory decline," said Carmen Vivar, Ph.D., corresponding author, Department of Physiology, Biophysics and Neuroscience, Centro de Investigacion y de Estudios Avanzados del IPN in Mexico.

Aging-related memory function decline is associated with the degradation of synaptic inputs from the perirhinal and entorhinal cortex onto the hippocampus, brain areas that are essential for pattern separation, and contextual and spatial memory.

"We show that running also substantially increases the back-projection from the dorsal subiculum onto old adult-born granule cells," said van Praag. "This connectivity may provide navigation-associated information and mediate the long-term running-induced improvement in spatial memory function."

Results from the study show that running not only rescued perirhinal connectivity but also increased and altered the contribution of the entorhinal cortices to the network of old adult-born neurons.

"Our study provides insight as to how chronic exercise, beginning in young adulthood and continuing throughout middle age, helps maintain memory function during aging, emphasizing the relevance of including exercise in our daily lives," said Vivar.

https://www.sciencedaily.com/releases/2023/05/230525140336.htm

Exercise seems to protect against major brain hemorrhage

May 22, 2023

Science Daily/University of Gothenburg

Regular physical activity and exercise may reduce bleeding in individuals with intracerebral hemorrhage, a University of Gothenburg study shows. The researchers emphasize the importance of physical activity to protect the brain.

The study, published in the journal Stroke and Vascular Neurology, analyzed data on 686 people treated for intracerebral hemorrhage at Sahlgrenska University Hospital in Gothenburg during the years 2014 to 2019.

The results are based on a retrospective analysis. Causal connections cannot be identified, but the findings are nonetheless clear: Those who reported regular physical activity had smaller hemorrhages than those who reported being inactive.

Physically active was defined as engaging in at least light physical activity, such as walking, cycling, swimming, gardening, or dancing, for at least four hours weekly.

50 percent less bleeding volume

The main author of the study is Adam Viktorisson, a PhD student in clinical neuroscience at Sahlgrenska Academy, University of Gothenburg, and doctor in general practice at Sahlgrenska University Hospital.

"We found that individuals who engage in regular physical activity had, on average, bleeding volumes that were 50 percent smaller upon arriving to the hospital. A similar connection has previously been seen in animal studies, but no prior study has demonstrated this in humans."

Everyone who comes to the hospital with a suspected intracerebral hemorrhage undergoes a computerized tomography (CT) scan of the brain. Depending on the severity of the hemorrhage, neurosurgery may be required. However, in most cases, non-surgical methods and medications are used to manage symptoms and promote patient recovery.

Intracerebral hemorrhage is the most dangerous type of stroke and can lead to life-threatening conditions. The risk of severe consequences from the hemorrhage increases with the extent of the bleeding.

"In cases of major intracerebral hemorrhages, there is a risk of increased pressure within the skull that can potentially lead to fatal outcomes" says Thomas Skoglund, associate professor of neurosurgery at the University of Gothenburg, neurosurgeon at the University Hospital, and one of the study's co-authors.

Better understanding of intracerebral hemorrhages

The findings were significant regardless of the location within the cerebrum. Physically active individuals exhibited reduced bleeding in both the deep regions of the brain, which are often associated with high blood pressure, and the surface regions, which are linked to age-related conditions like dementia.

The study creates scope for further research on intracerebral hemorrhages and physical activity. Katharina Stibrant Sunnerhagen, professor of rehabilitation medicine at the University of Gothenburg and senior consultant physician at Sahlgrenska University Hospital, oversees the study.

"We hope that our findings contribute to a deeper understanding of intracerebral hemorrhages and aid in the development of more effective preventive measures" she concludes.

https://www.sciencedaily.com/releases/2023/05/230522131358.htm

Whether physical exertion feels 'easy' or 'hard' may be due to dopamine levels

April 12, 2023

Science Daily/Johns Hopkins Medicine

Dopamine, a brain chemical long associated with pleasure, motivation and reward-seeking, also appears to play an important role in why exercise and other physical efforts feel "easy" to some people and exhausting to others, according to results of a study of people with Parkinson's disease led by Johns Hopkins Medicine researchers. Parkinson's disease is marked by a loss of dopamine-producing cells in the brain over time.

The findings, published online April 1 in NPG Parkinson's Disease, could, the researchers say, eventually lead to more effective ways to help people establish and stick with exercise regimens, new treatments for fatigue associated with depression and many other conditions, and a better understanding of Parkinson's disease.

"Researchers have long been trying to understand why some people find physical effort easier than others," says study leader Vikram Chib, Ph.D., associate professor in the Department of Biomedical Engineering at the Johns Hopkins University School of Medicine and research scientist at the Kennedy Krieger Institute. "This study's results suggest that the amount of dopamine availability in the brain is a key factor."

Chib explains that after a bout of physical activity, people's perception and self-reports of the effort they expended varies, and also guides their decisions about undertaking future exertions. Previous studies have shown that people with increased dopamine are more willing to exert physical effort for rewards, but the current study focuses on dopamine's role in people's self-assessment of effort needed for a physical task, without the promise of a reward.

For the study, Chib and his colleagues from Johns Hopkins Medicine and the Kennedy Krieger Institute recruited 19 adults diagnosed with Parkinson's disease, a condition in which neurons in the brain that produce dopamine gradually die off, causing unintended and uncontrollable movements such as tremors, fatigue, stiffness and trouble with balance or coordination.

In Chib's lab, 10 male volunteers and nine female volunteers with an average age of 67 were asked to perform the same physical task -- squeezing a hand grip equipped with a sensor -- on two different days within four weeks of each other. On one of the days, the patients were asked to take their standard, daily synthetic dopamine medication as they normally would. On the other, they were asked not to take their medication for at least 12 hours prior to performing the squeeze test.

On both days, the patients were initially taught to squeeze a grip sensor at various levels of defined effort, and then were asked to squeeze and report how many units of effort they put forth.

When the participants had taken their regular synthetic dopamine medication, their self-assessments of units of effort expended were more accurate than when they hadn't taken the drug. They also had less variability in their efforts, showing accurate squeezes when the researchers cued them to squeeze at different levels of effort.

In contrast, when the patients hadn't taken the medication, they consistently over-reported their efforts -- meaning they perceived the task to be physically harder -- and had significantly more variability among grips after being cued.

In another experiment, the patients were given a choice between a sure option of squeezing with a relatively low amount of effort on the grip sensor or flipping a coin and taking a chance on having to perform either no effort or a very high level of effort. When these volunteers had taken their medication, they were more willing to take a chance on having to perform a higher amount of effort than when they didn't take their medication.

A third experiment offered participants the choice between getting a small amount of guaranteed money or, with the flip of a coin, getting either nothing or a higher amount of money. Results showed no difference in the subjects on days when they took their medication and when they did not. This result, researchers say, suggests that dopamine's influence on risk-taking preferences is specific to physical effort-based decision-making.

Together, Chib says, these findings suggest that dopamine level is a critical factor in helping people accurately assess how much effort a physical task requires, which can significantly affect how much effort they're willing to put forth for future tasks. For example, if someone perceives that a physical task will take an extraordinary amount of effort, they may be less motivated to do it.

Understanding more about the chemistry and biology of motivation could advance ways to motivate exercise and physical therapy regimens, Chib says. In addition, inefficient dopamine signaling could help explain the pervasive fatigue present in conditions such as depression and long COVID, and during cancer treatments. Currently, he and his colleagues are studying dopamine's role in clinical fatigue.

https://www.sciencedaily.com/releases/2023/04/230412131051.htm

Age of first exposure to tackle football and years played associated with less white matter in brain

New finding suggests that future therapies should target white matter loss in former contact sport athletes

March 6, 2023

Science Daily/Boston University School of Medicine

Chronic traumatic encephalopathy (CTE) is not the only problem football players should be aware of. Long careers in American football are linked to less white matter in the brain and associated with problems with impulsive behavior and thinking according to a new study from the Boston University CTE Center. This finding is independent of whether football players had chronic traumatic encephalopathy (CTE).

CTE is a progressive neurodegenerative disease frequently found in contact sports athletes. However, many former contact sports athletes suffer from thinking problems and impulsive behavior in the absence of CTE, or with very mild CTE. This new study suggests that a separate type of brain damage, which can appear earlier than CTE, may underlie some of these symptoms.

"Damage to the white matter may help explain why football players appear more likely to develop cognitive and behavioral problems later in life, even in the absence of CTE," said corresponding author Thor Stein, MD, PhD, a neuropathologist at VA Boston Healthcare System and assistant professor of pathology and laboratory medicine at Boston University Chobanian & Avedisian School of Medicine.

The researchers studied the brains of 205 deceased American football players donated to the Veterans Affairs-Boston University-Concussion Legacy Foundation (VA-BU-CLF) Brain Bank and measured levels of myelin, a component of white matter that covers, protects and speeds up the connections in the brain. They then interviewed family members on measures of cognition and impulsivity and then compared how career length and age of beginning tackle football related to levels of myelin, and how myelin levels related to cognition and impulsivity. In addition to more years of football played, the researchers found that starting tackle football at a younger age was also related to more white matter loss, independent of career length.

"These results suggest that existing tests that measure white matter injury during life, including imaging and blood tests, may help to clarify potential causes of changes in behavior and cognition in former contact sport athletes. We can also use these tests to better understand how repeated hits to the head from football and other sports lead to long term injury to the white matter," said co-author Michael L. Alosco, PhD, associate professor of neurology.

The researchers hope these findings help reinforce the idea that more needs to be done to protect the brains of athletes, especially children, from repeated hits to the head.

These finding appear online in the journal Brain Communications.

This work was supported by grant funding from: NIA (AG057902, AG06234, RF1AG054156), NINDS (U54NS115266, K23NS102399, RF1NS122854), National Institute of Aging Boston University AD Center (P30AG072978); the United States Department of Veterans Affairs, Veterans Health Administration, BLRD Merit Award (I01BX005161); the Nick and Lynn Buoniconti Foundation, and BU-CTSI Grant Number 1UL1TR001430. The views, opinions and/or findings contained in this article are those of the authors and should not be construed as an official Veterans Affairs or Department of Defense position, policy or decision, unless so designated by other official documentation. Funders did not have a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

https://www.sciencedaily.com/releases/2023/03/230306143450.htm

A good night's sleep may make it easier to stick to exercise and diet goals

March 3, 2023

Science Daily/American Heart Association

People who reported getting regular, uninterrupted sleep did a better job sticking to their exercise and diet plans while trying to lose weight, according to preliminary research presented at the American Heart Association's Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions 2023. The meeting will be held in Boston, February 28-March 3, 2023, and offers the latest science on population-based health and wellness and implications for lifestyle and cardiometabolic health.

"Focusing on obtaining good sleep -- seven to nine hours at night with a regular wake time along with waking refreshed and being alert throughout the day -- may be an important behavior that helps people stick with their physical activity and dietary modification goals," said Christopher E. Kline, Ph.D., an associate professor in the department of health and human development at the University of Pittsburgh. "A previous study of ours reported that better sleep health was associated with a significantly greater loss of body weight and fat among participants in a year-long, behavioral weight loss program."

The researchers examined whether good sleep health was related to how well people adhered to the various lifestyle modifications prescribed in a 12-month weight loss program. The weight-loss program included 125 adults (average age of 50 years, 91% female, 81% white) who met criteria for overweight or obesity (body mass index of 27-44) without any medical conditions requiring medical supervision of their diet or physical activity.

Sleep habits were measured at the beginning of the program, at 6 months and at 12 months, through patient questionnaires, a sleep diary and 7-day readings from a wrist-worn device that recorded sleep, waking activity and rest. These measures were used to score each participant as "good" or "poor" on six measures of sleep: regularity; satisfaction; alertness; timing; efficiency (the percentage of time spent in bed when actually asleep); and duration. A composite sleep health score of 0-6 was calculated for each participant, with one point for each "good" measure of sleep health, with higher scores indicating better levels of sleep health.

Adherence to the weight loss program was measured by percentage of group intervention sessions attended; percentage of days in which each participant ate between 85-115% of their recommended daily calories; and change in daily duration of moderate or vigorous physical activity. Participants had an average sleep health score of 4.5 out of 6 at the start of the study, at 6 months and at 12 months. Participants self-reported their caloric intake each day using a phone app and researchers measured participants' physical activity with an accelerometer worn at the waist for one week at a time at the start of the study, at 6 months and at 12 months.

After adjusting the sleep health scores for age, gender, race and whether or not there was a partner sharing the bed, the researchers found that better sleep health was associated with higher rates of attendance at group interval sessions, adherence to caloric intake goals and improvement in time spent performing moderate-vigorous physical activity. They found:

• Participants attended 79% of group sessions in the first six months and 62% of group sessions in the second six months.

• Participants met their daily caloric intake goals on 36% of days in the first six months and 21% in the second six months.

• Participants increased their total daily time spent in moderate-vigorous activity by 8.7 minutes in the first six months, however, their total time spent decreased by 3.7 minutes in the second six months.

The decrease in group session attendance, caloric intake and in time spent in moderate-vigorous activity in the second six months was expected, Kline said. "As one continues in a long-term behavioral weight loss intervention, it's normal for the adherence to weight loss behaviors to decrease," he said.

Additionally, while there was an association between better sleep health scores and an increase in physical activity, it was not strong enough to be statistically significant, meaning that researchers cannot rule out that the results were due to chance.

"We had hypothesized that sleep would be associated with lifestyle modification; however, we didn't expect to see an association between sleep health and all three of our measures of lifestyle modification," he said. "Although we did not intervene on sleep health in this study, these results suggest that optimizing sleep may lead to better lifestyle modification adherence. "

The study's limitations include that it did not incorporate any intervention to help participants improve their sleep, that the study sample was not recruited based upon participants' sleep health characteristics, and that the overall sample population had relatively good sleep health at baseline. The sample was also primarily white and female, so it is unclear whether these results are generalizable to more diverse populations.

"One question of interest for future research is whether we can increase adherence to lifestyle modifications -- and, ultimately, increase weight loss -- if we improve a person's sleep health," Kline said.

A second question for the researchers is how such an intervention would be timed to improve sleep.

"It remains unclear whether it would be best to optimize sleep prior to rather than during attempted weight loss. In other words, should clinicians tell their patients to focus on getting better and more regular sleep before they begin to attempt weight loss, or should they try to improve their sleep while at the same time modifying their diet and activity levels?" Kline said.

Improving one's sleep health is something everyone can do to improve their cardiovascular health and is a key component of the American Heart Association's Life's Essential 8. Sleep was added in 2022 as the eighth component of optimal cardiovascular health, which includes eating healthy food, being physically active, not smoking, getting enough sleep, maintaining a healthy weight and controlling cholesterol, blood sugar and blood pressure levels. Cardiovascular disease claims more lives each year in the U.S. than all forms of cancer and chronic lower respiratory disease combined, according to the 2023 Statistical Update from the American Heart Association.

"There are over 100 studies linking sleep to weight gain and obesity, but this was a great example showing how sleep isn't just tied to weight itself, it's tied to the things we're doing to help manage our own weight. This could be because sleep impacts the things that drive hunger and cravings, your metabolism and your ability to regulate metabolism and the ability to make healthy choices in general," said Michael A. Grandner, Ph.D., MTR. Grandner is director of the Sleep and Heath Research Program at the University of Arizona, director of the Behavioral Sleep Medicine Clinic at the Banner-University Medical Center in Tucson, Arizona, and was a co-author of the Association's Life's Essential 8 cardiovascular health score. "Studies like this really go to show that all of these things are connected, and sometimes sleep is the thing that we can start taking control over that can help open doors to other avenues of health."

https://www.sciencedaily.com/releases/2023/03/230303175844.htm

For older adults, every 500 additional steps taken daily associated with lower heart risk

American Heart Association Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions 2023, Presentation 360

March 3, 2023

Science Daily/American Heart Association

A new study found that walking an additional 500 steps, or about one-quarter of a mile, per day was associated with a 14% lower risk of heart disease, stroke or heart failure, according to preliminary research to be presented at the American Heart Association's Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions 2023. The meeting will be held in Boston, February 28-March 3, 2023, and offers the latest science on population-based health and wellness and implications for lifestyle and cardiometabolic health.

"Steps are an easy way to measure physical activity, and more daily steps were associated with a lower risk of having a cardiovascular disease-related event in older adults," said Erin E. Dooley, Ph.D., an assistant professor of epidemiology at the University of Alabama at Birmingham School of Public Health and lead researcher of the study. "However, most studies have focused on early-to-midlife adults with daily goals of 10,000 or more steps, which may not be attainable for older individuals."

Participants in the current analysis were part of a larger study group of 15,792 adults originally recruited for the ongoing Atherosclerosis Risk in Communities (ARIC) study. The present study evaluated health data collected from ARIC study visit 6 (2016-17) to evaluate the potential association between daily step counts and cardiovascular disease.

Researchers analyzed health data for 452 participants who used an accelerometer device similar to a pedometer, worn at the hip, that measured their daily steps. Participants were an average age of 78 years old; 59% were women; and 20% of participants self-identified as Black adults (70% of whom were women, and 30% of whom were men).

The devices were worn for three or more days, for ten or more hours, and the average step count was about 3,500 steps per day. Over the 3.5-year follow-up period, 7.5% of the participants experienced a cardiovascular disease event, such as coronary heart disease, stroke or heart failure.

The analysis found:

• Compared to adults who took less than 2,000 steps per day, adults who took approximately 4,500 steps per day had a 77% lower observed risk of experiencing a cardiovascular event.

• Nearly 12% of older adults with less than 2,000 steps per day had a cardiovascular event, compared to 3.5% of the participants who walked about 4,500 steps per day.

• Every additional 500 steps taken per day was incrementally associated with a 14% lower risk of cardiovascular disease.

"It's important to maintain physical activity as we age, however, daily step goals should also be attainable. We were surprised to find that every additional quarter of a mile, or 500 steps, of walking had such a strong benefit to heart health," Dooley said. "While we do not want to diminish the importance of higher intensity physical activity, encouraging small increases in the number of daily steps also has significant cardiovascular benefits. If you are an older adult over the age of 70, start with trying to get 500 more steps per day."

Additional research is needed to determine if meeting a higher daily count of steps prevents or delays cardiovascular disease, or if lower step counts may be an indicator of underlying disease.

Everyone can improve their cardiovascular health by following the American Heart Association's Life's Essential 8: eating healthy food, being physically active, not smoking, getting enough sleep, maintaining a healthy weight, and controlling cholesterol, blood sugar and blood pressure levels. Cardiovascular disease claims more lives each year in the U.S. than all forms of cancer and chronic lower respiratory disease combined, according to the American Heart Association.

The study had limitations. Participants had to enroll in the accelerometer device study, and hip-worn accelerometers are limited in capturing other activity behaviors that may also be important to heart health, such as bicycling and swimming. Study participants were more likely to have had at least some college or above education compared to the overall ARIC sample, and primarily self-identified as white and female, which may limit the study's generalizability. Additionally, steps were only measured at one single point in time, and the researchers were unable to examine if changes in steps over time impacted CVD event risk.

https://www.sciencedaily.com/releases/2023/03/230303105410.htm

Daily 11 minute brisk walk enough to reduce risk of early death

February 28, 2023

Science Daily/University of Cambridge

One in ten early deaths could be prevented if everyone managed at least half the recommended level of physical activity, say a team led by researchers at the University of Cambridge.

In a study published today in the British Journal of Sports Medicine, the researchers say that 11 minutes a day (75 minutes a week) of moderate-intensity physical activity -- such as a brisk walk -- would be sufficient to lower the risk of diseases such as heart disease, stroke and a number of cancers.

Cardiovascular diseases -- such as heart disease and stroke -- are the leading cause of death globally, responsible for 17.9 million deaths per year in 2019, while cancers were responsible for 9.6 million deaths in 2017. Physical activity -- particularly when it is moderate-intensity -- is known to reduce the risk of cardiovascular disease and cancer, and the NHS recommends that adults do at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous-intensity activity a week.

To explore the amount of physical activity necessary to have a beneficial impact on several chronic diseases and premature death, researchers from the Medical Research Council (MRC) Epidemiology Unit at the University of Cambridge carried out a systematic review and meta-analysis, pooling and analysing cohort data from all of the published evidence. This approach allowed them to bring together studies that on their own did not provide sufficient evidence and sometimes disagreed with each other to provide more robust conclusions.

In total, they looked at results reported in 196 peer-reviewed articles, covering more than 30 million participants from 94 large study cohorts, to produce the largest analysis to date of the association between physical activity levels and risk of heart disease, cancer, and early death.

The researchers found that, outside of work-related physical activity, two out of three people reported activity levels below 150 min per week of moderate-intensity activity and fewer than one in ten managed more than 300 min per week.

Broadly speaking, they found that beyond 150 min per week of moderate-intensity activity, the additional benefits in terms of reduced risk of disease or early death were marginal. But even half this amount came with significant benefits: accumulating 75 min per week of moderate-intensity activity brought with it a 23% lower risk of early death.

Dr Soren Brage from the MRC Epidemiology Unit said: "If you are someone who finds the idea of 150 minutes of moderate-intensity physical activity a week a bit daunting, then our findings should be good news. Doing some physical activity is better than doing none. This is also a good starting position -- if you find that 75 minutes a week is manageable, then you could try stepping it up gradually to the full recommended amount."

Seventy-five minutes per week of moderate activity was also enough to reduce the risk of developing cardiovascular disease by 17% and cancer by 7%. For some specific cancers, the reduction in risk was greater -- head and neck, myeloid leukaemia, myeloma, and gastric cardia cancers were between 14-26% lower risk. For other cancers, such as lung, liver, endometrial, colon, and breast cancer, a 3-11% lower risk was observed.

Professor James Woodcock from the MRC Epidemiology Unit said: "We know that physical activity, such as walking or cycling, is good for you, especially if you feel it raises your heart rate. But what we've found is there are substantial benefits to heart health and reducing your risk of cancer even if you can only manage 10 minutes every day."

The researchers calculated that if everyone in the studies had done the equivalent of at least 150 min per week of moderate-intensity activity, around one in six (16%) early deaths would be prevented. One in nine (11%) cases of cardiovascular disease and one in 20 (5%) cases of cancer would be prevented.

However, even if everyone managed at least 75 min per week of moderate-intensity physical activity, around one in ten (10%) early deaths would be prevented. One in twenty (5%) cases of cardiovascular disease and nearly one in thirty (3%) cases of cancer would be prevented.

Dr Leandro Garcia from Queen's University Belfast said: "Moderate activity doesn't have to involve what we normally think of exercise, such as sports or running. Sometimes, replacing some habits is all that is needed. For example, try to walk or cycle to your work or study place instead of using a car, or engage in active play with your kids or grand kids. Doing activities that you enjoy and that are easy to include in your weekly routine is an excellent way to become more active."

The research was funded by the Medical Research Council and the European Research Council.

What counts as moderate-intensity physical activity?

Moderate-intensity physical activity raises your heart rate and makes you breathe faster, but you would still be able to speak during the activity. Examples include:

• Brisk walking

• Dancing

• Riding a bike

• Playing tennis

• Hiking

https://www.sciencedaily.com/releases/2023/02/230228205249.htm

Time in nature may help older adults with improved health, purpose in life

February 24, 2023

Science Daily/Penn State

Over time, research has demonstrated that spending time in nature confers psychological, emotional and physical benefits. To maximize benefits of spending time in nature for people over the age of 65, researchers from Penn State; National Open University, Taiwan; and Lunghwa University of Science and Technology, Taiwan, studied the attitudes, beliefs and actions of a group of elders -- people over the age of 65 -- who regularly spent time in a natural area. The researchers found that fostering social connections around nature-based activities may be connected to improved health and quality of life for elders.

In Japan, the term shinrin-yoku, or "forest bathing," was developed to refer to spending time in nature while engaging all of one's senses: tasting the air, smelling a forest, listening to a stream, and being present with whatever you experience.

For elders who encounter challenges when attempting to hike quickly over difficult trails, forest bathing may present an enjoyable and safe way to spend time in nature. According to the researchers, forest bathing is popular among older adults in Japan, China and Taiwan, where the practice originated, and it is becoming increasingly popular in the United States.

The researchers studied older visitors to the Xitou Education Area, a natural preserve in Taiwan. Between April and June of 2022, the researchers surveyed 292 visitors to the preserve who were at least 65 years old and who visited the park at least once a week. Participants were asked a range of questions, from whether they felt supported by others, to how much they thought about their futures, to how much purpose they felt that their lives had.

The results of the study were published in the journal Leisure Sciences. The researchers found that people who discussed their experiences in nature with others tended to have a greater sense of attachment to forest bathing and a stronger sense of purpose in life.

Prior research supports the conclusion that these factors are related to better physical and mental health and higher quality of life. This finding can guide leisure-service providers working in various settings including community recreation departments and retirement villages on how to facilitate leisure for elders, according to John Dattilo, professor of recreation, park and tourism management at Penn State and co-author of this research.

"Elders can access community and state parks where it is safe for them to spend time in nature: places with walkable paths and convenient, accessible parking, are helpful," Dattilo explained." Agencies can publicize these opportunities and help identify the value they offer to elders and others.

"Better yet, leisure-service providers could arrange transportation and then afterwards facilitate social interactions among participants," Dattilo continued. "Enabling people to get out into nature to experience their surroundings is one aspect of forest bathing. Part of what we found is the linkage between positive social relationships and spending time in nature. So, if leisure-service providers create opportunities for elders to return from an experience, meet over a warm beverage and talk about their experiences, there will be value in these connections for people's sense of purpose."

An improved sense of purpose is related to better physical functioning, higher quality of life, and lower fear of death, according to Liang-Chih Chang, professor of living sciences at National Open University in New Taipei City, Taiwan. Forest bathing matters, he continued, because it might be able to help people foster that sense of purpose.

"Forest bathing seems to connect people to the moment and the world," Chang said. "When elders use that same experience to develop social connections and support, they may experience a broad range of benefits associated with physiological functioning as well as cognitive health. These are associations, not cause and effect, but the potential consequences are exciting to consider."

The study continues Dattilo's research on the value of the leisure experience for elders that he has explored with his collaborators in Taiwan as well as locally with colleagues from Penn State's Center for Healthy Aging.

"We have conducted research on square dancing and karaoke, both of which are common activities for elders in Asia," Dattilo said. "Forest bathing, is unique in that it is closely tied to hiking, strolling or sitting in nature in which many elders engage across the globe. If leisure-service providers facilitate exposure to nature and help participants build a sense of community around those experiences, then elders could live, not only healthier, but richer and more meaningful lives."

https://www.sciencedaily.com/releases/2023/02/230224135027.htm

Exercise more effective than medicines to manage mental health

February 23, 2023

Science Daily/University of South Australia

University of South Australia researchers are calling for exercise to be a mainstay approach for managing depression as a new study shows that physical activity is 1.5 times more effective than counselling or the leading medications.

Published in the British Journal of Sports Medicine, the review is the most comprehensive to date, encompassing 97 reviews, 1039 trials and 128,119 participants. It shows that physical activity is extremely beneficial for improving symptoms of depression, anxiety, and distress.

Specifically, the review showed that exercise interventions that were 12 weeks or shorter were most the effective at reducing mental health symptoms, highlighting the speed at which physical activity can make a change.

The largest benefits were seen among people with depression, pregnant and postpartum women, healthy individuals, and people diagnosed with HIV or kidney disease.

According to the World Health Organization, one in every eight people worldwide (970 million people) live with a mental disorder. Poor mental health costs the world economy approximately $2.5 trillion each year, a cost projected to rise to $6 trillion by 2030. In Australia, an estimated one in five people (aged 16-85) have experienced a mental disorder in the past 12 months.

Lead UniSA researcher, Dr Ben Singh, says physical activity must be prioritised to better manage the growing cases of mental health conditions.

"Physical activity is known to help improve mental health. Yet despite the evidence, it has not been widely adopted as a first-choice treatment," Dr Singh says.

"Our review shows that physical activity interventions can significantly reduce symptoms of depression and anxiety in all clinical populations, with some groups showing even greater signs of improvement.

"Higher intensity exercise had greater improvements for depression and anxiety, while longer durations had smaller effects when compared to short and mid-duration bursts.

"We also found that all types of physical activity and exercise were beneficial, including aerobic exercise such as walking, resistance training, Pilates, and yoga.

"Importantly, the research shows that it doesn't take much for exercise to make a positive change to your mental health."

Senior researcher, UniSA's Prof Carol Maher, says the study is the first to evaluate the effects of all types of physical activity on depression, anxiety, and psychological distress in all adult populations.

"Examining these studies as a whole is an effective way to for clinicians to easily understand the body of evidence that supports physical activity in managing mental health disorders.

"We hope this review will underscore the need for physical activity, including structured exercise interventions, as a mainstay approach for managing depression and anxiety."

https://www.sciencedaily.com/releases/2023/02/230223193417.htm

Psychological stress impedes performance, even for Olympic athletes

February 16, 2023

Science Daily/Association for Psychological Science

The 2020 Tokyo Olympics were unique not just for taking place during the COVID-19 pandemic but for being the first athletic event to measure and broadcast competitors' heart rates as world-class archers took a shot at Olympic gold. Analysis of these biometric data by Yunfeng Lu (Nanjing University) and Songfa Zhong (National University of Singapore, New York University Abu Dhabi) in Psychological Science provides empirical support for something sports fans have long suspected: When athletes feel the pressure, their performance suffers.

"We found that high contactless real-time heart rate is associated with poor performance," said Lu and Zhong in an interview. "This suggests that even the best professional athletes are negatively influenced by psychological stress, even though they are generally well trained to cope with pressure."

Olympic archery includes several types of individual and team-based competitions, but for this study, Lu and Zhong focused on within-gender individual competitions for which heart-rate data were available. During these competitions, the heart rates of 122 male and female archers were broadcast as they took 2,247 shots. The World Archery Federation, in collaboration with Panasonic, measured athletes' heart rates using high-frame-rate cameras that are designed to detect skin reflectance and can determine a person's heart rate 96% as accurately as a pulse oximeter or electrocardiogram.

During each match, individual archers shot a set number of arrows at a target, with a 20-s time limit for each shot. Archers could earn a maximum of 10 points for a perfect bulls-eye shot, with points decreasing the farther an arrow landed from the center of the target.

Lu and Zhong found that athletes whose heart rates were higher before taking a shot consistently scored lower on those shots. While archers' age and gender were not found to significantly influence the relationship between stress and performance, a number of factors related to the nature of the competition did.

Increased heart rate was more likely to reduce the performance of lower-ranking archers and of all archers who shot second in a match or who had a lower score than their opponent at that point in the match. There was also a stronger relationship between stress and performance closer to the end of each match, possibly due to the increase in pressure as athletes progressed in the competition, the authors wrote.

"Elite athletes usually receive training to manage psychological stress, but our results suggest that they continue to be subject to the influence of psychological stress," wrote Lu and Zhong.

In addition to offering evidence for the link between stress and performance in a real-life setting, this research demonstrates that heart rate captured by high-frame-rate cameras can serve as a reliable source of biometric data, according to Lu and Zhong, particularly in situations like the COVID-19 pandemic in which researchers and participants may be unable to meet in person.

"This method could become increasingly important in diverse settings, ranging from sports and business to mental health and medicine," the researchers wrote. "In this regard, our study can be viewed as a proof of concept by showing that contactless real-time heart rates captured psychological stress."

In future work, this technology could be used to observe how psychological stress influences athletic performance across different sports, Lu and Zhong said. The researchers would also like to further investigate how contactless real-time heart rate can be incorporated into behavioral studies in laboratory and field settings.

https://www.sciencedaily.com/releases/2023/02/230216083952.htm

More steps, moderate physical activity cuts dementia, cognitive impairment risk

January 25, 2023

Science Daily/University of California - San Diego

Senior women were less likely to develop mild cognitive impairment or dementia if they did more daily walking and moderate-to-vigorous physical activity, according to a new study led by the Herbert Wertheim School of Public Health and Human Longevity Science at University of California San Diego.

In the Jan. 25, 2023 online edition of Alzheimer's & Dementia: The Journal of the Alzheimer's Association, the team reported that, among women aged 65 or older, each additional 31 minutes per day of moderate-to-vigorous physical activity was associated with a 21 percent lower risk of developing mild cognitive impairment or dementia. Risk was also 33 percent lower with each additional 1,865 daily steps.

"Given that the onset of dementia begins 20 years or more before symptoms show, the early intervention for delaying or preventing cognitive decline and dementia among older adults is essential," said senior author Andrea LaCroix, Ph.D., M.P.H., Distinguished Professor at the Herbert Wertheim School of Public Health and Human Longevity Science at UC San Diego.

While there are several types, dementias are a debilitating neurological condition that can cause loss of memory, the ability to think, problem solve or reason. Mild cognitive impairment is an early stage of memory loss or thinking problems that is not as severe as dementias.

According to the United States Department of Health and Human Services, dementia affects more than 5 million people in this country. That number is expected to double by 2050.

More women live with and are at higher risk of developing dementia than men.

"Physical activity has been identified as one of the three most promising ways to reduce risk of dementia and Alzheimer's disease. Prevention is important because once dementia is diagnosed, it is very difficult to slow or reverse. There is no cure," said LaCroix.

However, because few large studies have examined device measures of movement and sitting in relation to mild cognitive impairment and dementia, much of the published research on the associations of physical activity and sedentary behavior with cognitive decline and dementia is based on self-reported measures, said first author, Steven Nguyen, Ph.D., M.P.H., postdoctoral scholar at the Herbert Wertheim School of Public Health.

For this study, the researchers sampled data from 1,277 women as part of two Women's Health Initiative (WHI) ancillary studies -- the WHI Memory Study (WHIMS) and the Objective Physical Activity and Cardiovascular Health (OPACH) study. The women wore research-grade accelerometers and went about their daily activities for up to seven days to obtain accurate measures of physical activity and sitting.

The activity trackers showed the women averaged 3,216 steps, 276 minutes in light physical activities, 45.5 minutes of moderate-to-vigorous physical activity and 10.5 hours of sitting per day. Examples of light physical activity could include housework, gardening or walking. Moderate-to-vigorous physical activity could include brisk walking.

The study findings also showed that higher amounts of sitting and prolonged sitting were not associated with higher risk of mild cognitive impairment or dementia.

Together, this information has clinical and public health importance as there is little published information on the amount and intensity of physical activity needed for a lower dementia risk, said Nguyen.

"Older adults can be encouraged to increase movement of at least moderate intensity and take more steps each day for a lower risk of mild cognitive impairment and dementia," said Nguyen.

"The findings for steps per day are particularly noteworthy because steps are recorded by a variety of wearable devices increasingly worn by individuals and could be readily adopted."

The authors said further research is needed among large diverse populations that include men.

https://www.sciencedaily.com/releases/2023/01/230125085831.htm

Good news for athletes who are slow to recover from concussion

Most need just one more month to return to play

January 18, 2023

Science Daily/American Academy of Neurology

A new study suggests that athletes who recover more slowly from concussion may be able to return to play with an additional month of recovery beyond the typical recovery time, according to a new study published in the January 18, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology. Slow recovery was defined as taking more than 14 days for symptoms to resolve or taking more than 24 days to return to play, both of which are considered the typical recovery times for about 80% of athletes with concussion.

"Although an athlete may experience a slow or delayed recovery, there is reason to believe recovery is achievable with additional time and injury management," said study author Thomas W. McAllister, MD, of the Indiana University School of Medicine in Indianapolis. "This is an encouraging message that may help to relieve some of the discouragement that athletes can feel when trying to return to their sport. While some athletes took longer than 24 days to return to play, we found that three-quarters of them were able to return to sports if given just one more month to recover."

The study looked at 1,751 college athletes who had been diagnosed with a concussion by a team physician. Of the athletes, 63% were male and 37% were female. Male athletes participated primarily in football, soccer and basketball. Female athletes participated primarily in soccer, volleyball and basketball.

Participants were evaluated five times: within six hours after their injury, one to two days later, once free of symptoms, once cleared to return to play and at six months.

Participants reported symptoms daily to medical staff, up to 14 days following injury and then weekly if they had not yet returned to play.

A total of 399 athletes, or 23%, had a slow recovery.

Researchers found that of the athletes who took longer than 24 days to return to play, more than three-fourths, or 78%, were able to return to play within 60 days of injury, and four-fifths, or 83%, were able to return to play within 90 days of injury. Only 11% had not returned to play six months after injury.

For the slow recovery group, the average time for returning to play was 35 days after injury, compared to 13 days in the overall group.

"The results of this study provide helpful information for athletes and medical teams to consider in evaluating expectations and making difficult decisions about medical disqualification and the value of continuing in their sport," McAllister said.

A limitation of the study is that participants were all collegiate varsity athletes and may not be representative of other age groups or levels of sport, and the results may not apply to other types of mild brain injuries.

https://www.sciencedaily.com/releases/2023/01/230118195719.htm

Six minutes of high-intensity exercise could delay the onset of Alzheimer's disease

January 12, 2023

Science Daily/The Physiological Society 

Six minutes of high-intensity exercise could extend the lifespan of a healthy brain and delay the onset of neurodegenerative disorders, such as Alzheimer's disease and Parkinson's disease. New research published in The Journal of Physiology shows that a short but intense bout of cycling increases the production of a specialised protein that is essential for brain formation, learning and memory, and could protect the brain from age-related cognitive decline. This insight on exercise is part of the drive to develop accessible, equitable and affordable non-pharmacological approaches that anyone can adopt to promote healthy ageing.  

The specialised protein named brain-derived neurotrophic factor (BDNF) promotes neuroplasticity (the ability of the brain to form new connections and pathways) and the survival of neurons. Animal studies have shown that increasing the availability of BDNF encourages the formation and storage of memories, enhances learning and overall boosts cognitive performance. These key roles and its apparent neuroprotective qualities have led to the interest in BDNF for ageing research.

Lead author Travis Gibbons from University of Otago, New Zealand said: “BDNF has shown great promise in animal models, but pharmaceutical interventions have thus far failed to safely harness the protective power of BDNF in humans. We saw the need to explore non-pharmacological approaches that can preserve the brain’s capacity which humans can use to naturally increase BDNF to help with healthy ageing.”

To tease apart the influence of fasting and exercise on BDNF production the researchers, from the University of Otago, New Zealand, compared the following factors to study the isolated and interactive effects:

• Fasting for 20 hours,

• Light exercise (90-minute low intensity cycling),

• High-intensity exercise (six-minute bout of vigorous cycling),

• Combined fasting and exercise.

They found that brief but vigorous exercise was the most efficient way to increase BDNF compared to one day of fasting with or without a lengthy session of light exercise. BDNF increased by four to five-fold (396 pg L-1 to 1170 pg L-1) more compared to fasting (no change in BDNF concentration) or prolonged activity (slight increase in BDNF concentration, 336 pg L-1 to 390 pg L-1).

The cause for these differences is not yet known and more research is needed to understand the mechanisms involved. One hypothesis is related to the cerebral substrate switch and glucose metabolism, the brain’s primary fuel source. The cerebral substrate switch is when the brain switches its favoured fuel source for another to ensure the body’s energy demands are met, for example metabolising lactate rather than glucose during exercise. The brain’s transition from consuming glucose to lactate initiates pathways that result in elevated levels of BDNF in the blood.

The observed increase in BDNF during exercise could be due to the increased number of platelets (the smallest blood cell) which store large amounts of BDNF. The concentration of platelets circulating in the blood is more heavily influenced by exercise than fasting and increases by 20%.

12 physically active participants (six males, six females aged between 18 and 56 years) took part in the study. The balanced ratio of male and female participants was to provide a better representation of the population rather than indicate sex differences.

Further research is underway to delve deeper into the effects of calorie restriction and exercise to distinguish the influence on BDNF and the cognitive benefits.

Travis Gibbons said: “We are now studying how fasting for longer durations, for example up to three days, influences BDNF. We are curious whether exercising hard at the start of a fast accelerates the beneficial effects of fasting. Fasting and exercise are rarely studied together. We think fasting and exercise can be used in conjunction to optimise BDNF production in the human brain.”

https://www.sciencedaily.com/releases/2023/01/230112090919.htm

How does nature nurture the brain?

Study shows that a one-hour walk in nature reduces stress-related brain activity

September 6, 2022

Science Daily/Max Planck Institute for Human Development

Living in a city is a well-known risk factor for developing a mental disorder, while living close to nature is largely beneficial for mental health and the brain. A central brain region involved in stress processing, the amygdala, has been shown to be less activated during stress in people who live in rural areas, compared to those who live in cities, hinting at the potential benefits of nature. "But so far the hen-and-egg problem could not be disentangled, namely whether nature actually caused the effects in the brain or whether the particular individuals chose to live in rural or urban regions," says Sonja Sudimac, predoctoral fellow in the Lise Meitner Group for Environmental Neuroscience and lead author of the study.

To achieve causal evidence, the researchers from the Lise Meitner Group for Environmental Neuroscience examined brain activity in regions involved in stress processing in 63 healthy volunteers before and after a one-hour walk in Grunewald forest or a shopping street with traffic in Berlin using functional magnetic resonance imaging (fMRI). The results of the study revealed that activity in the amygdala decreased after the walk in nature, suggesting that nature elicits beneficial effects on brain regions related to stress.

"The results support the previously assumed positive relationship between nature and brain health, but this is the first study to prove the causal link. Interestingly, the brain activity after the urban walk in these regions remained stable and did not show increases, which argues against a commonly held view that urban exposure causes additional stress," explains Simone Kühn, head of the Lise Meitner Group for Environmental Neuroscience.

The authors show that nature has a positive impact on brain regions involved in stress processing and that it can already be observed after a one-hour walk. This contributes to the understanding of how our physical living environment affects brain and mental health. Even a short exposure to nature decreases amygdala activity, suggesting that a walk in nature could serve as a preventive measure against developing mental health problems and buffering the potentially disadvantageous impact of the city on the brain.

The results go in line with a previous study (2017, Scientific Reports) which showed that city dwellers who lived close to the forest had a physiologically healthier amygdala structure and were therefore presumably better able to cope with stress. This new study again confirms the importance for urban design policies to create more accessible green areas in cities in order to enhance citizens' mental health and well-being.

In order to investigate benedicial effects of nature in different populations and age groups, the researchers are currently working on a study examining how a one-hour walk in natural versus urban environments impacts stress in mothers and their babies.

https://www.sciencedaily.com/releases/2022/09/220906114334.htm

COVID rekindled an appreciation of nature for many

An opportunity to rediscover why the great outdoors are so great in the first place

September 2, 2022

Science Daily/University of Connecticut

The pandemic has impacted our lives in a multitude of ways, many of which will no doubt be felt for years to come. While many of those effects are clearly negative, UConn researchers have identified at least one positive impact -- our perception of natural spaces changed. The findings are published in Nature Scientific Reports.

As people flocked to outdoor spaces for recreation in the spring of 2020, Sohyun Park, assistant professor in UConn's College of Agriculture, Health and Natural Resources Department of Plant Science and Landscape Architecture, noticed some interesting trends: more people were on the trails, and many of those people had traveled from far away to enjoy nature.

Park was also part of the team for the Connecticut Trail Census and co-wrote a paper about the trends.

Sohyun Park of the Department of Plant Science and Landscape Architecture in her office in the W.B. Young Building. Mar. 8, 2022. (Jason Sheldon/UConn Photo)

"What's interesting was rural trail use increased compared to urban trails," Park says. "I wanted to try to find out how people were changing their mindset or their attitudes or perceptions."

To do this, Park and co-authors Seungman Kim and Jaehoon Lee of Texas Tech University, and Biyoung Heo of James Corner Field Operations, looked to social media data and machine learning techniques to help make sense of the vast quantities of information on Twitter and try to find a pattern among those data, says Park. They utilized Twitter's Application Programming Interface (API), which allows researchers to obtain aggregated data from Twitter posts.

"We wanted to know from the people who have been in greenspaces, what were they doing and what they were writing about on Twitter. We utilized very innovative and advanced levels of machine learning methods," says Park. "The machine categorized the keywords and classified them into several human-recognizable groups. One group was nature related. The second group is all traditional park-related activities and the third one is obviously the COVID-related one, so mask wearing and social distancing, and things like that."

A newfound appreciation for nature

Though what people were doing in the parks did not change significantly, the researchers noticed some significant changes in keyword usage between pre-pandemic and pandemic Twitter, with people frequently referencing nature, and their experiences within it.

"Users began to put the word 'nature' and nature-related activities or nature-related pictures on their Twitter," Park says. "It was very interesting because, in the past, there were not many keywords like that, but people used keywords like 'playing', 'walking the dog', 'baseball', and other traditional, active park activities that they were enjoying while they were there in the parks. If you look at post- 2020 Twitter, you can also see keywords thanking God or showing appreciation for nature, describing the birds singing or water sounds."

What the researchers found was people seemed to have realized a newfound appreciation for nature and greenspaces, especially true for those in urban settings. As a landscape architect, Park was interested to see if there was something more to the findings and perhaps if there might be some design implications for the results.

Common features in modern parks include benches, walking paths, and sports fields, for instance. However, Park says the results of the paper seem to suggest that natural greenspaces appeal to people differently.

"We might want to go back to the origin of public parks like those Olmsted designed," Park says. "In his time in 19th century, there was a lot of hustle and bustle in the city, and they wanted to have space for people to find respite and peace. We might want to go back to that era living with a 21st century health crisis and try to rethink about the design principles."

Park says to imagine Manhattan's Central Park, which hosts ponds, wooded areas, and meadows. Most of those natural features were introduced artificially and were not there in the first place. Compare this with contemporary parks:

"Modern parks may be well managed, maintained, and manicured, everything is clean and tidy," Park says. "There are some seating areas, paved surfaces, and structures where you can play something with your friends and family members, but not really in a naturalistic style. People can feel that in public spaces."

The outdoors as essential resource for overall well-being

Greenspaces impact mental, physical, and spiritual health, and Park reasons that these natural elements might be essential in public spaces, particularly for those who have less access to the public parks, or marginalized communities that don't have any green areas at their residences.

"I'm arguing that parks are not only recreational spaces; greenspaces and parks serve as essential amenities for all including those with low incomes or disabilities, and the elderly," Park says. "Parks need inclusive planning approaches that might be added to the current principles for park development."

Park explains that many people are involved in the planning, design, and management of parks and greenspaces. The tricky part is that the more naturalistic, garden concept for public parks may require more planning and maintenance, and therefore these design features rely more heavily on resources and budgets.

"In the long term, I think that will be the direction that we need to go and now officials and park managers need to work together with those who are living nearby so that we can have some kind of co-managing type of approaches to the future," Park says.

This study highlights the importance of those design features and their roles in our emotional and spiritual well-being, and Park says it is important for the public to advocate for our greenspaces. Research like this can inform decision-making.

"It is important for the public and decision-makers to understand that ultimately, we need to have a budget to have more natural features and nature-oriented programs in the park. We all need to be more active in terms of the things that towns are doing. That can start with joining your town's Conservation Commission or attending monthly meetings. Participate and make your voice heard. That makes a huge change and can impact big decisions. Sometimes these decision makers are really grounded by how the stakeholders are feeling so giving some input and feedback on the public decision-making should be the first step. It is empowering and more people need to be involved in public planning."

https://www.sciencedaily.com/releases/2022/09/220902103241.htm

Boosting duration, intensity & frequency of physical activity may lower heart failure risk

The study, in Circulation, is one of the first to examine the association between objectively measured physical activity levels and heart failure risk independently of sociodemographic, lifestyle and clinical factors

August 29, 2022

Science Daily/American Heart Association

Researchers tracked the incidence of heart failure over six years in more than 94,000 middle-aged adults in the U.K. Biobank who wore wrist accelerometers to record the amount and intensity of their physical activity over seven days between 2013-2015. Participants who engaged in 150-300 minutes of moderate physical activity or 75-150 minutes of vigorous physical activity during the week of observation reduced their risk of being hospitalized for or death from heart failure by two-thirds compared to participants who did not engage in the same amounts of moderate or vigorous physical activity during the week.

A six-year analysis of more than 94,000 adults in the U.K. Biobank with no history of heart failure at enrollment has found that engaging in moderate or vigorous physical activity may lower the risk of developing heart failure, according to new research published today in the American Heart Association's flagship journal Circulation.

The study is one of the first to use objectively measured activity levels to estimate heart failure risk. The results are consistent with previous studies finding that performing 150-300 minutes of moderate exercise or 75-150 minutes of vigorous exercise each week may reduce the incidence of heart attack and stroke.

Heart failure is a chronic, progressive condition that develops when the heart is not capable of pumping sufficient blood to keep up with the body's needs for blood and oxygen, and it can result in fatigue and difficulty breathing. Heart failure affects more than 6 million adults in the United States, according to the American Heart Association, and more than 86,000 Americans died of heart failure in 2019. The Association recommends adults should engage in at least 150 minutes per week of moderate-intensity or 75 minutes per week of vigorous-intensity aerobic physical activity.

"There are many potential ways that regular physical activity may reduce the risk of developing heart failure," said Frederick K. Ho, Ph.D., co-lead author of the study and a lecturer in public health at the University of Glasgow in Glasgow, Scotland. "For example, physical activity helps prevent weight gain and related cardiometabolic conditions, such as high blood pressure and Type 2 diabetes, all of which are risk factors for heart failure. Regular physical exercise may also strengthen the heart muscle, which, in turn, may prevent heart failure from developing."

The investigators analyzed the health records of 94,739 adults aged 37-73 in the U.K. Biobank -- a large research database in the United Kingdom that enrolled and collected health information on 500,000 adults who received care through the National Health Service. The participants in the U.K. Biobank were enrolled in the database between 2006 and 2010 across Scotland, England and Wales.

Data for this study was gathered between 2013-2015. During that time period, the subset of 94,739 participants were randomly invited to enroll in the study via the email address they had provided to the U.K. Biobank. Participants were an average age of 56 years at enrollment; 57% were female, and 96.6% were white adults. At the time each participant was invited, enrolled and analyzed, they had not been diagnosed with heart failure or had a heart attack. Each participant wore a wrist accelerometer for seven consecutive days, 24 hours per day, to measure the intensity and duration of physical activity. After enrollment, data was collected through linked hospital and death records.

During a median follow-up of 6.1 years after the physical activity measurement was conducted, the analysis found:

• The adults who logged 150-300 minutes of moderate physical activity in one week had a 63% lower risk of heart failure; and

• those who performed 75-150 minutes of vigorous physical activity in one week were estimated to have a 66% lower risk of heart failure compared to participants who engaged in minimal to no moderate or vigorous physical activity.

The estimated risk reductions were adjusted for age, sex, ethnicity, education, socioeconomic conditions, smoking, alcohol intake and dietary factors.

"These findings indicate that every physical movement counts. A leisurely, 10-minute walk is better than sitting and no physical activity. And, if possible, try to walk a little faster, which increases the intensity and potential benefits of exercise," Ho said.

According to Ho, the study results suggest that going above and beyond the current AHA recommendations for moderate activity may provide greater protection against heart failure. "We found that moderate physical activity has the potential increased cardiovascular risk benefits up until 500 minutes/week, as appropriate for each individual," he said.

People whose risk factors for heart failure include having a BMI that meets the criteria for overweight or obese, high blood pressure and elevated glucose or cholesterol, may be particularly likely to benefit from increasing their physical activity, according to Ho and colleagues.

"Health care professionals may suggest more physical activity based on a patient's current lifestyle and health status," Ho said. "Generally, moderate physical activity is easier to incorporate into daily routines, and it's generally safer. Vigorous physical activity is sometimes the most time-efficient and may be more suitable for busy people. However, caution is advised for all when beginning a new physical activity regimen to prevent injuries or acute adverse events (such as a heart attack in a formerly sedentary person initiating a vigorous exercise program)."

This observational study cannot prove a cause-and-effect link between the amount and intensity of physical activity and the risk of developing heart failure. Because participants in the U.K. Biobank are overwhelmingly white, further studies would be needed to confirm that these results apply to people from diverse backgrounds who may experience negative social determinants of health.

"Our findings add to the overwhelming body of other evidence, suggesting that maintaining even a modest amount of regular physical activity can help prevent a range of chronic conditions from developing, including heart failure," said Naveed Sattar, the senior author of the study. Sattar is a professor of metabolic medicine at the Institute of Cardiovascular & Medical Sciences at the University of Glasgow.

https://www.sciencedaily.com/releases/2022/08/220829085948.htm

Physical activity may have a stronger role than genes in longevity

August 24, 2022

Science Daily/University of California - San Diego

Previous research has shown that low physical activity and greater time spent sitting are associated with a higher risk of death. Does risk change if a person is genetically predisposed to live a long life?

That is the question researchers at the Herbert Wertheim School of Public Health and Human Longevity Science at University of California San Diego set out to answer in a study published in the August 24, 2022 online edition of the Journal of Aging and Physical Activity.

"The goal of this research was to understand whether associations between physical activity and sedentary time with death varied based on different levels of genetic predisposition for longevity," said lead author Alexander Posis, M.P.H., a fourth-year doctoral student in the San Diego State University/UC San Diego Joint Doctoral Program in Public Health.

In 2012, as part of the Women's Health Initiative Objective Physical Activity and Cardiovascular Health study (OPACH), researchers began measuring the physical activity of 5,446 women in the United States who were 63 and older, following them through 2020 to determine mortality. Participants wore a research-grade accelerometer for up to seven days to measure how much time they spent moving, the intensity of physical activity, and sedentary time.

The prospective study found that higher levels of light physical activity and moderate-to-vigorous physical activity were associated with lower risk of death. Higher sedentary time was associated with higher risk of mortality. These associations were consistent among women who had different levels of genetic predisposition for longevity.

"Our study showed that, even if you aren't likely to live long based on your genes, you can still extend your lifespan by engaging in positive lifestyle behaviors such as regular exercise and sitting less," said senior author Aladdin H. Shadyab, Ph.D., assistant professor at the Herbert Wertheim School of Public Health and Human Longevity Science at UC San Diego. "Conversely, even if your genes predispose you to a long life, remaining physically active is still important to achieve longevity."

Given the aging adult population in the United States, and longer time spent engaging in lower intensity activities, the study findings support recommendations that older women should participate in physical activity of any intensity to reduce the risk of disease and premature death, wrote the authors.

https://www.sciencedaily.com/releases/2022/08/220824152218.htm