Women living in more walkable neighborhoods have lower rates of obesity-related cancers
October 4, 2023
Science Daily/Columbia University's Mailman School of Public Health
Residing in a more walkable neighborhood protects against the risk of overall obesity-related cancers in women, specifically postmenopausal breast cancer, but also ovarian cancer, endometrial cancer, and multiple myeloma, according to a new study by Columbia University Mailman School of Public Health and NYU Grossman School of Medicine. Obesity has been linked to increased risk for 13 types of cancer in women, and physical activity, independent of body size, lowers risk for some of these cancers. Neighborhood walkability is a set of urban design features that promotes pedestrian activity, supports overall physical activity and is associated with lower body mass index. However, until now long-term studies of neighborhood walkability and risk for obesity-related cancer were limited. The findings are published in the journal Environmental Health Perspectives.
Women who resided in neighborhoods with higher walkability levels, as measured by average destination accessibility and population density over approximately 24 years of follow-up, had lower risk of obesity-related cancers, particularly postmenopausal breast cancer. However, moderate protective associations were also found for endometrial cancer, ovarian cancer, and multiple myeloma. Women in who had lived in areas with the highest levels of neighborhood walkability (the top 25 percent of walkability) had a 26 percent lower risk of obesity-related cancers compared to those who lived in neighborhoods in the lowest 25th percent of walkability.
"These results contribute to the growing evidence of how urban design affects the health and wellbeing in aging populations," said Andrew Rundle, DrPH, professor of epidemiology at Columbia Mailman School. Individual-level interventions to increase physical activity and reduce obesity are costly and often have only short-term effects, according to Rundle and colleagues. "However, urban design can create a context that promotes walking, increases overall physical activity, and reduce car-dependency, which could lead to subsequent improvements in preventing diseases attributed to unhealthy weight," Rundle observed.
"We further observed that the association between high neighborhood walkability and lower risk of overall obesity-related cancers was stronger for women living in neighborhoods with higher levels of poverty" said Sandra India-Aldana, Ph.D., Icahn School of Medicine at Mount Sinai, and lead author. "These findings suggest that neighborhood social and economic environments are also relevant to risk of developing obesity-related cancers."
The researchers studied 14,274 women between the ages of 34 and 65 and recruited at a mammography screening center in NYC between 1985 and 1991 and followed them over nearly three decades. They measured neighborhood walkability in the participant's residential Census-tract throughout follow-up and assessed the association between neighborhood walkability and risk of overall and site-specific obesity-related cancers including postmenopausal breast cancer, ovarian cancer, endometrial cancer, and multiple myeloma. Of the total number of women studied, 18% had a first obesity-related cancer by the end of 2016.The most common cancer was postmenopausal breast cancer at 53%, followed by colorectal cancer at 14%, and endometrial cancer at 12%.
"Our study is unique in that the long-term follow-up allowed us to study effects of walkability with potential long latency periods of cancer and we were able to measure neighborhood walkability as the participants moved residences around the country during follow-up" said co-author Yu Chen Ph.D., NYU Grossman School of Medicine.
https://www.sciencedaily.com/releases/2023/10/231004105202.htm
Walking more than five flights of stairs a day can cut risk of heart disease by 20 percent
September 29, 2023
Science Daily/Tulane University
Forget walking 10,000 steps a day. Taking at least 50 steps climbing stairs each day could significantly slash your risk of heart disease, according to a new study from Tulane University.
The study, published in Atherosclerosis, found that climbing more than five flights of stairs daily could reduce risk of cardiovascular disease by 20%.
Atherosclerotic cardiovascular disease (ASCVD) along with coronary artery disease and stroke are the leading causes of morbidity and mortality worldwide.
"Short bursts of high-intensity stair climbing are a time-efficient way to improve cardiorespiratory fitness and lipid profile, especially among those unable to achieve the current physical activity recommendations," said co-corresponding author Dr. Lu Qi, HCA Regents Distinguished Chair and professor at the Tulane University School of Public Health and Tropical Medicine. "These findings highlight the potential advantages of stair climbing as a primary preventive measure for ASCVD in the general population."
Using UK Biobank data collected from 450,000 adults, the study calculated participants' susceptibility to cardiovascular disease based on family history, established risk factors and genetic risk factors and surveyed participants about their lifestyle habits and frequency of stair climbing. Median follow-up time was 12.5 years.
The study found that climbing more stairs daily especially reduced risk of cardiovascular disease in those who were less susceptible. However, Qi said the increased risk of heart disease in more susceptible people could be "effectively offset" by daily stair climbing.
Qi touted the public availability of stairs as a low-cost, accessible way to incorporate exercise into daily routines.
"This study provides novel evidence for the protective effects of stair climbing on the risk of ASCVD, particularly for individuals with multiple ASCVD risk factors," Qi said.
https://www.sciencedaily.com/releases/2023/09/230929131402.htm
Exercise and muscle regulation: Implications for diabetes and obesity
September 27, 2023
Science Daily/Deutsches Zentrum fuer Diabetesforschung DZD
Prediabetes is a condition that precedes type 2 diabetes and increases the risk of heart attack, kidney and eye disease, and several types of cancer. Currently, there is no approved drug therapy for prediabetes available. Scientists at the German Center for Diabetes Research (DZD) now show how and by which mechanisms prediabetes can be brought into remission, i.e. into a state in which blood glucose levels return to normal. The multicenter study of the DZD also shows that remission of prediabetes protects against type 2 diabetes and is associated with better kidney and vascular function in the long term. Interestingly, the underlying mechanisms are different from those in type 2 diabetes remission, the researchers report in The Lancet Diabetes & Endocrinology.
People with type 2 diabetes have an increased risk of heart attack, kidney disease and stroke, and a higher mortality risk. Type 2 diabetes was thought to be irreversible until a few years ago. We now know that type 2 diabetes can be put into remission in a significant number of individuals through substantial weight loss. However, this remission rarely lasts as most people typically develop type 2 diabetes again within a few years.
"We aimed to explore the feasibility of commencing earlier and implementing preventive measures already at a stage that precedes type 2 diabetes, namely prediabetes, with the aim of reversing it," elucidates senior author Prof. Dr. Andreas Birkenfeld, Medical Director of Medical Clinic IV at Tübingen University Hospital, and Director of the Institute for Diabetes Research and Metabolic Diseases of Helmholtz Munich at the University of Tübingen. This could be crucial for patients with prediabetes as they are at increased risk to develop type 2 diabetes as well as heart, kidney, and eye complications among others.
But what causes prediabetes to go into remission? Scientists from the Institute of Diabetes Research and Metabolic Diseases (IDM) at Helmholtz Munich and the Department of Diabetology, Endocrinology, and Nephrology at the University Hospital of Tübingen, conducted a post-hoc analysis on participants with prediabetes from the Prediabetes Lifestyle Intervention Study (PLIS) to investigate this question.
In this randomized-controlled multicenter study conducted by the DZD, 1,105 individuals with prediabetes underwent a lifestyle intervention involving a healthy diet and increased physical activity for a duration of one year. The researchers then assessed the 298 participants who had achieved a minimum weight loss of five percent as a result of the intervention. Responders were the participants whose fasting blood glucose, 2-hour glucose, and HbA1c levels had normalized within twelve months, indicating that they had gone into remission. Non-responders were individuals who did not achieve remission despite losing weight and still had prediabetes.
Contrary to the researchers' initial assumptions, it was not weight loss that distinguished those who went into remission from those who did not, as there was no difference in relative weight loss between responders and non-responders. However, individuals who achieved remission demonstrated a notable improvement in insulin sensitivity compared to non-responders. In essence, they were able to enhance their sensitivity to insulin, a hormone that lowers blood glucose levels, significantly more than those who did not respond. Nonetheless, the quantity of insulin secreted remained unaltered in both groups. This difference is critical compared to type 2 diabetes remission, which depends primarily on enhanced insulin secretion.
Reducing abdominal fat mass may help reverse prediabetes
To determine the cause of increased insulin sensitivity in responders, the researchers conducted a comparative analysis of the two groups. The responders had lost more abdominal fat compared to non-responders despite losing the same amount of body weight. Visceral abdominal fat is located directly in the abdominal cavity and surrounds the intestines. Its impact on insulin sensitivity is partially attributed to an inflammatory response in adipose tissue.
Indeed, participants who went into remission also had fewer inflammatory proteins in their blood. "Since the responders showed a reduction in abdominal fat in particular, it will be important in the future to identify the factors that promote the loss of this fat depot," says Arvid Sandforth, one of the two lead-authors. Surprisingly, there were no differences between the two groups in the reduction of liver fat, which is also an important risk factor for the development of diabetes.
Participants who achieved remission showed a 73 percent reduced risk of developing type 2 diabetes even two years after the end of the lifestyle intervention. They also showed reduced markers of kidney damage and better status of their blood vessels.
Currently, treatment of prediabetes consists of weight reduction and lifestyle improvement to delay the onset of type 2 diabetes -- but without glucose-based targets to guide the treatment process. The DZD's new analysis fills this gap: "Based on the new data, remission should be the new therapeutic target in people with prediabetes. This has the potential to change treatment practice and minimize the complication rate for our patients," says co-first author Prof. Dr. Reiner Jumpertz-von Schwartzenberg.
According to the study, remission in prediabetes can be considered to have occurred when fasting blood glucose falls below 100 mg/dl (5.6 mmol/l), 2-hour glucose below 140 mg/dl (7.8 mmol/l), and HbA1c below 5.7 percent. The likelihood of remission increases when body weight is reduced and waist circumference decreases by at least about 4 cm in women and about 7 cm in men. Researchers state that these criteria can now be used as biomarkers.
https://www.sciencedaily.com/releases/2023/09/230927155347.htm
Increasing steps by 3,000 per day can lower blood pressure in older adults
This study sought to determine if older adults with hypertension could receive these benefits by moderately increasing their daily walking, which is one of the easiest and most popular forms of physical activity for this population.
September 27, 2023
Science Daily/University of Connecticut
An estimated 80% of older adults in the U.S. have high blood pressure. Maintaining healthy blood pressure can protect against serious conditions like heart failure, heart attacks, and strokes.
A new study including Linda Pescatello, distinguished professor of kinesiology in UConn's College of Agriculture, Health and Natural Resources, found that adding a relatively minimal amount of movement, about 3,000 steps per day, can significantly reduce high blood pressure in older adults.
Pescatello worked with Elizabeth Lefferts, the lead author of the paper, Duck-chun Lee, and others in Lee's lab at Iowa State University. They published their findings in a recent issue of the Journal of Cardiovascular Development and Disease.
"We'll all get high blood pressure if we live long enough, at least in this country," Pescatello says. "That's how prevalent it is."
Pescatello is an expert on hypertension (the clinical term for high blood pressure) and exercise. Her previous research has demonstrated that exercise can have a significant immediate and long-lasting impact on lowering blood pressure in hypertensive adults.
This study sought to determine if older adults with hypertension could receive these benefits by moderately increasing their daily walking, which is one of the easiest and most popular forms of physical activity for this population.
"It's easy to do, they don't need any equipment, they can do it anywhere at almost any time," Lee says.
The study focused on a group of sedentary older adults between ages 68 and 78 who walked an average of about 4,000 steps per day before the study.
After consulting existing studies, Lee determined that 3,000 steps would be a reasonable goal. This would also put most participants at 7,000 daily steps, in line with the American College of Sports Medicine's recommendation.
"3,000 steps is large enough but not too challenging to achieve for health benefits," Lee says.
The team conducted the study during the height of the COVID-19 pandemic, which meant they had to do everything remotely.
The researchers sent participants a kit with pedometers, blood pressure monitors, and step diaries for participants to log how much they were walking each day.
On average, participants' systolic and diastolic blood pressure decreased by an average of seven and four points, respectively, after the intervention.
Other studies suggest decreases of these magnitudes correspond to a relative risk reduction of all-cause mortality by 11%, and 16% for cardiovascular mortality, an 18% reduction in the risk of heart disease, and a 36% risk reduction of stroke.
"It's exciting that a simple lifestyle intervention can be just as effective as structured exercise and some medications," Lefferts says.
The findings suggest that the 7,000-step regimen the participants in the study achieved is on-par with reductions seen with anti-hypertensive medications.Eight of the 21 participants were already on anti-hypertensive medications. Those participants still saw improvements in systolic blood pressure from increasing their daily activity.
"In a previous study, we found that when exercise is combined with medication, exercise bolsters the effects of blood pressure medication alone," Pescatello says. "It just speaks to the value of exercise as anti-hypertensive therapy. It's not to negate the effects of medication at all, but it's part of the treatment arsenal."
The researchers found that walking speed and walking in continuous bouts did not matter as much as simply increasing total steps.
"We saw that the volume of physical activity is what's really important here, not the intensity," Pescatello says. "Using the volume as a target, whatever fits in and whatever works conveys health benefits."
This work was a pilot study, and the researchers hope to use these data to launch a larger clinical trial.
https://www.sciencedaily.com/releases/2023/09/230927003032.htm
Exercise and muscle regulation: Implications for diabetes and obesity
September 20, 2023
Science Daily/Helmholtz Munich
How do our muscles respond at the molecular level to exercise? Researchers at Helmholtz Munich and the German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE) have unraveled the cellular basis and signaling pathways responsible for the positive impact of physical activity on our overall health. Regulatory T cells, a type of immune cell, play a critical role in ensuring proper muscle function. These novel insights are paving the path towards precision medicines targeting metabolic disorders like obesity and diabetes, as well as muscle-related illnesses. Their discoveries are published in Cell Metabolism.
Obesity and type 2 diabetes pose an increasing threat to our global health. Overnutrition and physical inactivity contribute to the development of these conditions. Exercise is not only effective for preventing diseases but also offers numerous health benefits including improving the immune system. Researchers from the German Center for Diabetes (DZD) at Helmholtz Munich and the German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE) revealed new insights on the interconnections between exercise, muscle function, and the immune system. These new findings can not only benefit people living with obesity or type 2 diabetes seeking to improve their health through exercise or patients of muscle-related diseases, but also benefit professional athletes. Importantly, a better understanding of the immune-muscle crosstalk can contribute to the future development of precision immune therapies for diabetes and other complications.
Regulatory T Cells Ensure Proper Muscle Function
Although the beneficial effects of exercise training on metabolic health and the immune system are commonly known, the exact mechanisms of how physical activity affects muscle immune cells remained unknown until now. The team of researchers unraveled the molecular mechanisms by which a specialized subset of immune cells in the human body, the regulatory T cells (Tregs), control muscle crosstalk in a steady state, in response to exercise, as well as upon muscle injury. During exercise highly functional Tregs can be found in the muscles, which are important for proper muscle function, regeneration, and repair.
By manipulating the Tregs in multiple ways, the authors uncover their pivotal role in regulating muscle function, strength, and repair after injury. The research team identifies a critical mediator of these effects. A signaling pathway involved in the immune response and various other physiological processes, the interleukin-6 (IL6) receptor (IL6R) signaling on T cells, is critical for Treg functionality. The IL6R has to be present on the surface of T cells for the Treg-mediated control of muscle function.
These new findings can additionally offer a possible mechanistic explanation as to why anti-inflammatory treatment targeting IL6R has been associated with the development of muscle weakness as a side effect in the clinic. In conclusion, the new discoveries highlight the importance of dissecting the crosstalk between the immune system and the metabolism in conditions such as diabetes and obesity. These insights will be crucial for developing precision medicines targeting Tregs within distinct niches and contexts in the future.
https://www.sciencedaily.com/releases/2023/09/230920152413.htm
Morning and afternoon slightly better than evening physical activity for diabetes prevention
September 21, 2023
Science Daily/Diabetologia
New research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]) shows that morning and afternoon physical activity are associated with a lower risk of developing type 2 diabetes across all population levels of education and income, but found no statistically significant association between evening physical activity and risk type 2 diabetes. The study is by Dr Caiwei Tian, Harvard University, Cambridge, MA, USA, and Dr Chirag Patel, Harvard Medical School, Boston, MA. and colleagues.
Physical activity is a preventive factor for type 2 diabetes, but its timing and consistency (in contrast with overall sum of physical activity) has been relatively unexplored. Accelerometer-based devices that measure physical activity provide a new opportunity to objectively measure behaviour throughout the day and week. It has been shown that midday–afternoon but not evening physical activity is associated with a lower risk of mortality compared with morning physical activity, but the relationship with type 2 diabetes remains understudied. In this new study, the authors analysed the relationship between morning, afternoon, or evening physical activity and consistency (routine) and risk of type 2 diabetes.
A cohort of 93,095 UK Biobank participants (mean age 62 years) without a history of type 2 diabetes wore a wrist-worn accelerometer for 1 week. The authors converted accelerometer information to estimate metabolic equivalent of task (MET) (a common measure of physical activity), summing MET-hours of total physical activity. MET-hour physical activity captures all types of activity undertaken by an individual throughout the day and measured with the accelerometer, including chores, walking, and vigorous activity. The authors measured completed METs within three time segments (morning, afternoon, and evening), divided as 06:00–12:00 hours (morning); 12:00–18:00 hours (afternoon); and 18:00–24:00 hours (evening).
The authors quantified the consistency of physical activity by analysing the variance, or difference of each person’s activity from their own personal average. Those with smaller deviations were more consistent and vice versa. The authors also considered the intensity of exercise: moderate-to-vigorous physical activity (MVPA) and vigorous physical activity (VPA) in association with type 2 diabetes incidence.
The authors observed protective associations of physical activity, with each 1-unit increase in MET being associated with a 10% and 9% reduction in risk of type 2 diabetes in the morning and afternoon, respectively. However, there was no statistically significant association between evening physical activity and risk of type 2 diabetes.
The relationship with morning and afternoon physical activity was largely linear, meaning that those people with more MET-h completed had a much lower risk of developing type 2 diabetes than those with less (10% / 9% per MET-h, for morning and afternoon respectively).
The authors thought that lifestyle factors, such as amount of sleep and dietary intake, would influence the amount of physical activity in the morning, afternoon, and evening undertaken, and therefore the role activity has in diabetes risk. To address how these factors influence physical activity, the authors considered these factors in their analytic models. They found that when adjusting for lifestyle factors, associations for MET-hours with different times of day became more precise.
Consistency of MET-measured physical activity was not associated with type 2 diabetes; but intensity was – both MVPA and VPA were associated with decreased risk for type 2 diabetes at all times of the day. The authors say their study is the first report on the effect of consistency of activity, and explain: “The consistency or routine of physical activity was not strongly associated with type 2 diabetes. In other words, individuals who exercise a smaller amount of time more frequently are at no lesser risk for diabetes than individuals who exercise the same total amount, but with less of a routine.”
https://www.sciencedaily.com/releases/2023/09/230921105751.htm
Active children are more resilient
September 5, 2023
Science Daily/University of Basel
The school year has hardly begun and the first exams are already approaching. According to findings by researchers from the University of Basel, school children cope better with the stress if they get plenty of daily exercise.
"Get some exercise!" It's one suggestion adults frequently hear when they complain about stress in their lives. Exercise helps relieve stress. But does this also apply to children? Does exercise help them manage the pressures to achieve at school? A research team led by Dr. Manuel Hanke and Dr. Sebastian Ludyga from the Department of Sport, Exercise and Health recently examined the effect of physical activity on children's stress levels. Their findings appear in the Journal of Science and Medicine in Sport.
For their study, they had 110 children between the ages of 10 and 13 wear a sensor tracking their daily movement over the course of a week. They then brought the participants into the lab on two separate occasions to complete a stressful task and a non-stressful control task (see the box). The researchers tested the children's physical stress reaction via the concentration of the stress hormone cortisol in their saliva.
Less cortisol in active children
"We wanted to determine whether physical activity makes children more resilient under laboratory-controlled circumstances," explains project director Sebastian Ludyga. The results showed that the participants who got more than an hour of exercise per day, as the World Health Organization (WHO) recommends, did in fact produce less cortisol in the stress task than the children who were less active.
"Regularly active children seem to have a reduced physiological stress reaction in general," notes Manuel Hanke, lead author of the study. Even in the control task, which involved an unfamiliar situation, making it still somewhat unsettling for the participants, there was a difference in cortisol levels between more and less active children -- though overall cortisol levels were lower than in the stress task.
Stress hormone levels increase during exercise
One possible explanation for this finding could be that cortisol levels also increase during exercise, says Sebastian Ludyga. "When children regularly run, swim, climb, etc., the brain learns to associate a rise in cortisol with something positive. The body's reaction always has a cognitive component as well: this positive association helps to prevent the concentration of cortisol from rising to too high a level in exam situations as well."
Besides their analysis of the saliva samples, the researchers also examined cognitive reactions to the stress task by recording participants' brainwaves via electroencephalogram (EEG). The team plans to analyze these data next. "Stress can interfere with thinking. Some of us are familiar with this in its most extreme form -- a blackout," Hanke explains. The team now aims to determine whether physical activity also has an influence on these cognitive effects of stress.
Methodology
For their study, the researchers used the Trier Social Stress Test for Children: the participants had to read a story with an open ending, then had five minutes to prepare before using their notes to tell the rest of the story for a jury. What they didn't know in advance was that the preparation time was intentionally kept so short so that it would not be sufficient. After about a minute, their notes were mostly exhausted but they still had to fill five minutes and think something up on the spur of the moment. This task was followed by a seemingly simple arithmetic task in which participants were asked to repeatedly reduce a number in the high three digits by a certain value over the course of five minutes. The stress in this task is primarily caused by errors, which require the participant to restart the task from the beginning. In the control task, which was conducted on a separate occasion, the children also had to read a story, but they then discussed general questions about the story with a researcher without any pressure to perform. In both sessions, the researchers took saliva samples at regular intervals before and after the tasks in order to measure cortisol levels.
https://www.sciencedaily.com/releases/2023/09/230905124926.htm
Keep fit to avoid heart rhythm disorder and stroke
August 22, 2023
Science Daily/European Society of Cardiology
A study in more than 15,000 people has found that physical fitness is linked with a lower likelihood of developing atrial fibrillation and stroke. The research is presented at ESC Congress 2023.
Atrial fibrillation is the most common heart rhythm disorder, affecting more than 40 million people worldwide. It is estimated that one in three Europeans will develop atrial fibrillation in their lifetime. Patients with the condition have a five-fold higher risk of stroke than their peers. This study examined whether fitness was related to the likelihood of developing atrial fibrillation.
The study included 15,450 individuals without atrial fibrillation who were referred for a treadmill test between 2003 and 2012. The average age was 55 years and 59% were men. Fitness was assessed using the Bruce protocol, where participants are asked to walk faster and at a steeper grade in successive three-minute stages. Fitness was calculated according to the rate of energy expenditure the participants achieved, which was expressed in metabolic equivalents (METs).
Participants were followed for new-onset atrial fibrillation, stroke, myocardial infarction and death. The researchers analysed the associations between fitness and atrial fibrillation, stroke and major adverse cardiovascular events (MACE; a composite of stroke, myocardial infarction and death) after adjusting for factors that could influence the relationships including age, sex, cholesterol level, kidney function, prior stroke, hypertension and medications.
During a median of 137 months, 515 participants (3.3%) developed atrial fibrillation. Each one MET increase on the treadmill test was associated with an 8% lower risk of atrial fibrillation, 12% lower risk of stroke and 14% lower risk of MACE.
Participants were divided into three fitness levels according to METs achieved during the treadmill test: low (less than 8.57 METs), medium (8.57 to 10.72) and high (more than 10.72). The probability of remaining free from atrial fibrillation over a five-year period was 97.1%, 98.4% and 98.4% in the low, medium and high fitness groups, respectively.
Study author Dr. Shih-Hsien Sung of the National Yang Ming Chiao Tung University, Taipei, Taiwan said: "This was a large study with an objective measurement of fitness and more than 11 years of follow up. The findings indicate that keeping fit may help prevent atrial fibrillation and stroke."
https://www.sciencedaily.com/releases/2023/08/230822151718.htm
Playing tackle football may increase the risk for Parkinson's disease
New study shows risk increases with more years of play, even in high school and college players
August 11, 2023
Science Daily/Boston University School of Medicine
Identification of risk factors for Parkinson's disease (PD) is essential for early diagnosis. Dating back to the 1920s, Parkinson's disease and parkinsonism -- an umbrella term that refers to motor symptoms found in Parkinson's disease and also other conditions -- have long been described in boxers. Repetitive head impacts from tackle football can also have long-term neurological consequences like chronic traumatic encephalopathy (CTE). But research on the association between participation in tackle football and PD is limited.
In the largest study to describe the association between participation in football and the odds for having a reported diagnosis of PD, researchers from the BU CTE Center used a large online data set of people concerned for having PD and found participants with a history of playing organized tackle football had a 61% increased odds of having a reported parkinsonism or PD diagnosis.
In this study, the researchers evaluated 1,875 sport participants -- 729 men who played football, predominantly at the amateur level, and 1,146 men who played non-football sports who served as the control group. Participants were enrolled in Fox Insight, a longitudinal online study of people with and without PD sponsored by The Michael J. Fox Foundation for Parkinson's Research.
Notably, researchers found a link between playing football and increased odds for having a parkinsonism or PD diagnosis even after accounting for known risk factors for PD. Additionally, the data revealed that players who had longer careers and played at higher levels of competition experienced increased odds for having a reported diagnosis of parkinsonism or PD. Football players who played at the college or professional level were at 2.93 increased odds for having a PD diagnosis compared with those who just played at the youth or high school level. Age of first exposure to football was not associated with odds for having a reported parkinsonism or PD diagnosis.
"Playing tackle football could be a contributing risk factor to PD, particularly among people already at risk due to other factors (e.g., family history). However, the reasons for this relationship are not clear and we also know that not everyone who plays tackle football will develop later-life neurological conditions, meaning many other risk factors are at play," says corresponding author Michael L. Alosco, PhD, associate professor of neurology at Boston University Chobanian & Avedisian School of Medicine.
The researchers also emphasized that they compared the football players to another group of athletes, a noteworthy strength of the study. Furthermore, most of the participants played tackle football only at the amateur level, which is contrast to most of the research to date that has focused on professional athletes.
"Previous research has focused on the association between American football and risk for CTE. However, similar to what has historically been seen in boxers, American football might also affect risk for other neurodegenerative conditions such as PD," says Hannah Bruce, MSc, first author and research specialist at Boston University Chobanian & Avedisian School of Medicine.
https://www.sciencedaily.com/releases/2023/08/230811115422.htm
Increased step count linked to better health for people with heart failure
The results may inform interpretation of wearable device data in clinical and research settings, investigators say
July 26, 2023
Science Daily/Michigan Medicine - University of Michigan
Taking more daily steps is associated improved health, including fewer symptoms and physical limitations, for people with heart failure, a new study finds. Researchers say it's one of the first studies to provide context to wearable device data from heart failure patients and sheds light on what physical activity data from a wearable device means at a population level as well as at the individual level.
More often, people are turning to consumer wearable devices, such as smartwatches, to monitor their health and physical activity.
Using these wearable devices, a study led by Michigan Medicine and the University of Missouri with Saint Luke's Mid America Heart Institute finds that taking more daily steps is associated improved health, including fewer symptoms and physical limitations, for people with heart failure. The results are published in JACC: Heart Failure.
Clinicians are increasingly presented with their patients' wearable device data, though interpretation has been challenging given a lack of normative data in different populations, says first author Jessica R. Golbus, M.D., clinical instructor of internal medicine-cardiology at University of Michigan Medical School.
"This is one of the first studies to provide context to wearable device data from heart failure patients and helps us to understand what physical activity data from a wearable device means at a population level as well as at the individual level," Golbus said.
As part of a national, randomized clinical trial for heart failure, over 400 patients were given activity monitors to evaluate the relationship between daily step count, floors climbed, and their symptoms and physical limitations over 12 weeks. The CHIEF-HF trial used the Kansas City Cardiomyopathy Questionnaires (KCCQ) to gauge total symptoms and physical limitations.
Baseline step counts between 1,000 and 5,000 steps were associated with significantly improved symptoms and fewer physical limitations reflected by KCCQ scores, with little association seen beyond 5,000 steps.
People who walked 2,000 steps per day had total symptoms scores 3.11 points higher, and physical limitation scores 5.36 points higher, than those who walked 1,000 steps a day.
Participants who increased their step counts by 2,000 steps per-day during the 12 weeks experienced a clinically important greater than 5-point increase in physical limitation scores compared to those who did not change their step counts. While increases in step counts over time showed better symptom control and physical function, declines showed no relationship with these outcomes.
This study design provides unique insights for both researchers and clinicians, says co-senior author Brahmajee Nallamothu, M.D., professor of internal medicine-cardiology at U-M Medical School.
"Up until this point, it has been tough to collect data from patients outside of office visits," Nallamothu said. "By collecting data from wearable devices, we can now examine folks in their home environments and over time. That's something special about this work. We will have much more to learn as we consider things that can affect step counts like travel, weather and holidays."
Consumer wearable devices are consistently mentioned in clinical care as possible tools to interpret functional performance and activity, and mobile health technology is increasingly used for recruitment, data collection and outcomes assessments in clinical trials.
For heart failure, the United States Food and Drug Administration has endorsed the use of patient-reported measures to support regulatory approval but not data from wearable devices.
The latest findings, researchers say, highlight the importance of understanding whether and how data from consumer wearables is clinically meaningful.
Given the growing interest in using measures of patients' 'real-world' activity, the clinical and research community need to understand how to interpret the data shared by patients, says co-senior author John Spertus, M.D., Professor and Lauer/Missouri Endowed Chair at the University of Missouri-Kansas City School of Medicine.
"These data provide the first insight into how changes in activity relate to changes in patients' health status, suggesting that we should interpret improvements in activity as indicating better health status but that we need not necessarily be as concerned about reductions in activity," Spertus said.
https://www.sciencedaily.com/releases/2023/07/230726171257.htm
Pupil size during very light exercise predicts benefits to prefrontal function
July 26, 2023
Science Daily/University of Tsukuba
Researchers have investigated the impact of 10-min very light exercise on pupil size and prefrontal function. Their findings provide the first evidence that changes in pupil size during exercise can serve as an indicator for the enhancement of cognitive function associated with the prefrontal cortex resulting from very light exercise.
Recent studies have revealed that mild forms of exercise, such as yoga or walking, can improve mood and enhance executive function, which involves the brain's prefrontal cortex and refers to the ability to control one's behavior to achieve a goal. However, the specific neural activity in the human brain that leads to the improvement of executive function during exercise has remained poorly understood due to tecFhnical limitations.
It is often said that the eyes are a part of the brain and can effectively reflect a person's mental state. In recent years, there has been growing interest in investigating pupil size variations as these are closely linked to the neural activity associated with the brain's noradrenergic arousal system. Pupillometry, a noninvasive and contactless measurement technique, allows for the assessment of neural activity during aerobic exercise and could serve as an indicator of arousal neural activity. Based on this premise, a research team led by KUWAMIZU Ryuta and SOYA Hideaki hypothesized that changes in pupil size during very light exercise could predict improvement in prefrontal executive function after a single exercise session.
To test this theory, the research team asked a group of healthy young adults to participate in 10-min very light exercise followed by an executive function task. The findings revealed that pupils dilated during the exercise, and the extent of the dilation was an indicator of a subsequent improvement in executive function. Prefrontal cortex activity during the executive function task was examined using functional near-infrared spectroscopy, demonstrating an increase in the activity of the left dorsolateral prefrontal cortex, a region associated with executive function.
These results strongly suggest that the enhancement of prefrontal executive function resulting from very light exercise can be attributed to pupil-linked neural activity, specifically the activation of the brain's noradrenergic arousal system. Looking ahead, pupil diameter holds promising potential as a novel biomarker that can be used to predict the effects of exercise on the brain.
https://www.sciencedaily.com/releases/2023/07/230726113027.htm
Exercise, metabolism: Cellular mechanisms by which lactate helps our brains develop
July 24, 2023
Science Daily/Tohoku University
Lactate is a byproduct of exercise and metabolism, fueling our brain when oxygen is limited. More recently, scientists have become aware of the many roles it plays in developing our nervous system. Now, researchers have unearthed the cellular mechanisms by which lactate helps our brains develop.
Scientists at Tohoku University have discovered the critical role that lactate plays in helping neural stem cells develop into specialized neurons, a process dubbed neuronal differentiation. They also unearthed a means by which lactate sends signals to the cells, helping modify and strengthen neuronal functions.
Details of their study were reported in the Journal of Biological Chemistry on June 10, 2023.
Lactate is a byproduct of exercise and metabolism. Glucose gets converted into lactate when oxygen supplies to cells are limited, giving the brain a source of energy. Lactate levels in fetal brains increase from the middle state of gestation, highlighting the significant role it has in brain development and neuronal differentiation.
Recent studies and reports have demonstrated that lactate is a vital component of our nervous system. They have shown that lactate functions as an important cellular signaling molecule in the nervous system, and that lactate metabolism is involved in neuronal functions, including neuroplasticity and memory consolidation. However, the role of lactate signaling in neuronal cells has, until now, remained unknown.
"Given the growing evidence that shows lactate providing signal-regulatory functions in various cell types under physiological and pathological conditions, we hypothesized that lactate affects neuronal function through changing comprehensive gene expression," says Professor Ryoichi Nagatomi from Tohoku University's Graduate School of Biomedical Engineering and leader of the research team along with PhD student Yidan Xu and Associate Professor Joji Kusuyama from Tokyo Medical and Dental University.
The researchers tested their hypothesis by examining the gene regulation of cells treated with lactate when NDRG3, a protein previously identified to mediate gene regulation when lactate is present, was removed from neuroblastoma cell SH-SY5Y. They found that lactate helps with neural differentiation through ways that depend on NDRG3 and ways that don't. Additionally, they identified that two specific transcription factors, TEAD1 and ELF4, are controlled by both lactate and NDRG3 during neuronal differentiation.
Nagatomi and his team believe their findings not only further basic knowledge of lactate, but could serve as a basis for harnessing lactate signaling for encouraging exercise or designing drugs as a way to prevent or control cognitive diseases. "Our findings provide a novel insight into the mechanisms by which exercise-induced high serum lactate levels may beneficially affect the nervous system. Furthermore, since the changes in lactate levels caused by human exercise can be measured, the adaptational changes in the brain function such as cognition and memory function can be better understood when changes in the lactate level is considered."
https://www.sciencedaily.com/releases/2023/07/230724122207.htm
Lower levels of physical activity can protect against depression among older adults
Major new study shows even moderate daily activity can lower risk of depressive symptoms
July 11, 2023
Science Daily/University of Limerick
Brand new research from University of Limerick in Ireland has revealed that even moderate daily physical activity can reduce the risk of depression.
The new study, conducted by physical activity and mental health experts at University of Limerick and Trinity College Dublin, has shown that a physical activity dose equivalent to just 20 minutes a day (for five days a week) of moderate-intensity physical activity, like brisk walking, was linked with less risk of depressive symptoms and odds of major depression.
The study, funded by Ireland's Health Research Board, has just been published in the JAMA Network Open journal.
Depression is unfortunately increasingly common among older adults, and has significant risk factors for major chronic conditions, including cognitive decline, cardiovascular disease and chronic pain, and increased risk of death and suicide.
Depression causes over 5-10% of the burden of all diseases in Europe and the economic cost in the United States alone is estimated to be over $210.5 billion. Identifying potentially easy and low-cost health and lifestyle solutions that could reduce the risk of depression remains a top priority.
Recent research has shown moderate-to-vigorous physical activity (MVPA) was linked with benefits for depression.
"However," explained Dr Eamon Laird, lead author on the paper and a post-doctoral researcher in the Department of Physical Education and Sport Sciences at UL, "there is no agreement on how much physical activity is protective for depression overall, or how this may vary among adults with disease.
"For this work, we used 10 years of data from the Irish Longitudinal Study On Ageing which included information on depression, MVPA, and other key health-related variables such as disease, lifestyle factors and socio-economic status.
"We sought to identify the lowest dose of MVPA associated with protection against Major Depression and depressive symptoms and the extent to which this varied based on the presence of chronic disease," added Dr Laird.
Key findings from the study include:
A physical activity dose equivalent to 20 minutes a day of MVPA (brisk walking) for five days per week was associated with a 16% lower rate of depressive symptoms and 43% lower odds of Major Depression
A dose-response effect was found, such that more MVPA was associated with greater protection for Depression;
- Specifically, doses equivalent to ~30 minutes a day of MVPA were associated with 7% lower risk of depressive symptoms and 44% lower odds of Major Depression;
- Doses equivalent to ~60 minutes a day of MVPA were associated with: 16% lower risk of depressive symptoms and 41% lower odds of Major Depression;
- Doses equivalent to ~120 minutes a day of MVPA were associated with: 23% lower risk depressive symptoms and 49% lower odds of Major Depression
These findings remained significant even after controlling for relevant health-related factors like biological sex, education, age, smoking and alcohol, obesity, antidepressant use and time.
These findings were also materially the same for older adults with and without a chronic illness.
According to Dr Laird: "This study is very relevant given the high prevalence of depression in our increasing older adult population. Physical activity at lower doses than World Health Organization recommendations for overall health may offer protection against depressive symptoms and Major Depression -- at minimum, try to engage in 20 minutes a day of moderate-intensity activity at least five days per week, with more benefits seen at higher doses.
"Try and build it into a routine with hobbies or activities you enjoy and trying to do it with others as social interactions particularly with activity can also have mental health benefits. Remember that it is one component, and that nutrition and healthy lifestyle will also give additive benefits in addition to the physical activity."
Dr Matthew Herring, a Senior Lecturer and Investigator in the Physical Activity for Health Research Centre at UL and Principal Investigator of this HRB-funded research, added: "The current findings have significant implications in highlighting that significant antidepressant benefits appear to be associated with doses of physical activity that are lower than current World Health Organization recommendations for overall health, though greater doses were associated with stronger protection.
"We are clearly not advocating for lower physical activity among the older adult population, but findings suggest that the largest improvements in protection against depression among older adults may be made by engaging inactive older adults in physical activity even at doses below those recommended for overall health."
https://www.sciencedaily.com/releases/2023/07/230711133208.htm
Lack of sleep lessens cognitive benefits of physical activity
July 5, 2023
Science Daily/University College London
A new study looked at cognitive function over 10 years in 8,958 people aged 50 and over in England. The research team investigated how different combinations of sleep and physical activity habits might affect people's cognitive function over time.
Regular physical activity may protect against cognitive decline as we get older, but this protective effect may be diminished for people who are not getting enough sleep, according to a new study by UCL researchers.
The study, published in The Lancet Healthy Longevity, looked at cognitive function over 10 years in 8,958 people aged 50 and over in England. The research team investigated how different combinations of sleep and physical activity habits might affect people's cognitive function over time.
They found that people who were more physically active but had short sleeps -- less than six hours on average -- had faster cognitive decline overall, meaning that after 10 years their cognitive function was equivalent to peers who did less physical activity.
Lead author Dr Mikaela Bloomberg (UCL Institute of Epidemiology & Health Care) said: "Our study suggests that getting sufficient sleep may be required for us to get the full cognitive benefits of physical activity. It shows how important it is to consider sleep and physical activity together when thinking about cognitive health.
"Previous studies examining how sleep and physical activity might combine to affect cognitive function have primarily been cross-sectional -- only focusing on a snapshot in time -- and we were surprised that regular physical activity may not always be sufficient to counter the long-term effects of lack of sleep on cognitive health."
The study found, in line with previous research, that sleeping between six and eight hours per night and higher levels of physical activity were linked to better cognitive function.
Those who were more physically active also had better cognitive function regardless of how long they slept at the start of the study. This changed over the 10-year period, with more physically active short sleepers (less than six hours) experiencing more rapid cognitive decline.
This rapid decline was true for those in their 50s and 60s in this group, but for older participants (aged 70 and over) the cognitive benefits of exercise appeared to be maintained, despite short sleep.
Co-author Professor Andrew Steptoe (UCL Institute of Epidemiology & Health Care) said: "It is important to identify the factors that can protect cognitive function in middle and later life as they can serve to prolong our cognitively healthy years and, for some people, delay a dementia diagnosis.
"The World Health Organisation already identifies physical activity as a way to maintain cognitive function, but interventions should also consider sleep habits to maximise long-term benefits for cognitive health."
For the study, the researchers used data from the English Longitudinal Study of Ageing (ELSA), a nationally representative cohort study of the English population. Participants were asked how long they slept on an average weeknight and were split into three sleep groups: short (less than six hours), optimal (six to eight hours) and long (greater than eight hours).
They were also given a score based on the frequency and intensity of self-reported physical activity and divided into two groups: more physically active (the top third of scorers) and less physically active (the other two thirds). Cognitive function was assessed on the basis of an episodic memory test (asking participants to recall a 10-word list, both immediately and after a delay) and a verbal fluency test (asking participants to name as many animals as they can in a minute).
The researchers adjusted for a number of confounding factors, such as participants having done the same cognitive test before and therefore being likely to perform better. They also excluded people with self-reported dementia diagnoses and those whose test scores indicated some cognitive impairment, so that behaviour changes linked to preclinical Alzheimer's disease (such as sleep disturbance) did not inadvertently affect the results.
In terms of study limitations, the researchers relied on participants self-reporting their sleep duration and physical activity. The next steps, the researchers said, may be to repeat the results in more diverse study populations, examine more cognitive domains and more domains of sleep quality, and use objective measures such as a wearable physical activity tracker.
The research was funded by the UK's Economic and Social Research Council.
https://www.sciencedaily.com/releases/2023/07/230705194620.htm
Older adults who remain more active have a better quality of life
July 4, 2023
Science Daily/University of Cambridge
A reduction in the amount of time spent physically active when adults are over sixty years old is linked to lower quality of life, a Cambridge study of almost 1,500 adults has shown.
The same was also true for increases in the amount of sedentary time, such as watching TV or reading. The researchers say this highlights the need to encourage older adults to remain active.
Physical activity -- particularly when it is moderate-intensity and raises your heart rate -- is known to reduce the risk of a number of diseases, including heart disease, stroke, diabetes and cancer. The NHS recommends that adults do at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous-intensity activity a week. Older adults are also recommended to break up prolonged periods of being sedentary with light activity when physically possible, or at least with standing, as this has distinct health benefits for older people.
A team led by researchers at the University of Cambridge examined activity levels among 1,433 participants aged 60 and above using accelerometers. The participants had been recruited to the EPIC (European Prospective Investigation into Cancer)-Norfolk study.
Alongside this, the team also looked at health-related quality of life, a measure of health and wellbeing that includes pain, ability to care for yourself and anxiety/mood. Participants were given a score between 0 (worst quality of life) and 1 (best) based on their responses to a questionnaire. Lower quality of life scores are linked with an increased risk of hospitalisation, worse outcomes following hospitalisation, and early death.
Participants were followed up an average of just under six years later to look at changes in their behaviour and quality of life. The results of the study are published in Health and Quality of Life Outcomes.
On average, six years after their first assessment, both men and women were doing around 24 minutes less moderate-to-vigorous physical activity per day. At the same time, the total sedentary time increased by an average of around 33 minutes a day for men and around 38 minutes a day for women.
Those individuals who did more moderate-to-vigorous physical activity and spent less time sedentary at their first assessment had a higher quality of life later on. An hour a day spent more active was associated with a 0.02 higher quality of life score.
For every minute a day less of moderate-to-vigorous physical activity measured six years after the first assessment, quality of life scores dropped by 0.03. This means that an individual who spent 15 minutes a day less engaged in such activity would have seen their score drop by 0.45.
Increases in sedentary behaviours were also associated with poorer quality of life -- a drop in the score of 0.012 for everyone minute a day increase in total sedentary time six years after the first measurement. This means that an individual who spent 15 minutes a day more sitting down would have seen their score drop by 0.18.
To put the results into a clinical context, a 0.1 point improvement in quality of life scores has previously been associated with a 6.9% reduction in early death and a 4.2% reduction in risk of hospitalisation.
Dr Dharani Yerrakalva from the Department of Public Health and Primary Care at the University of Cambridge said: "Keeping yourself active and limiting -- and where you can, breaking up -- the amount of time you spend sitting down is really important whatever stage of life you're at. This seems to be particularly important in later life, when it can lead to potentially significant improvements to your quality of life and your physical and mental wellbeing."
Because the team measured physical activity and sedentary behaviour at different points of time, they say they can be reasonably confident that they have shown a causal link -- that is, that quality of life improves becausepeople remain more physically active, for example.
Dr Yerrakalva added: "There are several ways in which improvements in our physical behaviours might help maintain a better quality of life. For example, more physical activity reduces pain in common conditions such as osteoarthritis, and we know that being more physically active improves muscle strength which allows older adults to continue to care for themselves. Similarly, depression and anxiety are linked to quality of life, and can be improved by being more active and less sedentary."
The EPIC-Norfolk study is funded by the Medical Research Council and Cancer Research UK.
Five ways to keep yourself physically-active in older age
A brisk daily walk -- ideally for around 20 minutes
Gardening
A bicycle ride
Dancing
Tennis
https://www.sciencedaily.com/releases/2023/07/230704110923.htm
Walkable neighborhoods help adults socialize, increase community
June 20, 2023
Science Daily/University of California - San Diego
Adults who live in walkable neighborhoods are more likely to interact with their neighbors and have a stronger sense of community than people who live in car-dependent communities, report researchers at the Herbert Wertheim School of Public Health and Human Longevity Science at University of California San Diego.
The findings of the study, published online in the journal Health & Place, support one of six foundational pillars suggested by United States Surgeon General Vivek Murthy as part of a national strategy to address a public health crisis caused by loneliness, isolation and lack of connection in this country.
In May 2023, the Surgeon General Advisory stated that loneliness and isolation can lead to a 29% increased risk of heart disease, a 32% increased risk of stroke, a 50% increased risk of developing dementia among older adults, and increases risk of premature death by more than 60%.
To address this public health crisis, the Surgeon General recommends strengthening social infrastructure by designing environments that promote connection.
"Our built environments create or deny long-lasting opportunities for socialization, physical activity, contact with nature, and other experiences that affect public health," said James F. Sallis, Ph.D., Distinguished Professor at the Herbert Wertheim School of Public Health and senior author of the UC San Diego study.
"Transportation and land use policies across the U.S. have strongly prioritized car travel and suburban development, so millions of Americans live in neighborhoods where they must drive everywhere, usually alone, and have little or no chance to interact with their neighbors."
Walkable neighborhoods promote active behaviors like walking for leisure or transportation to school, work, shopping or home.
The study analyzed data from the Neighborhood Quality of Life Study, which included 1,745 adults ages 20 to 66 living in 32 neighborhoods located in and around Seattle, Baltimore and Washington, D.C.
Neighborhood walkability may promote social interactions with neighbors -- like waving hello, asking for help or socializing in their homes, said the first author, Jacob R. Carson, M.P.H., a student in the UC San Diego -- San Diego State University Joint Doctoral Program in Public Health. Carson began the research while a Master of Public Health student at the Herbert Wertheim School of Public Health.
Neighborhoods where people must drive in and out, and where there is an absence of gathering places, may have the opposite effect, preventing neighbors from socializing.
"Promoting social interaction is an important public health goal. Understanding the role of neighborhood design bolsters our ability to advocate for the health of our communities and the individuals who reside in them," said Carson.
"Fewer traffic incidents, increases in physical activity, and better neighborhood social health outcomes are just a few of the results of designing walkable neighborhoods that can enrich our lives."
https://www.sciencedaily.com/releases/2023/06/230620113745.htm