Exercise may improve thinking skills in people as young as 20

January 30, 2019

Science Daily/American Academy of Neurology

Regular aerobic exercise such as walking, cycling or climbing stairs may improve thinking skills not only in older people but in young people as well, according to a new study. The study also found that the positive effect of exercise on thinking skills may increase as people age.

The specific set of thinking skills that improved with exercise is called executive function. Executive function is a person's ability to regulate their own behavior, pay attention, organize and achieve goals.

"As people age, there can be a decline in thinking skills, however our study shows that getting regular exercise may help slow or even prevent such decline," said study author Yaakov Stern, PhD, of Columbia University in New York, and a member of the American Academy of Neurology. "We found that all participants who exercised not only showed improvements in executive function but also increased the thickness in an area of the outer layer of their brain."

The study involved 132 people between the ages of 20 and 67 who did not smoke or have dementia but who also did not exercise at the start of the study and were determined to have below average fitness levels. Participants were randomly assigned to six months of either aerobic exercise or stretching and toning four times a week. The two groups were equally balanced for age, sex, education as well as memory and thinking skills at the start of the study.

All participants either exercised or stretched and toned at a fitness center and checked in weekly with coaches monitoring their progress. They all wore heart rate monitors as well. Participants' thinking and memory skills were evaluated at the start of the study as well as at three months and at the end of the six-month study.

Participants in the exercise group chose from aerobic activities including walking on a treadmill, cycling on a stationary bike or using an elliptical machine. They ramped up their activity during the first month, then during the remainder of the six-month study they trained at 75 percent of their maximum heart rate. People in the stretching and toning group did exercises to promote flexibility and core strength.

Researchers measured participants' aerobic capacity using a cycling machine called an ergometer that estimates exercise intensity. Participants also had MRI brain scans at the start and end of the study.

Researchers found that aerobic exercise increased thinking skills. From the beginning of the study to the end, those who did aerobic exercise improved their overall scores on executive function tests by 0.50 points, which was a statistically significant difference from those who did stretching and toning, who improved by 0.25 points. At age 40, the improvement in thinking skills was 0.228 standard deviation units higher in those who exercised compared to those who did stretching and toning and at age 60, it was 0.596 standard deviation units higher.

"Since a difference of 0.5 standard deviations is equivalent to 20 years of age-related difference in performance on these tests, the people who exercised were testing as if they were about 10 years younger at age 40 and about 20 years younger at age 60," Stern said.

He added, "Since thinking skills at the start of the study were poorer for participants who were older, our findings suggest that aerobic exercise is more likely to improve age-related declines in thinking skills rather than improve performance in those without a decline."

Researchers also found an increase in the thickness of the outer layer of the brain in the left frontal area in all those who exercised, suggesting that aerobic exercise contributes to brain fitness at all ages.

"Our research confirms that exercise can be beneficial to adults of any age," said Stern.

Overall, researchers did not find a link between exercise and improved memory skills. However, those with the genetic marker for dementia, the APOE ?4 allele, showed less improvement in thinking skills.

A limitation of the study is the small number of participants. Larger studies over longer periods of time may allow researchers to see other effects in thinking and memory skills.

The study was supported by the National Institutes of Health.

https://www.sciencedaily.com/releases/2019/01/190130161638.htm

Exercise may be as effective as prescribed drugs to lower high blood pressure

But no direct head to head comparative trials and relatively small numbers for some studies

Science Daily/December 18, 2018

BMJ

Exercise may be as effective as prescribed drugs to lower high (140 mm Hg) blood pressure, suggests a pooled analysis of the available data, in what is thought to be the first study of its kind.

But there are no direct head to head comparative trials of exercise and blood pressure lowering drugs, and the numbers of participants in some of the included studies were relatively small, caution the researchers.

While promising, the findings shouldn't persuade patients to ditch their blood pressure lowering drugs in favour of an exercise regimen just yet, although patients might want to boost their physical activity levels, advises the lead study author in a linked podcast.

Exercise can lower systolic blood pressure -- the amount of pressure in the arteries when the heart is beating and expressed as the top number in any blood pressure reading. But what isn't clear is how exercise compares with blood pressure lowering drugs, of which there are several types, as no direct head to head clinical trials have been carried out.

To get round this, the researchers pooled the data from 194 clinical trials looking at the impact of drugs on lowering systolic blood pressure and 197 trials looking at the impact of structured exercise, and involving a total of 39,742 people.

Structured exercise was categorised as: endurance, to include walking, jogging, running, cycling and swimming, and high intensity interval training; dynamic resistance, to include strength training -- for example, with dumbbells or kettle bells; isometric resistance, such as the static push-up (plank); and a combination of endurance and resistance.

Three sets of analyses were done: all types of exercise compared with all classes of blood pressure lowering drugs; different types of exercise compared with different types of drug; and different intensities of exercise compared with different drug doses.

And finally, these analyses were repeated, but in a group of exercise trials that included only participants with high blood pressure, as most of these trials were of young healthy participants with normal blood pressure.

The results showed that blood pressure was lower in people treated with drugs than in those following structured exercise programmes.

But when the analyses were restricted to those with high blood pressure, exercise seemed to be just as effective as most drugs. What's more, the effectiveness of exercise increased the higher the threshold used to define high blood pressure -- that is, anything above 140 mm Hg.

The researchers also found "compelling evidence that combining endurance and dynamic resistance training was effective in reducing [systolic blood pressure]."

But structured exercise trials were fewer and smaller than those for drugs, they caution.

The researchers point out that prescriptions for drugs to lower blood pressure have risen sharply in recent years. In England alone the number of adults prescribed them increased by 50 per cent between 2006 and 2016.

This trend is likely to continue, say the researchers, given that major clinical practice guidelines have recently lowered the threshold for high systolic blood pressure to 130 mm Hg.

But substituting exercise for drugs may be challenging as people with high blood pressure often have several long term conditions, and an estimated 40 per cent of adults in the US and many European countries are physically inactive, they say.

"We don't think, on the basis of our study, that patients should stop taking their antihypertensive medications," says lead author Dr Huseyin Naci, Department of Health Policy, London School of Economics and Political Science, in a linked podcast.

"But we hope that our findings will inform evidence based discussions between clinicians and their patients," he adds.

As to whether doctors should be handing out prescriptions for exercise to patients with high blood pressure, there are some issues to consider, he suggests.

"It's one thing to recommend that physicians start prescribing exercise to their patients, but we also need to be cognisant of the resource implications and ensure that the patients that have been referred to exercise interventions can adhere to them and so really derive benefit," he emphasises.

https://www.sciencedaily.com/releases/2018/12/181218185823.htm

Physical activity in the evening does not cause sleep problems

December 13, 2018

Science Daily/ETH Zurich

Contrary to popular belief, there is no reason to avoid exercising in the evening, an analysis of the scientific literature has revealed.

Even among sleep researchers, it is a widely held belief that sleep quality can be improved by avoiding exercise in the evening. However, as researchers from the Institute of Human Movement Sciences and Sport at ETH Zurich have demonstrated, it is not generally true.

The scientists combed through the literature on the subject and analysed all 23 studies that met their quality requirements. They concluded that doing exercise in the four hours before going to bed does not have a negative effect on sleep. "If doing sport in the evening has any effect on sleep quality at all, it's rather a positive effect, albeit only a mild one," says Christina Spengler, head of the Exercise Physiology Lab at ETH Zurich.

By combining the data from the different studies, the researchers showed that in the night after study participants had done some sport in the evening, they spent 21.2 percent of their sleeping time in deep sleep. Following an evening without exercise, the average figure was 19.9 percent. While the difference is small, it is statistically significant. Deep sleep phases are especially important for physical recovery.

Intensive training late in the evening: an exception to the rule

Vigorous training within an hour before bedtime is an exception to the rule. According to this analysis, it is the only type of evening exercise that may have a negative effect on sleep. "However, this preliminary observation is based on just one study," Spengler says.

"As a rule of thumb, vigorous training is defined as training in which a person is unable to talk. Moderate training is physical activity of an intensity high enough that a person would no longer be able to sing, but they could speak," Spengler says. One example of vigorous training is the kind of high-intensity interval training that competitive athletes often perform. In many cases, though, a longer endurance run or a longer ride on a racing bike would fall into the moderate training category.

As the analysis showed, it took study participants who completed an intensive training session shortly before bedtime longer to fall asleep. The study also provided insight into why this is the case: the test subjects were not able to recover sufficiently in the hour before they went to bed. Their hearts were still beating more than 20 beats per minute faster than their resting heart rate.

Possible sleep problems are no excuse

According to the official recommendations of sport physicians, people should do at least 150 minutes of moderate exercise each week. Many may ask themselves: should I exercise in the evening if I didn't have time during the day, or will that have a negative effect on my sleep? "People can do exercise in the evening without hesitation. The data shows that moderate exercise in the evening is no problem at all," says Jan Stutz, a doctoral student in Spengler's research group and lead author of the analysis, which was published in the journal Sports Medicine. Moderate exercise did not cause sleep problems in any of the studies examined, not even when the training session ended just 30 minutes before bedtime. "However, vigorous training or competitions should be scheduled earlier in the day, if possible," Stutz says.

Stutz and Spengler point out that they examined average values over the course of their analysis, which made only general statements possible. "Not everyone reacts to exercise in the same way, and people should keep listening to their bodies. If they notice they are having problems falling asleep after doing sport, they should try to work out a little earlier," Stutz says.

"It is well known that doing exercise during the day improves sleep quality," Spengler says, adding: "Now we have shown that, at the very least, exercising in the evening doesn't have a negative effect."

https://www.sciencedaily.com/releases/2018/12/181213112057.htm

Performance on exercise test predicts risk of death from cardiovascular disease and cancer

December 6, 2018

Science Daily/European Society of Cardiology

Performance on an exercise test predicts the risk of death from cardiovascular disease, cancer, and other causes, a new study finds. Good performance on the test equates to climbing three floors of stairs very fast, or four floors fast, without stopping. The findings underline the importance of fitness for longevity.

The study included 12,615 participants with known or suspected coronary artery disease. Participants underwent treadmill exercise echocardiography, in which they were asked to walk or run, gradually increasing the intensity, and continue until exhaustion. The test also generates images of the heart to check its function.

During a median 4.7-year follow-up, there were 1,253 cardiovascular deaths, 670 cancer deaths, and 650 deaths from other causes. After adjusting for age, sex, and other factors that could potentially influence the relationship, each MET (metabolic equivalent)* achieved was independently associated with 9%, 9%, and 4% lower risks of cardiovascular death, cancer death, and other causes of death during follow-up.

The death rate from cardiovascular disease was nearly three times higher in participants with poor compared to good functional capacity (3.2% versus 1.2%, p<0.001). Non-cardiovascular and non-cancer deaths were also nearly three-fold higher in those with poor compared to good functional capacity (1.7% versus 0.6%, p<0.001). Cancer deaths were almost double in participants with poor compared to good functional capacity (1.5% versus 0.8%, p<0.001).

As expected, the imaging part of the examination was predictive of cardiovascular death, but not of deaths caused by cancer or other conditions.

Study author Dr Jesús Peteiro, a cardiologist at University Hospital A Coruña, A Coruña, Spain, said: "Our results provide further evidence of the benefits of exercise and being fit on health and longevity. In addition to keeping body weight down, physical activity has positive effects on blood pressure and lipids, reduces inflammation, and improves the body's immune response to tumours."

Dr Peteiro said people do not need to undergo exercise echocardiography to check their fitness level. "There are much cheaper ways to estimate if you could achieve ten METs on the treadmill test," he said. "If you can walk very fast up three floors of stairs without stopping, or fast up four floors without stopping, you have good functional capacity. If not, it's a good indication that you need more exercise."

ESC guidelines recommend at least 150 minutes a week of moderate aerobic physical activity or 75 minutes a week of vigorous aerobic physical activity, or a combination of the two intensities.

https://www.sciencedaily.com/releases/2018/12/181206120043.htm

Single workout can boost metabolism for days

Study offers insight into brain's potential role in fitness, diabetes therapy

Science Daily/December 4, 2018

UT Southwestern Medical Center

A new study shows neurons in mice that influence metabolism are active for up to two days after a single workout.

Lounging around all weekend may weigh heavy on the minds of the health conscious. But these sedentary stretches may not affect the waistline, provided they're preceded by a bit of exercise.

A new study from UT Southwestern Medical Center shows neurons in mice that influence metabolism are active for up to two days after a single workout. The research offers new insight into the brain's potential role in fitness and -- in the longer term -- may provide a target for developing therapies that improve metabolism.

"It doesn't take much exercise to alter the activity of these neurons," said Dr. Kevin Williams, a neuroscientist at UT Southwestern. "Based on our results, we would predict that getting out and exercising even once in a semi-intense manner can reap benefits that can last for days, in particular with respect to glucose metabolism."

The study, published in the December edition of Molecular Metabolism, measured the effects of short- and long-term exercise on two types of neurons that comprise the melanocortin brain circuit, which is shared by both humans and mice. One of the neuron types (POMC) is associated with reduced appetite, lower blood glucose levels, and higher energy burning when activated; the other type (NPY/AgRP) increases appetite and diminishes metabolism when activated.

The study found that a single bout of exercise can boost the activity of POMC neurons and inhibit the counterpart NPY/AgRP neuron for up to two days. Those changes last longer with more training.

The findings expand the scientific understanding of the melanocortin circuit, which previous studies showed could be altered through feeding or fasting but had not yet been linked to exercise.

The results also provide another avenue to research potential treatments to improve glucose metabolism in patients with conditions such as diabetes. More than 30 million Americans have diabetes, accounting for nearly 10 percent of the population. Another 84 million have prediabetes, which can lead to diabetes within five years, according to the Centers for Disease Control and Prevention.

"It is possible that activating melanocortin neurons may hold therapeutic benefits for patients one day, especially for diabetics who need improved blood-glucose regulation," Dr. Williams said.

The study measured brain circuit activity in mice given training regiments that lasted from zero to 10 days. Scientists found that a single workout (consisting of three 20-minute treadmill runs) caused a decrease in appetite that lasted up to six hours. "This result may explain at the neural circuit level why many people don't feel hungry immediately after exercise," Dr. Williams said.

The longer-term effects of exercise were seen in the POMC neurons, which improve glucose metabolism when activated. These neurons remained active longer if they also expressed a protein called the leptin receptor.

Dr. Williams' lab is preparing a second study to establish the mechanisms by which exercise triggers changes in melanocortin neurons. The planned study will also record more data on how those changes correlate with biological functions such as glucose metabolism and energy balance.

"This research is not just for improving fitness," Dr. Williams said. "A better understanding of neural links to exercise can potentially help a number of conditions affected by glucose regulation."

https://www.sciencedaily.com/releases/2018/12/181204143854.htm

Study takes stand on true health benefits of getting up out of your chair

December 3, 2018

Science Daily/University of Bath

A new health study provides fresh insights on the energy cost of sitting versus standing for sedentary workers.

Office employees who opt to stand when working are likely to be burning only fractionally more calories than their seated colleagues, according to new research from the University of Bath.

The study, published in the journal Medicine & Science in Sports & Exercise, reveals that the 'benefits' of standing over sitting equate to little more than 9 calories an hour -- the equivalent of just one stalk of celery. In fact, purely for weight gain perspective, it would take individuals who opted to stand nearly the entire day to burn just one cup of coffee.

Prolonged sitting has become a major health concern, targeted via government policy and the increase in of height-adjustable workstations and wearable technologies that encourage standing. Yet despite these interventions, which have the potential to influence energy balance, remarkably little had been known of the true energy cost of sitting versus standing naturally.

For this study, which involved researchers at Bath and Westmont College (US), the team tested the resting metabolic rates of 46 healthy men and women. Participants were then asked to either lie down, sit down or stand up before measurements were taken of their expired gases in order to assess how many calories they burnt through the activity.

With only marginal gains in calories expended observed, the study questions the effectiveness of standing as an effective strategy for weight loss and in the treatment of obesity.

Professor James Betts of the University of Bath's Department for Health explains: "The biomechanics of standing means that more muscles are used to support a greater proportion of the body weight in an upright position, so should cost more energy than when sitting.

"Past research has shown this by comparing sitting and standing when completely motionless. Other research has also explored the energy costs of various daily activities that can be completed whether or not seated but also allow people to walk around, so may not tell us about the simple difference between siting versus standing per se.

"In the real-world people also do not usually have their bodily movements restricted but instead do spontaneously fidget to remain comfortable, so we saw an opportunity to understand the fundamental difference between sitting and standing naturally."

Collaborator, Professor Gregg Afman, Professor of Kinesiology at Westmont College (US) said: "We found that energy cost increase of 0.65 kJ per minute from sitting to standing naturally which equates to a 12% difference. However current interventions to reduce prolonged sitting like standing desks or wearable technologies only increase standing by a maximum of two hours per day. This limited time-frame would cause a person to expend less than 20 kcals more each day."

Dr Javier Gonzalez, who was also involved in the study from the University of Bath, added: "The very small increase in energy cost of standing compared to sitting that we observed suggests that replacing time spent sitting with time spent standing is unlikely to influence our waist lines in any meaningful way.

"To put this difference in context, it would require an additional 20 hours of standing time, on average, to burn of a medium latte. Many people are becoming aware of the negative health effects of prolonged sitting, and so may opt for standing desks. These people should be aware that whilst there are still some health benefits to standing more, they should not expect to see drastic changes in their body weight. In order to lose body weight, people should focus on increasing physical activity and focus on their diet too."

https://www.sciencedaily.com/releases/2018/12/181203131112.htm

Curry spice boosts exercise performance in mice with heart failure

Curcumin treatment improved muscle function, exercise capacity in mice with heart failure and healthy controls

November 29, 2018

Science Daily/American Physiological Society

New research suggests that curcumin, a main ingredient in curry, may improve exercise intolerance related to heart failure.

Curcumin, a chemical that comes from the turmeric plant, has been used as a traditional Asian medicine for centuries, primarily to treat gastrointestinal ailments and skin wounds. Studies increasingly suggest that the compound may prevent or limit muscle wasting associated with a number of health conditions, including heart failure.

Heart failure affects more than 6 million people living in the U.S. People with heart failure have a reduced function of the left ventricle -- the chamber of the heart that pumps blood out to the rest of the body -- called reduced ejection fraction. A decreased ability to exercise (exercise intolerance) is another significant characteristic of heart failure. Previous research has found that higher than normal levels of oxidative stress -- an imbalance of two different kinds of molecules that can result in cell damage -- contribute to exercise intolerance in people with heart failure. Heart failure is also associated with lower than normal expression of antioxidant enzymes in the muscles, but the reason for this is unclear. Antioxidant enzymes both prevent and repair damage from oxidative stress. Boosting enzyme levels may improve exercise performance in people in heart failure.

Researchers from the University of Nebraska Medical Center theorized that a reduction in the normal signaling of Nrf2, a protein that regulates the expression of antioxidant enzymes, may play a role in the impaired expression of antioxidant enzymes. They examined the effects of curcumin, which is known to promote activation of Nrf2, on a mouse model of heart failure with reduced ejection fraction. One group of mice with heart failure received daily doses of curcumin for 12 weeks, and another group did not receive treatment. The heart failure groups were compared to a control group of healthy mice that received curcumin and an untreated control group.

The research team measured the exercise capacity of all the mice before and after curcumin treatment. The researchers also examined muscle fiber samples to assess enzyme expression levels. They found that expression of Nrf2 increased and levels of antioxidant enzymes improved in the animals with heart failure that were given curcumin. In addition, both groups that received curcumin -- even the animals without heart failure -- had improved exercise capacity when compared with the untreated groups, suggesting the effects of curcumin on skeletal muscle is not exclusive to heart failure.

"These data suggest that activation of Nrf2 in skeletal muscle may represent a novel therapeutic strategy to improve ... quality of life" in people with heart failure with reduced ejection fraction, the researchers wrote.

https://www.sciencedaily.com/releases/2018/11/181129122448.htm

Healthy? Stay fit to avoid a heart attack

Low cardiorespiratory fitness could be a warning sign of future problems, even in the fit and healthy

November 28, 2018

Science Daily/European Society of Cardiology

Even if you are a fit and healthy person with no signs of any heart or blood vessel disease, low cardiorespiratory fitness could be a warning sign of future problems, according to a new study.

Cardiorespiratory fitness refers to the ability of the blood circulation and respiratory systems to supply adequate oxygen to muscles during sustained physical activity. The main measure of it is VO2max -- the maximum rate of oxygen consumption during exercise that increases with intensity.

In the study published today, 4527 fit and healthy men and women with no history of cardiovascular or lung disease, cancer or raised blood pressure, had their cardiorespiratory fitness assessed when they joined a large, population-based health study in Norway (the HUNT3 study) between 2006-2008. Wearing a face mask and a heart rate monitor, they warmed up for ten minutes on a treadmill before running faster and faster. Their oxygen intake was measured to establish their VO2max. The researchers also gathered information on tobacco use, alcohol consumption, family history of cardiovascular disease, physical activity, weight, height and waist circumference, blood pressure and cholesterol levels.

After an average follow-up time of nearly nine years, the researchers found that greater cardiorespiratory fitness was linked to a lower risk of cardiovascular disease, such as heart attacks. Only 147 participants (3.3%) were diagnosed with heart disease or died from it, or required intervention to unblock clogged arteries during this period.

"We found a strong link between greater fitness and reduced risk of a coronary event during the nine years of follow-up in a very healthy sample of adults," said Dr Bjarne Nes, a researcher at the Norwegian University of Science and Technology (NTNU). "In fact, the participants who were in the 25% of those with the highest cardiorespiratory fitness had nearly half the risk compared to those in the 25% with the lowest fitness levels."

The researchers found that, in both men and women, the risk of cardiovascular problems fell by 15% for every extra unit of measurement of cardiorespiratory fitness -- metabolic equivalents (METs). METs measure the oxygen required for the energy expended on physical activity, with one MET being the amount needed if a person is sitting quietly (3.5 mL of oxygen per kg of body weight per minute), while high exertion such as running would use about eight METs.

"This indicates that greater cardiorespiratory fitness protects against both chronic and acute heart and blood vessel problems," said Dr Nes. "Even a small increase in fitness could have a large impact on health."

The lead author of the study, Dr Jon Magne Letnes, who is a medical doctor and research fellow in the Cardiac Exercise Research Group at NTNU, said: "Our results should encourage the use of exercise as preventive medicine. A few months of regular exercise may be an efficient way of reducing the cardiovascular risk."

A strength of the study is that cardiorespiratory fitness was measured with a gold-standard maximal exercise test of peak oxygen uptake (VO2peak) -- the first to do this in a healthy sample of the general population. Previous studies that have linked fitness to disease risk in healthy populations are mainly based on self-report or less accurate estimates.

A limitation of the study is that participating in voluntary exercise testing introduces the possibility that more active people might choose to join the study, which might reduce its applicability to the general population.

In an accompanying editorial, Professor Sanjay Sharma, of St George's University of London (UK), who is medical director of the London Marathon and chair of the expert cardiology panel for the English Football Association, and Dr Aneil Malhotra, also of St George's, write: "This study adds to the current literature by demonstrating a similar benefit in an ostensibly healthy population with an incremental benefit that continues beyond 12 METS and suggests that there is no obvious upper threshold for the cardioprotective effects of exercise. Although the number of subjects is laudable, there are several points to note."

They highlight that there is an unavoidable but inherent selection bias towards participants who were motivated to take part and were probably more aware of lifestyle measures to avoid cardiovascular disease; and the participants were young and healthy, which explains the low number of cardiovascualar-related events during the follow-up period.

They conclude: "In an era where primary prevention is playing an increasingly significant role in society, this study helps highlight that improving CRF [cardiorespiratory fitness] is a pivotal factor in reducing CV [cardiovascular] risk and mortality. Regular physical activity and measures of CRF should be incorporated into clinical practice and CV risk models. All individuals should be encouraged to exercise to the minimal level recommended by the European guidelines for disease prevention, although the observations of Letnes and colleagues and several others suggest that substantially higher physical activity levels and CRF provide additional prognostic benefit. For those who are compromised due to comorbidities or functional status, there is overwhelming evidence that some physical activity is better than none."

https://www.sciencedaily.com/releases/2018/11/181128192147.htm

Only 12 percent of American adults are metabolically healthy

Trends help sound alarm for efforts to lower associated risk of types 2 diabetes, heart disease and other complications

November 28, 2018

Science Daily/University of North Carolina at Chapel Hill

The prevalence of metabolic health in American adults is 'alarmingly low,' even among people who are normal weight, according to a new study. Only one in eight Americans is achieving optimal metabolic health. This carries serious implications for public health since poor metabolic health leaves people more vulnerable to developing Type 2 diabetes, cardiovascular disease and other serious health issues.

This study, published Nov. 28 in the journal Metabolic Syndrome and Related Disorders, presents the most updated U.S. data on metabolic health, which is defined as having optimal levels of five factors: blood glucose, triglycerides, high-density lipoprotein cholesterol, blood pressure, and waist circumference, without the need for medications.

For the study, researchers examined National Health and Nutrition Examination Survey data from 8,721 people in the United States between 2009 and 2016 to determine how many adults are at low versus high risk for chronic disease. Data revealed that only 12.2 percent of American adults are metabolically healthy, which means that only 27.3 million adults are meeting recommended targets for cardiovascular risk factors management.

In the last decade the thresholds for common health measures, for example those that are used to determine if someone has high blood pressure or blood sugar levels, have been lowered by respected professional medical societies. These more restrictive guidelines may mean that a smaller proportion of people are meeting the optimal levels for the cardiovascular risk factors.

"The study fills a gap. We wanted to know how many American adults really meet the guidelines for all of these risk factors and are within optimal levels for disease prevention and health," said Joana Araujo, postdoctoral research associate in nutrition and the study's first author. "Based on the data, few Americans are achieving metabolic health, but the most disturbing finding was the complete absence of optimal metabolic health in adults who had obesity, less than a high school education, were not physically active and were current smokers. Our findings should spur renewed attention to population-based interventions and widely accessible strategies to promote healthier lifestyles."

The data showed that being more physically active, female, younger, more educated and a nonsmoker were factors associated with being more metabolically healthy. Whereas, being non-Hispanic black or having a higher body mass index meant people were less likely to be metabolically healthy.

The research team looked at how health-related behaviors might play into metabolic health and how the proportion of people who are metabolically healthy changes when BMI, physical activity or smoking rates are higher or lower. They found that less than 1 percent of obese adults are metabolically healthy. On the other hand, people who exercise more appear to have higher levels of metabolic health.

The authors call for further study to understand the mechanisms of risk factor development, with a focus on people of normal weight as well as heavier adults.

https://www.sciencedaily.com/releases/2018/11/181128115045.htm

Weightlifting is good for your heart and it doesn't take much

November 13, 2018

Science Daily/Iowa State University

Lifting weights for less than an hour a week may reduce your risk for a heart attack or stroke by 40 to 70 percent, according to a new study. Spending more than an hour in the weight room did not yield any additional benefit, the researchers found. The results show benefits of strength training are independent of running, walking or other aerobic activity.

"People may think they need to spend a lot of time lifting weights, but just two sets of bench presses that take less than 5 minutes could be effective," said DC (Duck-chul) Lee, associate professor of kinesiology.

The results -- some of the first to look at resistance exercise and cardiovascular disease -- show benefits of strength training are independent of running, walking or other aerobic activity. In other words, you do not have to meet the recommended guidelines for aerobic physical activity to lower your risk; weight training alone is enough. The study is published in Medicine and Science in Sports and Exercise.

Lee and his colleagues analyzed data of nearly 13,000 adults in the Aerobics Center Longitudinal Study. They measured three health outcomes: cardiovascular events such as heart attack and stroke that did not result in death, all cardiovascular events including death and any type of death. Lee says resistance exercise reduced the risk for all three.

"The results are encouraging, but will people make weightlifting part of their lifestyle? Will they do it and stick with it? That's the million-dollar question," Lee said.

Barriers to resistance training

The researchers recognize that unlike aerobic activity, resistance exercise is not as easy to incorporate into our daily routine. Lee says people can move more by walking or biking to the office or taking the steps, but there are few natural activities associated with lifting. And while people may have a treadmill or stationary bike at home, they likely do not have access to a variety of weight machines.

For these reasons, Lee says a gym membership may be beneficial. Not only does it offer more options for resistance exercise, but in a previous study Lee found people with a gym membership exercised more. While this latest study looked specifically at use of free weights and weight machines, Lee says people will still benefit from other resistance exercises or any muscle-strengthening activities.

"Lifting any weight that increases resistance on your muscles is the key," Lee said. "My muscle doesn't know the difference if I'm digging in the yard, carrying heavy shopping bags or lifting a dumbbell."

Other benefits of strength training

Much of the research on strength training has focused on bone health, physical function and quality of life in older adults. When it comes to reducing the risk for cardiovascular disease, most people think of running or other cardio activity. Lee says weight lifting is just as good for your heart, and there are other benefits.

Using the same dataset, Lee and his colleagues looked at the relationship between resistance exercise and diabetes as well as hypercholesterolemia, or high cholesterol. The two studies, published in Mayo Clinic Proceedings, found resistance exercise lowered the risk for both.

Less than an hour of weekly resistance exercise (compared with no resistance exercise) was associated with a 29 percent lower risk of developing metabolic syndrome, which increases risk of heart disease, stroke and diabetes. The risk of hypercholesterolemia was 32 percent lower. The results for both studies also were independent of aerobic exercise.

"Muscle is the power plant to burn calories. Building muscle helps move your joints and bones, but also there are metabolic benefits. I don't think this is well appreciated," Lee said. "If you build muscle, even if you're not aerobically active, you burn more energy because you have more muscle. This also helps prevent obesity and provide long-term benefits on various health outcomes."

https://www.sciencedaily.com/releases/2018/11/181113115430.htm

A hypocaloric Mediterranean diet and daily exercise maintain weight loss

November 5, 2018

Science Daily/Universitat Rovira i Virgili

Following a Mediterranean diet low in calories and engaging daily physical activity have been demonstrated to result in reduce body weight and cardiovascular risk in overweight patients and patients with metabolic syndrome, and to maintain these benefits after one year.

Overweight or obese patients, particularly those with metabolic syndrome, are often told to lose weight by changing their lifestyle. The aim of these recommendations is to reduce their cardiovascular risk; however, there is no scientific evidence that this beneficial effect can be maintained in the long-term. Although low fat and low carbohydrate diets have proven effective in losing weight and improving cardiovascular risk, the benefits tend to diminish after a year. Following a Mediterranean diet low in calories and engaging daily physical activity have been demonstrated to result in reduce body weight and cardiovascular risk in overweight patients and patients with metabolic syndrome, and to maintain these benefits after one year.

With this investigation, the researchers from the Human Nutrition Unit at the Universitat Rovira i Virgili, in collaboration with 23 other research groups in the PREDIMED-Plus study, have evaluated the changes in body weight, fat accumulation and different cardiovascular risk factors after one year in 626 patients. The results have shown that the lifestyle changes included in the study are effective in maintain clinically significant weight loss. Indeed, after 12 months of intervention, 33.7% of the patients following the hypocaloric Mediterranean diet and daily exercise showed a minimum of 5% weight loss. These patients also showed improvements in those parameters related with glucose metabolism and certain inflammatory markers, in contrast with those patients who did not follow the diet. Furthermore, for those patients with diabetes or at risk of diabetes, the benefits from these lifestyle changes were particularly high in terms of glucose control.

The researchers highlight that, in this study, the greatest weight loss has been found after 12 months, which illustrates that weight loss was maintained over time. In the light of these results, the researchers expect that this weight-loss maintenance in response to the PREDIMED-Plus lifestyle programme can provide the same or more benefits for cardiovascular disease (myocardial infarction, stroke or mortality from these causes) in the long term. In fact, this is the main objective of the PREDIMED-PLUS trial.

https://www.sciencedaily.com/releases/2018/11/181105105353.htm

Vitamin D levels in the blood linked to cardiorespiratory fitness

October 30, 2018

Science Daily/European Society of Cardiology

Vitamin D levels in the blood are linked to cardiorespiratory fitness, according to a study published today in the European Journal of Preventive Cardiology, a publication of the European Society of Cardiology (ESC).

"Our study shows that higher levels of vitamin D are associated with better exercise capacity," said Dr Amr Marawan, assistant professor of internal medicine, Virginia Commonwealth University, Virginia, US. "We also know from previous research that vitamin D has positive effects on the heart and bones. Make sure your vitamin D levels are normal to high. You can do this with diet, supplements, and a sensible amount of sun exposure."

It is well established that vitamin D is important for healthy bones, but there is increasing evidence that it plays a role in other areas of the body including the heart and muscles.

Cardiorespiratory fitness, a reliable surrogate for physical fitness, is the ability of the heart and lungs to supply oxygen to the muscles during exercise. It is best measured as the maximal oxygen consumption during exercise, referred to as VO2 max. People with higher cardiorespiratory fitness are healthier and live longer.

This study investigated whether people with higher levels of vitamin D in the blood have improved cardiorespiratory fitness. The study was conducted in a representative sample of the US population aged 20-49 years using the National Health and Nutrition Survey (NHANES) in 2001-2004. Data was collected on serum vitamin D and VO2 max. Participants were divided into quartiles of vitamin D levels.

Of 1,995 participants, 45% were women, 49% were white, 13% had hypertension, and 4% had diabetes. Participants in the top quartile of vitamin D had a 4.3-fold higher cardiorespiratory fitness than those in the bottom quartile. The link remained significant, with a 2.9-fold strength, after adjusting for factors that could influence the association such as age, sex, race, body mass index, smoking, hypertension, and diabetes.

Dr Marawan said: "The relationship between higher vitamin D levels and better exercise capacity holds in men and women, across the young and middle age groups, across ethnicities, regardless of body mass index or smoking status, and whether or not participants have hypertension or diabetes."

Each 10 nmol/L increase in vitamin D was associated with a statistically significant 0.78 mL/kg/min increase in VO2 max. "This suggests that there is a dose response relationship, with each rise in vitamin D associated with a rise in exercise capacity," said Dr Marawan.

Dr Marawan noted that this was an observational study and it cannot be concluded that vitamin D improves exercise capacity. But he added: "The association was strong, incremental, and consistent across groups. This suggests that there is a robust connection and provides further impetus for having adequate vitamin D levels, which is particularly challenging in cold, cloudy places where people are less exposed to the sun."

On the other hand, Vitamin D toxicity can lead to excess calcium in the blood, which can cause nausea, vomiting, and weakness. "It is not the case that the more vitamin D, the better," said Dr Marawan. "Toxicity is caused by megadoses of supplements rather than diet or sun exposure, so caution is needed when taking tablets."

Regarding further research, Dr Marawan said: "We know the optimum vitamin D levels for healthy bones but studies are required to determine how much the heart needs to function at its best. Randomised controlled trials should be conducted to examine the impact of differing amounts of vitamin D supplements on cardiorespiratory fitness. From a public health perspective, research should look into whether supplementing food products with vitamin D provides additional benefits beyond bone health."

https://www.sciencedaily.com/releases/2018/10/181030091449.htm

When fathers exercise, children are healthier, even as adults

October 22, 2018

Science Daily/Ohio State University Wexner Medical Center

Most parents know that the diet and exercise habits of a pregnant woman impacts the health of her baby, but little is known about how a father's health choices are passed to his children. A new study finds that lifestyle practices of fathers prior to conception may have a major impact on the lifelong health of their children.

In a new study led by Kristin Stanford, a physiology and cell biology researcher with The Ohio State University College of Medicine at the Wexner Medical Center, paternal exercise had a significant impact on the metabolic health of offspring well into their adulthood.

Laurie Goodyear of the Joslin Diabetes Center and Harvard Medical School co-led the study, published today in the journal Diabetes.

"This work is an important step in learning about metabolic disease and prevention at the cellular level," said Dr. K. Craig Kent, dean of the Ohio State College of Medicine.

Recent studies have linked development of type 2 diabetes and impaired metabolic health to the parents' poor diet, and there is increasing evidence that fathers play an important role in obesity and metabolic programming of their offspring.

Stanford is a member of Ohio State's Diabetes and Metabolism Research Center. Her team investigated how a father's exercise regimen would affect his offspring's metabolic health. Using a mouse model, they fed male mice either a normal diet or a high-fat diet for three weeks. Some mice from each diet group were sedentary and some exercised freely. After three weeks, the mice bred and their offspring ate a normal diet under sedentary conditions for a year.

The researchers report that adult offspring from sires who exercised had improved glucose metabolism, decreased body weight and a decreased fat mass.

"Here's what's really interesting; offspring from the dads fed a high-fat diet fared worse, so they were more glucose intolerant. But exercise negated that effect," Stanford said. "When the dad exercised, even on a high-fat diet, we saw improved metabolic health in their adult offspring."

Stanford's team also found that exercise caused changes in the genetic expression of the father's sperm that suppress poor dietary effects and transfer to the offspring.

"We saw a strong change in their small-RNA profile. Now we want to see exactly which small-RNAs are responsible for these metabolic improvements, where it's happening in the offspring and why," Stanford said.

Previous studies from this group have shown that when mouse mothers exercise, their offspring also have beneficial effects of metabolism.

"Based on both studies, we're now determining if both parents exercising has even greater effects to improve metabolism and overall health of offspring. If translated to humans, this would be hugely important for the health of the next generation," Goodyear said.

The researchers believe the results support the hypothesis that small RNAs could help transmit parental environmental information to the next generation.

"There's potential for this to translate to humans. We know that in adult men obesity impairs testosterone levels, sperm number and motility, and it decreases the number of live births," Stanford said. "If we ask someone who's getting ready to have a child to exercise moderately, even for a month before conception, that could have a strong effect on the health of their sperm and the long-term metabolic health of their children."

Other Ohio State researchers involved in the study were Lisa Baer, Adam Lehnig and Joseph White.

Funding from the National Institutes of Health supported this research.

https://www.sciencedaily.com/releases/2018/10/181022085844.htm

Aerobic exercise has antidepressant treatment effects

October 17, 2018

Science Daily/University of Michigan

One question that scientists and fitness experts alike would love to answer is whether exercise or nutrition has a bigger positive impact on bone strength.

University of Michigan researchers looked at mineral supplementation and exercise in mice, and found surprising results -- nutrition has a greater impact on bone mass and strength than exercise. Further, even after the exercise training stopped, the mice retained bone strength gains as long as they ate a mineral-supplemented diet.

"The longer-term mineral-supplemented diet leads to not only increases in bone mass and strength, but the ability to maintain those increases even after detraining," said David Kohn, a U-M professor in the schools of dentistry and engineering. "This was done in mice, but if you think about the progression to humans, diet is easier for someone to carry on as they get older and stop exercising, rather than the continuation of exercise itself."

The second important finding is that the diet alone has beneficial effects on bone, even without exercising. This surprised Kohn, who expected exercise with a normal diet to fuel greater gains in bone strength, but that wasn't the case.

"The data suggests the long-term consumption of the mineral-supplemented diet could be beneficial in preventing the loss of bone and strength with age, even if you don't do exercise training," he said.

Combining the two amplifies the effect.

Most other studies look at effects of increasing dietary calcium, Kohn said. The U-M study increased calcium and phosphorus, and found benefits to increasing both.

This isn't to suggest that people run out and buy calcium and phosphorus supplements, Kohn said. The findings don't translate directly from mice to humans, but they do give researchers a conceptual place to start.

It's known that humans achieve peak bone mass in their early 20s, and after that it declines. The question becomes how to maximize the amount of bone when young, so that when declines do begin, people start from a better position, Kohn said.

In addition to testing bone mass and strength, Kohn and colleagues performed a full battery of mechanical assessments on the bone, which is important because the amount of bone doesn't always scale with or predict the mechanical quality of the tissue.

They tested the mice after eight weeks of training and supplemented diet or normal diet, and then after eight weeks of detraining.

https://www.sciencedaily.com/releases/2018/10/181017080802.htm

Endurance exercise training has beneficial effects on gut microbiota composition

October 15, 2018

Science Daily/University of Jyväskylä - Jyväskylän yliopisto

According to recent research, endurance exercise training beneficially modifies gut microbiota composition. After six weeks of training, potentially inflammation causing microbes (Proteobacteria) decreased and microbes that are linked to enhanced metabolism (Akkermansia) increased.

Even though there was no significant drop in the weight of the subjects, exercise had other beneficial health effects, says Academy of Finland research fellow Satu Pekkala from the Faculty of Sport and Health Sciences of the University of Jyväskylä.

"We found that phospholipids and cholesterol in VLDL particles decreased in response to exercise. These changes are beneficial for cardiometabolic health because VLDL transports lipids from the liver to peripheral tissues, converts into 'bad' LDL cholesterol in the circulation, and thus has detrimental cardiovascular effects."

Exercise training also decreased Vascular adhesion protein-1 activity, which can have beneficial anti-inflammatory effects especially on vasculature, though the underlying mechanisms could not be determined in this study.

Whether Akkermansia mediates the health benefits of exercise is under further investigation

A few other cross-sectional studies have shown that microbes belonging to the Akkermansia genus are more abundant among physically active subjects than they are among inactive ones. Akkermansia has been a target of intense research recently, and some researchers believe that it may prevent obesity and diabetes.

"However, more studies are needed to prove that Akkermansia might mediate some of the health benefits of exercise," Pekkala says.

In addition to the composition of the gut microbiota, changes in their genes, that is, in their functionality, were studied.

"The abundance of the functional genes did not change much, which was perhaps to be expected because the diet did not change during training," Pekkala points out. "If the training period had been longer, greater effects probably would have been seen."

The research team made an exercise intervention for overweight women, which was completed by 17 subjects. Over a six-week period, previously sedentary women participated in three training sessions per week with a bicycle ergometer. The training intensity was controlled with heart rate. During the study, other lifestyle factors, including diet, were not changed in order to ensure that the effects of exercise could be observed. The research was carried out as a collaboration between the Faculty of Sport and Health Sciences of the University of Jyväskylä, University of Turku and the Spanish nonprofit research and healthcare organization FISABIO.

https://www.sciencedaily.com/releases/2018/10/181015105451.htm

Increasing vigorous exercise decreases risk of type two diabetes, cardiovascular disease in childhood

October 15, 2018

Science Daily/University of Eastern Finland

Physical exercise can reduce the risk factors of type two diabetes and cardiovascular disease even in children, a new study shows. In a two-year follow-up of primary school children, sedentary behavior increased the accumulation of risk factors, whereas increasing the amount of vigorous exercise reduced it. This is one of the first follow-up studies to reliably demonstrate these associations in children.

The results are based on follow-up data from the Physical Activity and Nutrition in Children (PANIC) Study, ongoing at the University of Eastern Finland. Conducted in collaboration with scientists from the University of Cambridge, the Norwegian School of Sport Sciences and the University of Copenhagen, the findings of the study were published in the Scandinavian Journal of Medicine & Science in Sports.

The two-year follow-up study analysed associations of changes in the amount of vigorous, moderate and light exercise, as well as sedentary behaviour, with risk factors of type 2 diabetes and cardiovascular disease, such as body fat content, waist circumference, blood insulin and glucose levels, blood lipids and blood pressure. The amounts of vigorous, moderate and light exercise, as well as sedentary behaviour, were objectively measured using the Actiheart® device, which records heart rate and body movement. Children wore the Actiheart® device continuously for a minimum of four days, and the measurement period included weekdays and days of the weekend.

During the two-year follow-up, the overall risk and individual risk factors of type 2 diabetes and cardiovascular reduced in children who increased their amount of vigorous exercise. In children whose sedentary behaviour increased, the risk increased as well. These changes were independent of gender, biological maturity and lean body mass, as well as of the levels of risk factors and physical activity measured at the beginning of the study. The study is highly significant, as it is one of the first follow-up studies in the world to reliably show that increasing the amount of vigorous exercise is independently associated with a reduced risk of type 2 diabetes and cardiovascular disease in ordinary primary school children.

"A physically passive lifestyle is gradually becoming alarmingly widespread among children and young people almost all over the world. Our findings provide support for the role of physical activity in preventing common chronic diseases already in childhood," says Researcher Juuso Väistö, the first author of the article, from the University of Eastern Finland.

He points out that children and young people should engage in more physical exercise than what it takes to go about their daily activities.

"Our findings show that increasing the amount of vigorous exercise and reducing sedentary behaviour are equally important in preventing type 2 diabetes and cardiovascular disease. According to latest recommendations, children need diverse physical activity every day, and at least 60 minutes should be vigorous exercise. In practice, vigorous exercise refers to exercise or games that cause shortness of breath and perspiration."

Prevention of type 2 diabetes and cardiovascular disease are best begun already in childhood

The PANIC Study has earlier shown that the accumulation of risk factors of type 2 diabetes and cardiovascular disease, which typically exists in people who are overweight, often begins already in childhood. This is a cause for concern, as the accumulation of risk factors in childhood significantly increases the risk of these diseases in adulthood. According to this newly published study, regular exercise and avoiding a physically passive lifestyle constitute efficient means of mitigating the risk factors type 2 diabetes and cardiovascular disease.

PANIC Study -- a source of scientifically valuable data on children's health

The Physical Activity and Nutrition in Children (PANIC) Study is an on-going lifestyle intervention study. A total of 512 children aged 6 to 8 years participated in the onset measurements in 2007-2009. The study applies scientifically sound methods to extensively study the lifestyles, health and well-being of children. The study provides novel information on children's physical activity, sedentary behaviour, nutrition, physical fitness, body composition, metabolism, cardiovascular system function, brain function, oral health, life quality, effects of exercise and nutrition on children's health and well-being, and on the effects of these factors on health care costs.

https://www.sciencedaily.com/releases/2018/10/181015100459.htm

Exercise reduces stress, improves cellular health in family caregivers

October 3, 2018

Science Daily/University of British Columbia

Exercising at least three times a week for six months reduced stress in a group of family caregivers and even appeared to lengthen a small section of their chromosomes that is believed to slow cellular aging.

"I am hoping that a new focus on the family caregiver will emerge out of this research," said Eli Puterman, a professor in the University of British Columbia's school of kinesiology and lead author of the study. "We need to design interventions that help caregivers take care of their bodies and their minds, and provide the type of support that's needed to maintain that long-term."

The population of seniors in the U.S., where Puterman and colleagues from the University of California conducted the study, is expected to nearly double by 2050. Younger family members will increasingly be providing this type of care and it can take a toll on their health.

"What caregivers need is support for healthy behaviours, because that is one of the first things to drop when you become a family caregiver," said Puterman. "The time to take care of yourself just goes out the window."

The researchers recruited physically inactive people who care for family members with Alzheimer's disease and dementia, and who reported feeling high levels of stress. The 68 participants were divided randomly into two groups. One group undertook 40 minutes of aerobic exercise three to five times per week, while the others were asked not to alter their level of activity. Those in the exercise group had free access to a gym, and a fitness coach for weekly conversations. Eighty-one per cent of them adhered to at least 120 minutes of exercise per week for the duration of the study.

At the end of the study, not only had the caregivers improved their cardiorespiratory fitness, reduced their body mass index and trimmed their waistlines, they also reported lower levels of perceived stress.

At the cellular level, the researchers observed longer telomeres in the participants' white blood cells after the program. Telomeres protect the ends of chromosomes, much like the aglets that protect the ends of shoelaces. Without them, chromosomes shorten to the point where they either die or enter a state called "senescence," in which they stop replicating. Senescent cells have been shown to be predictive of future health problems such as cardiovascular disease.

The study's findings suggest that in addition to reducing stress, exercise can slow or even reverse telomeric aging in a highly stressed, at-risk group.

https://www.sciencedaily.com/releases/2018/10/181003090339.htm

Exercise may lessen fall risk for older adults with Alzheimer's

Study indicates exercise may decrease risk of falling for older adults who have Alzheimer's disease and mental health challenges

October 29, 2018

Science Daily/American Geriatrics Society

A research team decided to explore whether exercise could reduce the risk of falling among community-dwelling people with Alzheimer's Disease who also had neuropsychiatric symptoms.

Alzheimer's disease (AD) is a brain disease that causes changes that kill brain cells. AD is a type of dementia, which causes memory loss and problems with thinking and making decisions. People with AD and other forms of dementia have difficulties performing the daily activities others might consider routine.

Dementia takes a toll on those who live with it -- and it also places a burden on caregivers. Along with problems connected to memory, language, and decision-making, dementia can cause neuropsychiatric symptoms, such as depression, anxiety, changes in mood, increased irritability, and changes in personality and behavior. People who have AD/dementia also have twice the risk for falls compared to people without dementia. About 60 percent of older adults with dementia fall each year.

Researchers suggest that having neuropsychiatric symptoms might predict whether an older person with AD/dementia is more likely to have a fall. We also know that exercise can reduce the number of falls in older adults with dementia. However, we don't know very much about how neuropsychiatric symptoms may increase the risk of falls, and we know even less about how exercise may reduce the risk of falls for people with dementia and neuropsychiatric symptoms. A research team decided to explore whether exercise could reduce the risk of falling among community-dwelling people with AD who also had neuropsychiatric symptoms.

To learn more, the researchers reviewed a study that investigated the effects of an exercise program for older adults with AD (the FINALEX trial). The study included a range of people living with different stages of AD/dementia and with neuropsychiatric symptoms. Their findings were published in the Journal of the American Geriatrics Society.

The original FINALEX study examined and compared older adults who had home- or group-based exercise training with people who didn't exercise but who received regular care. The researchers learned that the people who exercised had a lower risk for falls than those who didn't exercise. There was also a higher risk for falls among those who had lower scores on psychological tests and who didn't exercise.

This study revealed that people with AD/dementia and neuropsychiatric symptoms such as depression and anxiety have a higher risk for falls. Exercise can reduce the risk of falling for older adults with these symptoms. Further studies are needed to confirm these results.

https://www.sciencedaily.com/releases/2018/10/181029135235.htm

Exercise linked to improved mental health, but more may not always be better

August 8, 2018

Science Daily/The Lancet

A study of 1.2 million people in the USA has found that people who exercise report having 1.5 fewer days of poor mental health a month, compared to people who do not exercise. The study found that team sports, cycling, aerobics and going to the gym are associated with the biggest reductions, according to the largest observational study of its kind.

More exercise was not always better, and the study found that exercising for 45 minutes three to five times a week was associated with the biggest benefits.

The study included all types of physical activity, ranging from childcare, housework, lawn-mowing and fishing to cycling, going to the gym, running and skiing.

Exercise reduces the risk of cardiovascular disease, stroke, diabetes, and mortality from all causes, but its association with mental health remains unclear.

Previous research into the effect of exercise on mental health has conflicting results. While some evidence suggests that exercise may improve mental health, the relationship could go both ways -- for example inactivity could be a symptom of and contributor to poor mental health, and being active could be a sign of or contribute to resilience. The authors note that their study cannot confirm cause and effect.

"Depression is the leading cause of disability worldwide, and there is an urgent need to find ways to improve mental health through population health campaigns," says Dr Adam Chekroud, Assistant Professor of Psychiatry at Yale University, and Chief Scientist at Spring Health, USA. "Exercise is associated with a lower mental health burden across people no matter their age, race, gender, household income and education level. Excitingly, the specifics of the regime, like the type, duration, and frequency, played an important role in this association. We are now using this to try and personalise exercise recommendations, and match people with a specific exercise regime that helps improve their mental health."

In the study, the authors used data from 1.2 million adults across all 50 US states who completed the Behavioural Risk Factor Surveillance System survey in 2011, 2013, and 2015. This included demographic data, as well as information about their physical health, mental health, and health behaviours. The study did not take mental health disorders into account, other than depression.

Participants were asked to estimate how many days in the past 30 days they would rate their mental health as 'not good' based on stress, depression and emotional problems. They were also asked how often they took part in exercise in the past 30 days outside of their regular job, as well as how many times a week or month they did this exercise and for how long.

All results were adjusted for age, race, gender, marital status, income, education level, employment status, BMI, self-reported physical health and previous diagnosis of depression.

On average, participants experienced 3.4 days of poor mental health each month.

Compared to people who reported doing no exercise, people who exercised reported 1.5 fewer days of poor mental health each month -- a reduction of 43.2% (2.0 days for people who exercised vs 3.4 days for people who did not exercise).

The reduction in number of poor mental health days was larger for people who had previously been diagnosed with depression, where exercise was associated with 3.75 fewer days of poor mental health compared with people who did not exercise -- equivalent to a 34.5% reduction (7.1 days for people who exercised vs 10.9 days for people who did not exercise).

Overall, there were 75 types of exercise recorded and these were grouped into eight categories -- aerobic and gym exercise, cycling, household, team sports, recreational activity, running and jogging, walking, and winter or water sports.

All types of exercise were associated with improved mental health, but the strongest associations for all participants were seen for team sports, cycling, aerobic and gym exercise (reduction in poor mental health days of 22.3%, 21.6%, and 20.1%, respectively).

Even completing household chores was associated with an improvement (reduction in poor mental health days of around 10%, or around half a day less each month).

The association between exercise and improved mental health (a 43.2% reduction in poor mental health) was larger than many modifiable social or demographic factors. For example, people with a college education had a 17.8% reduction in poor mental health days compared with people with no education, people with normal BMI had a 4% reduction compared with people who were obese, and people earning more than US$50,000 had a 17% reduction compared with people earning less than US$15,000.

How often and for how long people completed exercise was also an important factor. People who exercised between three and five times a week had better mental health than people who exercised less or more each week (associated with around 2.3 fewer days of poor mental health compared with people who exercised twice a month).

Exercising for 30-60 minutes was associated with the biggest reduction in poor mental health days (associated with around 2.1 fewer days of poor mental health compared with people who did not exercise). Small reductions were still seen for people who exercised more than 90 minutes a day, but exercising for more than three hours a day was associated with worse mental health than not exercising at all. The authors note that people doing extreme amounts of exercise might have obsessive characteristics which could place them at greater risk of poor mental health.

"Previously, people have believed that the more exercise you do, the better your mental health, but our study suggests that this is not the case. Doing exercise more than 23 times a month, or exercising for longer than 90 minute sessions is associated with worse mental health," continues Dr Chekroud.

"Our finding that team sports are associated with the lowest mental health burden may indicate that social activities promote resilience and reduce depression by reducing social withdrawal and isolation, giving social sports an edge over other kinds."

The study used people's self-reported assessment of their mental health and exercise levels so could be subject to bias. It also only asked participants about their main form of exercise so could underestimate the amount of exercise they do if they do more than one type.

Writing in a linked Comment, Dr Gary Cooney, Gartnavel Royal Hospital, UK, says: "There is gathering interest and momentum around research into exercise as a treatment for mental health disorders. The appeal is multifaceted: patients, particularly those reluctant to pursue medication or psychological approaches, are drawn to the self efficacy of exercise, the ability to attain a degree of agency in their own process of recovery. Mental health professionals, for their part, recognise the urgent need to address the comparatively poor physical health outcomes in the psychiatric patient population. With very high rates of physical comorbidity, and marked reductions in life expectancy, an intervention that might improve both mental and physical health is of particular clinical interest."

https://www.sciencedaily.com/releases/2018/08/180808193656.htm

Exercise cuts risk of chronic disease in older adults

July 23, 2018

Science Daily/Westmead Institute for Medical Research

People who engaged in the highest levels of total physical activity were twice as lively to avoid stroke, heart disease, angina, cancer and diabetes, and be in optimal physical and mental shape 10 years later, experts found.

Researchers at the Westmead Institute for Medical Research interviewed more than 1,500 Australian adults aged over 50 and followed them over a 10-year period.

People who engaged in the highest levels of total physical activity were twice as lively to avoid stroke, heart disease, angina, cancer and diabetes, and be in optimal physical and mental shape 10 years later, experts found.

Lead Researcher Associate Professor Bamini Gopinath from the University of Sydney said the data showed that adults who did more than 5000 metabolic equivalent minutes (MET minutes) each week saw the greatest reduction in the risk of chronic disease.

"Essentially we found that older adults who did the most exercise were twice as likely to be disease-free and fully functional," she said.

"Our study showed that high levels of physical activity increase the likelihood of surviving an extra 10 years free from chronic diseases, mental impairment and disability."

Currently, the World Health Organization recommends at least 600 MET minutes of physical activity each week. That is equivalent to 150 minutes of brisk walking or 75 minutes of running.

"With aging demographics in most countries, a major challenge is how to increase the quality and years of healthy life," Associate Professor Gopinath said.

"Our findings suggest that physical activity levels need to be several times higher than what the World Health Organization currently recommends to significantly reduce the risk of chronic disease.

"Some older adults may not be able to engage in vigorous activity or high levels of physical activity.

"But we encourage older adults who are inactive to do some physical activity, and those who currently only engage in moderate exercise to incorporate more vigorous activity where possible," she concluded.

The research compiled data from the Blue Mountains Eye Study, a benchmark population-based study that started in 1992.

It is one of the world's largest epidemiology studies, measuring diet and lifestyle factors against health outcomes and a range of chronic diseases.

https://www.sciencedaily.com/releases/2018/07/180723142920.htm