New Study: Six Years Of Exercise May Be Enough To Change Heart Failure Risk

By analyzing reported physical activity levels over time in more than 11,000 American adults, Johns Hopkins Medicine researchers conclude that increasing physical activity to recommended levels over as few as six years in middle age is associated with a significantly decreased risk of heart failure. This condition affects an estimated five million to six million Americans. The same analysis found that as little as six years without physical activity in middle age was linked to an increased risk of the disorder.

Unlike heart attack, in which heart muscle dies, heart failure is marked by a long-term, chronic inability of the heart to pump enough blood, or pump it hard enough, to bring needed oxygen to the body. The leading cause of hospitalizations in those over 65, the disorder’s risk factors include high blood pressure, high cholesterol, diabetes, smoking and a family history.

“In everyday terms our findings suggest that consistently participating in the recommended 150 minutes of moderate to vigorous activity each week, such as brisk walking or biking, in middle age may be enough to reduce your heart failure risk by 31 percent,” says Chiadi Ndumele, M.D., M.H.S., the Robert E. Meyerhoff Assistant Professor of Medicine at the Johns Hopkins University School of Medicine, and the senior author of a report on the study. “Additionally, going from no exercise to recommended activity levels over six years in middle age may reduce heart failure risk by 23 percent.”

The researchers caution that their study, described in the journal Circulation, was observational, meaning the results can’t and don’t show a direct cause-and-effect link between exercise and heart failure. They say the trends observed in data gathered on middle-aged adults suggest that it may never be too late to reduce the risk of heart failure with moderate exercise.

Strategies For Prevention

“The population of people with heart failure is growing because people are living longer and surviving heart attacks and other forms of heart disease,” says Roberta Florido, M.D., cardiology fellow at the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease. “Unlike other heart disease risk factors like high blood pressure or high cholesterol, we don’t have specifically effective drugs to prevent heart failure, so we need to identify and verify effective strategies for prevention and emphasize these to the public.” There are drugs used to treat heart failure, such as beta blockers and ACE inhibitors, but they are essentially “secondary” prevention drugs, working to reduce the heart’s workload after dysfunction is already there.

Several studies suggest that in general people who are more physically active have lower risks of heart failure than those who are less active, but little was known about the impact of changes in exercise levels over time on heart failure risk. For example, if you are sedentary most of your life but then start exercising in middle age, does that decrease your risk of heart failure? Or, if you are active much of your life but then stop being active at middle age, will that increase your risk?

To address those questions, the researchers used data already gathered from 11,351 participants in the federally-funded, long-term Atherosclerosis Risk in Communities (ARIC) study, recruited from 1987 to 1989 in Forsyth County, North Carolina; Jackson, Mississippi; greater Minneapolis, Minnesota; and Washington County, Maryland. The participants’ average age was 60. Fifty-seven percent were women and most were either white or African-American. Participants were monitored annually for an average of 19 years for cardiovascular disease events such as heart attack, stroke and heart failure using telephone interviews, hospital records and death certificates. Over the course of the study there were 1,693 hospitalizations and 57 deaths due to heart failure.

In addition to those measures, at the first and third ARIC study visits – six years apart – each participant filled out a questionnaire, which asked them to evaluate their physical activity levels, which were then categorized as poor, intermediate or “recommended,” in alignment with guidelines issued by the American Heart Association. The “recommended” amount is at least 75 minutes per week of vigorous intensity or at least 150 minutes per week of moderate intensity exercise. One to 74 minutes per week of vigorous intensity or one to 149 minutes per week of moderate exercise per week counted as intermediate level activity. And physical activity qualified as “poor” if there was no exercise at all.

After the third visit, 42 percent of participants – 4,733 people – said they performed recommended levels of exercise; 23 percent – 2,594 people – said they performed intermediate levels; and 35 percent – 4,024 people – said they had poor levels of activity. From the first to the third visit over about six years, 24 percent of participants increased their physical activity, 22 percent decreased it and 54 percent stayed in the same category. Those with recommended activity levels at both the first and third visits showed the highest associated heart failure risk decrease – at 31 percent – compared with those with consistently poor activity levels.

Reducing Heart Failure Risk

Heart failure risk decreased by about 12 percent in the 2,702 participants who increased their physical activity category from poor to intermediate or recommended, or from intermediate to recommended, compared with those with consistently poor or intermediate activity ratings. Conversely, heart failure risk increased by 18 percent in the 2,530 participants who reported decreased physical activity from visit one to visit three, compared with those with consistently recommended or intermediate activity levels.

The researchers determined how much of an increase in exercise, among those initially doing no exercise, was needed to reduce the risk of future heart failure. Exercise was calculated as METs (metabolic equivalents), where one MET is 1 kilocalorie per kilogram per hour. Essentially, sitting watching television is 1 MET, fast walking is 3 METs, jogging is 7 METs and jumping rope is 10 METs. The researchers calculated outcomes in METs times the number of minutes of exercise. The researchers found that each 750 MET minutes per week increase in exercise over six years reduced heart failure risk by 16 percent. And each 1,000 MET minutes per week increase in exercise was linked to a reduction in heart failure risk by 21 percent.

Benefits Of Physical Activity Vs. Impact Of Obesity

The benefits of physical activity may outweigh the impact of overweight and obesity on cardiovascular disease in middle-aged and elderly people, according to research published in the European Journal of Preventive Cardiology. The observational study was conducted in more than 5,000 people aged 55 years and older who were followed-up for 15 years. “Obesity is associated with a higher risk of cardiovascular disease and it is recommended to lose weight,” said author Dr. Klodian Dhana, a postdoctoral researcher in the Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, the Netherlands. “But in the elderly this is slightly different because weight loss, especially unintentional, is associated with muscle loss and death. Physical activity is associated with a lower risk of cardiovascular disease regardless of age. We investigated the combined impact of body mass index (BMI) and physical activity on cardiovascular disease in the middle age to elderly population.”

The study included 5,344 individuals aged 55 to 97 years of age  – average 70 years – who participated in the Rotterdam Study and were free of cardiovascular disease at baseline. Information about BMI, physical activity, smoking, alcohol use, diet, education, and family history of premature heart attack was collected during the enrollment period from 1997 to 2001. Participants were categorized by BMI: normal weight, overweight, and obese; and physical activity, which was below and above the median in the study population. The group was followed from 1997 to 2012 for cardiovascular events – heart attack and stroke.

During the 15-year follow-up, 16% of participants had a cardiovascular event. When analyzed alone, physical activity was associated with a decreased risk of cardiovascular disease regardless of BMI category. There was no association between BMI alone and cardiovascular disease. “In the overall population we found that physical activity was protective for cardiovascular risk,” Dhana said. “Overweight and obese participants were not at increased cardiovascular risk compared to those of normal weight. We do not refute the risk associated with obesity in the general population even though we did not find it in this older group. BMI may not be the best way to measure adiposity risk in the elderly.”

The Impact Of BMI

The researchers analyzed the joint effect of physical activity and BMI. Compared to normal weight people with high physical activity levels, overweight or obese individuals with high levels of physical activity were not at increased risk of cardiovascular disease, but overweight or obese people with low levels of physical activity had 1.33 and 1.35 times higher risk for developing cardiovascular disease, respectively. “Our results show that physical activity plays a crucial role in the health of middle age to elderly people,” Dhana said. “Those who are overweight and obese without adequate physical activity are at higher risk of developing cardiovascular disease.”

Those overweight or obese exert harmful effects through adipose tissue which accelerates the atherosclerotic process and increases cardiovascular risk. Physical activity lowers the harmful effects of atherosclerosis by reducing the stabilization of plaques on blood vessels and reducing the heart’s oxygen demand. “People who engage in high levels of physical activity are protected from the harmful effects of adipose tissue on cardiovascular disease,” Dhana said. “This may be why we found that the beneficial impact of physical activity on cardiovascular disease outweighs the negative impact of BMI.”

The Rotterdam Study was an active population, with the “low” and “high” groups doing two and four hours of daily activity. This included biking, walking and housework. The important point was that the study compared the two groups and found that more activity was better for health. “Any physical activity is positive for cardiovascular health and in elderly people of all weights walking, biking and housework are good ways to keep moving,” Dhana added. “European guidelines recommend 150 minutes a week of moderate intensity physical activity to decrease the risk of cardiovascular disease.”

Mindful Motivation To Move

A meditation and stress reduction program may be as effective at getting people to move more as structured exercise programs, according to a new study led by an Iowa State University researcher. The study compared two intervention programs – mindfulness-based stress reduction and aerobic exercise training – with a control group and measured changes in exercise, general physical activity and sedentary time. People assigned to the two interventions were more active than those in the control group, logging roughly an extra 75 minutes a week of moderate-to-vigorous physical activity following the eight-week interventions. The results are published in the journal Medicine & Science in Sports & Exercise.

Jacob Meyer, an ISU assistant professor of kinesiology, and his colleagues at the University of Wisconsin-Madison and University of Mississippi Medical Center, say helping sedentary adults get those 75 minutes of exercise can extend life expectancy by nearly two years. Researchers expected the exercise intervention to increase physical activity more than the meditation training. Meyer says to see similar results from the mindfulness intervention was somewhat surprising. “Structured exercise training is something as a field we have used for decades to improve physical activity and physical health,” Meyer said. “To see a similar effect on physical activity from an intervention that focuses on the way someone thinks or perceives the world, was completely unexpected.”

The researchers used a mindfulness-based stress reduction program developed by Jon Kabat-Zinn, which aims to reduce stress through meditation, self-awareness and being present in the moment. People in the mindfulness intervention spent two-and-a-half hours a week in class learning how to be mindful. They practiced mindful stretching and movement as well as breathing exercises to incorporate into their daily activities. Similarly, those in the exercise group attended two-and-a-half hour weekly sessions learning various exercise techniques and discussing strategies to change behavior. An hour of each class was dedicated to a group activity such as walking or jogging. Both groups were encouraged to do the intervention at home for 20 to 45 minutes each day.

Shifting From Structured Exercise To Overall Movement

While the interventions did not significantly increase time spent exercising or decrease sedentary time, participants generally maintained activity levels. This is important given the timeframe for the study. Researchers collected data during the fall and early winter months as part of a larger study focused on the cold and flu season. Seasonal variation in weather likely contributed to the sharp decline in activity for the control group, but the intervention groups did not experience the same drop-off. The study focused on exercise in bouts that lasted at least 10 minutes, but also tracked general physical activity, such as walking from the parking lot to the office or working in the yard. Both intervention groups saw smaller drop-offs in general activity levels than the control group.

Researchers used the 10-minute threshold to be consistent with guidelines of 150 minutes of moderate-to-vigorous exercise weekly, in bouts of at least 10 minutes. However, the recommendations only focus on a small percentage – 1.5 percent – of minutes in the week. That is one reason why updated federal guidelines emphasize overall activity regardless of length of time. “There are clinical and cardiovascular health benefits to exercise training, but there are also important general health benefits from a more active lifestyle,” Meyer said. “Shifting from thinking we need to be in a gym for an hour at a time to thinking about being more active throughout the day helps people understand how physical activity could play a role in helping improve their health.”

Resistance Training And Depression

A primary focus of Meyer’s research examines the benefits of exercise for people with depression. As part of a separate study, Meyer worked with researchers at the University of Limerick in Ireland and Karolinska Institutet in Sweden to test the effects of resistance training on symptoms of depression. The results, published in JAMA Psychiatry, found weightlifting and muscle-strengthening exercises significantly reduced depressive symptoms.

The meta-analysis, led by Brett Gordon at the University of Limerick, included 33 randomized controlled trials with more than 1,800 participants. Resistance training reduced symptoms for adults regardless of health status, the volume of training and whether or not strength improved. The results appear similar to the benefits from aerobic exercise found in other studies. Depression affects more than 300 million people, according to the World Health Organization. Meyer says resistance training could provide a treatment option with benefits that extend beyond mental health. In the paper, researchers explain the economic costs as well as other health risks associated with depression. Resistance training also gives patients an alternative to medication.

“For general feelings of depression and the beginning phases of major depression, antidepressants and medications may not be very effective,” Meyer said. “There also is a shift toward finding options that do not require someone to start a drug regimen they may be on for the rest of their lives. Understanding that resistance training appears to have similar benefits to aerobic exercise may help those wading through daunting traditional medication treatment options.” Future research is needed to know if aerobic exercise and resistance training work through similar channels to reduce depressive symptoms or work independently.

Stairs For Stimulation

A midday jolt of caffeine isn’t as powerful as walking up and down some stairs, according to research from the University of Georgia. In a study published in the journal Physiology and Behavior, researchers in the UGA College of Education found that 10 minutes of walking up and down stairs at a regular pace was more likely to make participants feel energized than ingesting 50 milligrams of caffeine – about the equivalent to the amount in a can of soda.

“We found, in both the caffeine and the placebo conditions, that there was not much change in how they felt,” said Patrick J. O’Connor, a professor in the department of kinesiology who co-authored the study with former graduate student Derek Randolph. “But with exercise they did feel more energetic and vigorous. It was a temporary feeling, felt immediately after the exercise, but with the 50 milligrams of caffeine, we didn’t get as big an effect.”

The study aimed to simulate the hurdles faced in a typical office setting, where workers spend hours sitting and staring at computer screens and don’t have time for a longer bout of exercise during the day. For the study, participants on separate days either ingested capsules containing caffeine or a placebo, or spent 10 minutes walking up and down stairs – about 30 floors total – at a low-intensity pace. O’Connor wanted to compare an exercise that could be achieved by people in an office setting, where they have access to stairs and a little time to be active, but not enough time to change into workout gear, shower and change back into work clothes.

“Office workers can go outside and walk, but weather can be less than ideal. It has never rained on me while walking the stairs,” said O’Connor. “And a lot of people working in office buildings have access to stairs, so it’s an option to keep some fitness while taking a short break from work.” Study participants were female college students who described themselves as chronically sleep deprived – getting less than six-and-a-half hours per night. To test the effects of caffeine versus the exercise, each group took some verbal and computer-based tests to gauge how they felt and how well they performed certain cognitive tasks. Neither caffeine nor exercise caused large improvements in attention or memory, but stair walking was associated with a small increase in motivation for work.

There is still much research to be done on the specific benefits of exercising on the stairs, especially for just 10 minutes. But even a brief bout of stair walking can enhance feelings of energy without reducing cognitive function. “You may not have time to go for a swim, but you might have 10 minutes to walk up and down the stairs,” O’Connor added.

Standing May Save You From Sedentary Lifestyle

While it’s normal for many people to be stuck at their desks for hours upon hours during the day, this trend isn’t good for body composition or health. In fact, it has been shown that individuals who lead more sedentary lifestyles that aren’t physically active are more prone to being overweight and having other health risks.  A study that was conducted in Europe may have found a feasible and easy antidote to this problem. The study examined if the simple act of standing is conducive to weight loss and improved health.

The study first reviewed many prior studies with data points that took into consideration overall health, weight, amount of time standing and sitting as well as other factors. The average age of the participants was 33. Researchers found that standing burned 0.15 calories per minute more than sitting. By that math, standing for even a fraction of the day would lead to expending more calories per day. This is obviously assuming there is no additional calories being added to the person’s diet. Just three hours standing would account for nearly three pounds a year.

N.E. A. T.

“Overall, our study shows that, when you put all the available scientific evidence together, standing accounts for more calories burned than sitting,” says senior author Francisco Lopez-Jimenez. “Standing for long periods of time for many adults may seem unmanageable, especially those who have desk jobs, but for the person who sits for 12 hours a day, cutting sitting time to half would give great benefits. Standing is one of the components of N.E.A.T. (non-exercise activity thermogenesis), and the results of our study support this theory. The idea is to work into our daily routines some lower-impact activities that can improve our long-term health.”

This is excellent news because the difference between sitting and standing for most people that have desk jobs isn’t necessarily that difficult. Getting a standing desk or an insert that allows you to put your keyboard or laptop at waist height while you stand is incredibly simple to do. It’s not always possible to be away from your computer for long periods of the day but you can change how often you’re sitting throughout the day.

Constantly standing may take a bit of getting used to, especially if you’re used to sitting, but you can increase the amount gradually. Start on your feet for an hour, and then try two – slowly increasing the amount each week. Standing desks also help your posture and your alignment. Standing also forces your body to work harder than if you are just sitting, or worse, lying down.

Food Choices And Concerns

There are so many health concerns and risks associated with being overweight. Excess weight has been proven to be linked to conditions such as heart disease, diabetes and high blood pressure. There is also something to be said for the choices people may make at desk jobs when it comes to food. There is often a preponderance of greasy, carb-laden foods and sweet treats in office settings. Combined with little caloric output, this is a tough combination on the body which can lead to packing on the pounds.

Endurance Training After Inflammation Aids Recovery

Recovering from any type of injury can take a lot of time, patience and painstaking steps. From research that was conducted in Sweden, it was found that individuals who suffer from some type of muscle inflammation injury do much better in their recovery when they implement endurance training.

Depending on the type of muscular ailment and how it presents itself, it could be the cause of an injury, infection or chronic disease. Either way, the inflammation that is experienced can be pretty terrible. Getting someone back in the saddle and towards a place where they can feel comfortable working out again is certainly ideal.

One of the researchers says of the predicament, “All the drugs people are using target one immune cell or group of immune cells, but there are no new drugs that target muscles that are dying. Yet, exercise takes care of the immune cells that are killing the muscles, and repairs the cell death of the muscle. The results weren’t surprising. The reason why exercise wasn’t considered before is that if people have muscles that are already inflamed or weak, they believe exercise would make the muscles worse. However, what is surprising is that question of why exercise is so effective. It’s because exercise takes care of the immune cells that are damaging the muscle while simultaneously targeting specific parts of dead or affected muscles.”

The Study

Exercise fundamentally alters the immune systems process as well as shifting the protein levels. The overall experiment took two groups for a period of 12 weeks. One group was deemed the exercise group while the other did not exercise. The muscle biopsies were taken both before and after for both groups. It was clear from how the participants were feeling that their levels of inflammation were decreasing.

Even though some may not see the correlation clearly, it makes sense that exercise would enliven and return the muscle back to its original form prior to its disruption by inflammation. Many inflammatory conditions do not exist in the same manner as traditional, external injuries that may cause inflammation.

Get Out There

Instead, these types of conditions can be better helped and healed in the presence of consistent exercise. What endurance training does is that it works the muscle at a point that it will then have to rest. Plus, the activation of the immune system variable is highly beneficial as most inflammation responses are triggered by the immune system not being able to ward off certain variables that make the inflammation begin in the first place. All in all it is almost indisputable the benefits that can be directly linked to physical activity.

While endurance training is ostensibly more specific than most types of exercise, the overarching theme is the same. If you are able and you won’t do more harm to your body, get out there and move. Work up a sweat. Do something that will activate your heart and refresh your mind. Your body will thank you for it in the form of improved health, dexterity, flexibility and so many other ways.

Burning Bone Fat: Another Reason To Hit The Gym

It’s been long argued and endlessly proven that exercise and staying active is one of the most imperative choices we can make for ourselves and our physical health. New research is showing that the specific act of running actually helps to burn fat that can accumulate in your bone marrow.

Bone health is exceedingly important and one of the ways to ensure your bones are getting the proper care and nutrients is to be mindful of overall body fat composition. The more fat in the bone marrow, the more susceptible you may be to certain bone health red flags. Researchers in North Carolina took to the lab, using obese mice as their model to see exactly what running would do to the fat in bone marrow.

“One of the main clinical implications of this research is that exercise is not just good, but amazing for bone health,” says Maya Styner, MD and lead author of the study. “In just a very short period of time, we saw that running was building bone significantly in mice. I see a lot of patients with poor bone health, and I always talk to them about what a dramatic effect exercise can have on bones, regardless of what the cause of their bone condition is. With obesity, it seems that you get even more bone formation from exercise. Our studies of bone biomechanics show that the quality and the strength of the bone is significantly increased with exercise and even more so in the obese exercisers.”

While many people think of bone as this sturdy entity that doesn’t really have much dynamic power, there is actually quite a lot of activity that goes on intrinsically in the marrow. It helps to coordinate the cartilage and the bone while also working through cycling immune cells, blood cells and various other cells in the body. For eons, the fact that marrow produces fat has been largely puzzling to so many medical professionals. After much research, in recent years a number of studies have shown that the greater the fat composition around and in the bone marrow the more susceptible to fractures and breaks that bone is.

There is a huge correlation between marrow fat and low bone density, which means a bone is way more prone to breaks. Wherever the presence of fat looms, its undeniable that the introduction of exercise is helpful to the burning of fat.

The Study

Two different groups of mice were used. One group was fed a lean diet while the other was fed a high-fat diet. This was done from birth to four months old. Half of the mice in each group were given the running wheel while all of their progress and milestones were closely logged. After a six-week time period, the evidence was clear. There was a significant reduction in the amount of fat cells, and the size of fat cells, on the mice given the running wheel.

The obese mice obviously started out with a greater amount of fat cells and they were still able to lose a significant amount by running on the wheel fairly often. All in all, the conclusion was as Styner stated above: Exercise is essential in burning fat within bone marrow and this is ultimately good for the health of bones.

Your Desk Job Isn’t Doing You Any Health Favors

Staying active is so imperative to overall health, so much so that many healthy living spaces and medical establishments continually vocalize how vital it is. For this reason, it isn’t surprising that more data is being released regarding how having a desk job and living a mostly sedentary lifestyle can be catastrophic for your waistline and your health.

Those who typically have less risk factors for serious health conditions such as heart disease tend to walk at least seven miles per day or spend upwards of seven hours on their feet. The correlation here is that how you use and move your body directly affects the health factors within.

Dr. William Tigbe, from the Warwick Medical School, led research regarding how bad excessive sitting is for our waistline, and subsequently, our health. For people who have desk jobs, their waists are typically bigger and their risk for heart disease is also increased.

The Findings

The research looked at over 100 postal workers who were given activity monitors. Half of the workers worked in the office while the other half delivered the mail. There were huge differences between the two groups that were found. Firstly, the office workers had a bigger average waist circumference. Their risk for cardiovascular disease was also 2.2% higher than those who were constantly walking throughout the duration of their shift.

With each hour of sitting – up to around five hours – the bad cholesterol – also known as LDL – increased. The good cholesterol – (HDL) – decreased. Most shifts are anywhere from 6 to 8 hours so this is definitely an issue to one’s health.

“Longer time spent in sedentary posture is significantly associated with larger waist circumference, higher triglycerides – fat in the blood – and lower HDL cholesterol, all adding up to a worse risk of heart disease,” Tigbe says. “The levels associated with zero risk factors were walking more than 15,000 steps per day, which is equivalent to walking seven to eight miles, or spending seven hours per day upright. Our findings could be used as the basis of new public health targets for sitting, lying, standing and stepping to avoid metabolic risks.”

Increasing Physical Activity

There is an irrefutable link to health and physical activity. This has long been discussed, tested and confirmed in the scientific and medical community. Scientists explain that our biological evolutionary purpose did not account for our bodies being stagnant and sitting down for copious amounts of time each day. The hunters and gatherers spent a good portion of the day on their feet and we’re probably more biologically inclined to do that than we are – with us being largely inactive as we type away at a keyboard for hours and hours.

This is why being active despite having a sedentary job is so crucial. Those who have desk jobs really need to be mindful of incorporating enough standing and walking into their day despite being tied to their desk for their work.

There are a couple of ways to incorporate additional steps or upright movement. Get a headset and take some of your calls standing at your desk if you can. Make a commitment to use the stairs when you are coming to and from work. Do a full body stretch and a few squats every time you get up to go to the bathroom. The importance of how even the little things can increase your physical activity thus positively affecting your health cannot be overstated.

Running: How It Affects The Heart, Bone Health, Risk Of Atherosclerosis And More

Can a single minute of exercise each day lead to better bone health in women? Yes. Scientists from the University of Exeter and the University of Leicester found those who did “brief bursts” of high-intensity, weight-bearing activity equivalent to a medium-paced run for pre-menopausal women, or a slow jog for post-menopausal women, had better bone health.

Using data from UK Biobank, the researchers found that women who on average did 60 to 120 seconds of high-intensity, weight-bearing activity per day had four percent better bone health than those who did less than a minute.

“We don’t yet know whether it’s better to accumulate this small amount of exercise in bits throughout each day or all at once, and also whether a slightly longer bout of exercise on one or two days per week is just as good as one to two minutes a day,” said lead author Dr. Victoria Stiles, of the University of Exeter. “But there’s a clear link between this kind of high-intensity, weight-bearing exercise and better bone health in women.

“Because this is a cross-sectional study – which assesses data taken from a subset of the population at a particular point in time – we can’t be sure whether the high-intensity physical activity led to better bone health, or whether those with better bone health do more of this exercise,” Stiles continued. “However, it seems likely that just one to two minutes of running a day is good for bone health.”

Good Bone Health Benefits

The researchers looked at data on more than 2,500 women and compared activity levels – measured by wrist-worn monitors – with bone health -measured by an ultrasound scan of heel bone. As well as finding four percent better bone health among women who did one to two minutes of high-intensity, weight-bearing exercise, they found six percent better bone health among those who did more than two minutes a day.

Stiles said the data from UK Biobank – taken from monitors worn for a week – was broken down into single seconds to understand how people go about their daily activities. “We wanted to make every second count in our analysis, because short snippets of high-intensity activity are more beneficial to bone health than longer, continuous periods,” she said. “We were careful not to ignore short bursts of activity throughout the day.”

As a suggestion for anyone interested in increasing their day-to-day levels of activity, Stiles said: “The UK’s National Osteoporosis Society recommends increasing your walking activity first. Further on, we would suggest adding a few running steps to the walk, a bit like you might if you were running to catch a bus.”

Good bone health has multiple health benefits, including a reduced risk of osteoporosis and fractures in older age.

Running Marathons And Risk Of Athersclerosis

Running multiple marathons does not increase the risk of atherosclerosis, according to research published last summer in the European Journal of Preventive Cardiology.

“There has been a debate over whether intensive endurance exercise such as marathon running may be dangerous for the heart,” said lead author Dr. Axel Pressler, Head of the Prevention Centre, Technical University of Munich, Germany. “Previous studies found that after running a marathon, the same cardiac biomarkers were acutely elevated as after a heart attack. Other research discovered increased coronary atherosclerosis in marathon runners as a potential chronic consequence of running. However, this may have been due to exposure to traditional risk factors such as current or past smoking.”

This study aimed to find out whether running itself could induce the early development of atherosclerosis. It therefore included only healthy men without any history of cardiovascular risk factors such as cardiovascular disease, hypertension or smoking. Pre-atherosclerotic changes to the function and structure of the blood vessels were evaluated by increased stiffness of the arteries, increased intima-media-thickness – due to early atherosclerosis – and endothelial dysfunction, which indicates an impaired reaction of the vessel to blood flow.

Marathons And Blood Vessels

The study included 97 participants of the 2013 Munich marathon who had already completed multiple events. Each participant did an exercise capacity test to measure peak oxygen uptake, and gave their training history. The finishing time for the marathon was recorded for each runner. Measurements of arterial stiffness, intima-media-thickness, and endothelial dysfunction were taken before and after the event.

Prior to the current marathon, participants had successfully finished a median of 11 running events which included half marathons, full marathons, and ultramarathons. The average weekly and annual training distances were 59 kilometers and 1, 639 kilometers, respectively.

Runners had normal mean values for arterial stiffness, intima-media-thickness, and endothelial dysfunction. There was no association between exercise capacity, marathon finishing time, number of completed races, or weekly and annual training distances with arterial stiffness, intima-media-thickness, or endothelial dysfunction. The only characteristic of the runners that was independently associated with the three measurements of pre-atherosclerosis was age.

“When we get older our arteries get stiffer and are not so elastic anymore,” said Pressler. “Our study shows that runners who have finished 20 marathons do not have stiffer arteries or more impaired vessel function than people of the same age who have finished five or zero marathons. We can conclude that marathon running itself is not a risk factor for atherosclerosis. It appears that you can run as many marathons as you want and not be in danger of developing impaired blood vessel function or atherosclerosis.”

While running multiple marathons did not have a deleterious effect on the blood vessels, it did not have a positive effect either. Pressler said: “Running had a neutral effect on the blood vessels. The state of the blood vessels in these runners depended solely on their age.”

The findings are good news for runners, but Pressler warned that marathons do put strain on the body and participants should ensure they are prepared through training, nutrition, and appropriate hydration. “Many people are interested in marathon running and are doing ambitious recreational sports. Our study shows that running multiple marathons is not risk factor for atherosclerosis.”

Is Running Good For The Heart?

Other news stories about runners suffering sudden cardiac arrest (SCA) and other heart-related complications mid-race might leave some wondering if there may actually be a risk to running. Last year ABC News reported about a man who had an SCA while running the Key West half marathon, The Telegraph shared news of a runner in the London marathon who collapsed three miles before the finish line in 2016, and Philadelphia Magazine reported in 2015 that two athletes suffered an SCA during the Broad Street Run.

“Running, or any kind high-intensity exercise, puts a strain on the heart muscle, as it does on lung tissue, and leg and arm muscles,” said Neel Chokshi, MD, an assistant professor of Clinical Cardiovascular Medicine, and medical director of the Penn Sports Cardiology and Fitness Program. “While evidence suggests an increased risk of cardiac events during high intensity exercise, the overall likelihood of such events is ultimately very, very low. There is more far research to support running and exercise as a benefit to heart health, rather than a detriment.”

The World Health Organization suggest that adults ages 18 to 64 do at least 150 minutes of a moderate exercise or at least 75 minutes of high-intensity physical activity each week. Guidelines also recommend adding muscle strengthening exercises into the routine two or more days per week.

Based on these recommendations, a casual runner could log eight miles per week at about a nine-minute mile pace. But what about someone training for something more rigorous, like a marathon, or triathlon? Is there more risk for competitive athletes, who run say 20 to 40 miles a week – or 210 to 300 minutes of vigorous exercise – effectively tripling or quadrupling this recommendation?

Progressive Training Is Key

“It’s important to understand that the likelihood of cardiac events is greatest in those individuals who have a low baseline level of physical activity and suddenly jump into moderate to high intensity exercise,” Chokshi said. “So, as long as you train in a progressive manner, gradually increasing mileage, pace of a run, or amount and type of exercise, and you listen to your body, your heart and lungs will adapt at the same rate. This will allow you to continue your training while minimizing risk of injury to both your heart and other muscles.”

And this same advice applies to anyone looking incorporate more exercise into their routine. Everyone should be aware of the possible risks and listen to their bodies, but the most important thing is engaging in some level of activity each day or week – which has been shown to have immense heart and overall health benefits.

A recent study published in JAMA Internal Medicine found that even those who exercised for fewer than the recommended time – 150 minutes of moderate or 75 minutes of vigorous exercise per week – showed a decrease in risk of death, when compared to those who had little to no physical activity each day. Researchers concluded that any amount of physical activity lowered risk of death, specifically from heart disease, by approximately 40 percent, as compared to those who led a sedentary lifestyle.

In an Associated Press article about the study, Daniel Rader, MD, chair of Genetics and director of Penn’s Preventive Cardiovascular Program, said, “People who exercise more regularly report that they feel like they have a better quality of life,” among other benefits. However, even if you only have time to do something once a week, this study would suggest it’s still worth doing.”

A Preventative Measure

This seems promising for those who find 150 minutes of exercising to be daunting, for those who are coming back from an injury, or those looking to take the first step toward leading a more active lifestyle. The main message seems to be that anything is better than nothing. But for some, the question of how to minimize any risk from exercise still remains.

“In general, most individuals who increase their workouts gradually and feel well while doing so are at low risk and require no medical evaluation,” Chokshi added. “But, patients with pre-existing heart conditions or those who experience heart-related symptoms such as chest pain, shortness of breath or palpitations during exercise, may be at increased risk during exertion. This group should work in closely with their physician to understand risk factors, determine if any pre-exercise testing is needed, and to create an exercise regime that can help reduce risk of an exercise-induced cardiac event, while still maintaining a healthy lifestyle.”

But if most people have little to no risk for a cardiac event while exercising, why has there been so much buzz linking exercise to sudden cardiac arrest? As a 2016 paper from the American College of Cardiology’s (ACC’s) Sports and Exercise Cardiology Leadership Council points out, “the public media has embraced the idea that exercise may harm the heart and disseminated this message, thereby diverting attention away from the benefits of exercise as a potent intervention for the primary and secondary prevention of heart disease.”

So perhaps we don’t need to cut back on exercise, but instead need to read past the headlines to understand what is really good or bad for our hearts. For Chokshi, the recommendation to exercise as a preventative measure will continue, as will his focus on clinical and research efforts evaluating the effects of rigorous, and regular, exercise on the heart.

Running, Lifting Weights And Reducing Injury

Experts say a few sessions in the weight room can improve your abilities while reducing your chance of injury. Finding time for strength-training exercises can be difficult for runners with busy schedules. Lifting weights doesn’t have to be time consuming, and runners can follow workout routines that take less than 20 minutes to complete.

The results are well worth the time. “Lifting weights can make a big difference for runners,” says Chris Kolba, a physical therapist at The Ohio State University Wexner Medical Center. “In a nutshell, the weight training will give your running muscles more strength, which improves athletic performance and reduces your risk of injury. It’s all about the forces your feet and legs experience while you are running. Your foot is on the ground for maybe a tenth of a second, but during that time it’s handling five to eight times your body weight.”

Strength training also increases your body’s ability to both absorb shock and control motion. This improves your athletic performance while also significantly reducing the risk of injury.

Protect Your Legs With Fewer Distractions

Runners who encounter visual and auditory distractions may be more likely to sustain leg injuries, according to research from the University of Florida presented last year at the Association of Academic Physiatrists Annual Meeting.

The team looked at the effect of auditory and visual distractions on 14 runners to determine what effect, if any, distractions would have on things such as how much a runner breathes per minute and how much of that oxygen is utilized by the body, heart rate, the amount of energy expended, running rhythm, the length and width of steps, the speed in which runners apply force to their bodies, and the force the ground applies to the runners’ bodies when they come in contact with it.

“There isn’t a lot of research that looks at the connections between cognitive stressors, or distractions, and injury risk, says Daniel Herman, MD, PHD; assistant professor at University of Florida Department of Orthopedics and Rehabilitation and lead investigator in the study. “This is an important topic to study as runners commonly attend to distractions such as music, crowd noise, or other runners.”

Running Environments

The runners – eight men and six women – were all injury free at the time of the study, and they were approximately 26 years old. On average, the runners logged 31 miles each week.

The team had each participant run on a treadmill three separate times. The first time was without any distractions. The second time added a visual distraction, which consisted of the runner concentrating on a screen displaying different letters in different colors with the runner having to note when a specific letter-color combination appeared. The third time added an auditory distraction similar to the visual distraction, with the runner having to note when a particular word was spoken by a particular voice.

When compared to running without distractions, the participants had faster application of force to their left and right legs – called loading rate – with auditory and visual distractions. They also experienced an increased amount of force from the ground – called ground reaction force – on both legs with auditory distractions. Finally, the runners tended to breathe heavier and have higher heart rates with auditory and visual distractions than without any distractions at all.

“Running in environments with different distracting features may adversely affect running performance and injury risk,” explains Herman. “Sometimes these things cannot be helped, but you may be able to minimize potentially cumulative effects. For example, when running a new route in a chaotic environment such as during a destination marathon, you may want to skip listening to something which may require more attention – like a new song playlist or a podcast.”

Herman’s team will continue to investigate the potential relationship between distracted running and leg injuries, including the characteristics of runners who may be more or less susceptible to this effect, and any effect this relationship has on different training techniques that use auditory or visual cues.

Bike Riding To Work: Fit In Exercising Where You Can

The importance of being and remaining active over the course of your life is beneficial in many different ways. One of the foremost concerns often expressed is the lack of time some have to get the amount of exercise in that they would like. Some are under the preconceived notion that, in order to have a meaningful, good workout, it must be calculated and overly strenuous. This is not the case.

Researchers in Copenhagen wanted to inquire if riding a bike to work could be considered as effective as any other type of leisure time exercise. Bike riding to work could be a great, time-effective solution for those who simply can’t find the time to work out the way they would like.

Any type of physical activity can change the trajectory of your body and increase your mood. A professor at Copenhagen University, Bente Stallknecht says: “This is good news to the many overweight people who may not have the time or inclination to join a fitness center because they also have to pick up their children and cook dinner after work. Our results show that it is possible to combine transport to and from work with effective physical exercise.”

With the busy lives so many lead and the responsibilities that are already set in stone, it can sometimes be difficult to figure out exactly when and where you have time to do something for your own health, well-being, and fitness level. Riding to work is the perfect opportunity to do something active within an allotted amount of time you can dedicate to the act.

Riding Research

The study dealt with 130 overweight participants who had a Body Mass Index (BMI) between 25 and 35. They were divided into four groups and given different tasks. One group also incorporated increased intensity of movement and exercise types. After a six-month period, the first three groups had less overall fat mass. The fourth group, who was the control group and didn’t participate in any physical activities, stayed stagnant.

Any and all forms of exercise are beneficial to the body. This is especially the case in those who are overweight or who struggle with weight issues. While there is an increased benefit of high-intensity workouts, those do yield the most fat loss and overall positive effects. It’s also worth mentioning that there needs to be a level of consistency attributed to this type of plan.

The first three groups did this for a six-month time span at five days a week. A lesser amount of time and a lesser commitment of consistency would yield lesser results. The body needs to stay in motion on a regular basis to gain and retain optimal health.

Riding Results

This study’s results are a clear indication that you can fit in a worthwhile and necessary workout in moments where you least expect it. You only need to be diligent and committed to the practice. Leisurely exercise is exercise all the same, even if it isn’t intense bouts of cardio on the stair stepper or lifting heavy at the weight bench.

All types of movement and activity matter and make a necessary amount of difference. So hop on a bike and pedal to your office. After a few weeks, it will become second nature and you’ll likely even start to enjoy it, no matter how exercise resistant you may be.

Yoga Improves Heart Disease, Brain Function And Energy

Several recent reports and studies have shed light on the positive health benefits of yoga. Interestingly though, there have also been a few reports detailing some down sides as well.

Heart disease patients who practice yoga in addition to aerobic exercise saw twice the reduction in blood pressure, body mass index and cholesterol levels when compared to patients who practiced either Indian yoga – a combination of whole exercise of body, mind and soul, and a common practice throughout India – or aerobic exercise alone, according to research presented recently at the 8th Emirates Cardiac Society Congress in collaboration with the American College of Cardiology Middle East Conference.

Researchers in this study looked specifically at Indian yoga and aerobic training’s effect on the coronary risk factors of obese heart disease patients with type 2 diabetes. Lifestyle intervention has been shown to aid in reducing the co-occurring risk of death and heart disease when used alongside medical management.

Combing Yoga And Aerobic Exercise

The study looked at 750 patients who had previously been diagnosed with coronary heart disease. One group of 225 patients participated in aerobic exercise, another group of 240 patients participated in Indian yoga, and a third group of 285 participated in both yoga and aerobic exercise. Each group did three, six-month sessions of yoga and/or aerobic exercise.

The aerobic exercise only and yoga only groups showed similar reductions in blood pressure, total cholesterol, triglycerides, LDL, weight and waist circumference. However, the combined yoga and aerobic exercise group showed a two times greater reduction compared to the other groups. They also showed significant improvement in left ventricular ejection fraction, diastolic function and exercise capacity.

“Combined Indian yoga and aerobic exercise reduce mental, physical and vascular stress and can lead to decreased cardiovascular mortality and morbidity,” says Sonal Tanwar, PhD, a scholar in preventative cardiology, and Naresh Sen, DM, PhD, a consultant cardiologist, both at HG SMS Hospital, Jaipur, India. “Heart disease patients could benefit from learning Indian yoga and making it a routine part of daily life.”

Yoga, Meditation Improve Brain Function And Energy Level

In another recent study from the University of Waterloo, practicing brief sessions of Hatha yoga and mindfulness meditation can significantly improve brain function and energy levels. The study found that practicing just 25 minutes of Hatha yoga or mindfulness meditation per day can boost the brain’s executive functions, cognitive abilities linked to goal-directed behavior, and the ability to control knee-jerk emotional responses, habitual thinking patterns and actions.

“Hatha yoga and mindfulness meditation both focus the brain’s conscious processing power on a limited number of targets like breathing and posing, and also reduce processing of nonessential information,” says Peter Hall, associate professor in the School of Public Health & Health Systems. “These two functions might have some positive carryover effect in the near- term following the session, such that people are able to focus more easily on what they choose to attend to in everyday life.”

Hatha yoga is one of the most common styles of yoga practiced in Western countries. It involves physical postures and breathing exercises combined with meditation. Mindfulness mediation involves observing thoughts, emotions and body sensations with openness and acceptance.

“Although the meditative aspect might be even more important than the physical posing for improving executive functions, there are additional benefits to Hatha yoga including improvements in flexibility and strength,” said Hall. “These benefits may make Hatha yoga superior to meditation alone, in terms of overall health benefits.”

Mindfulness Meditation

Thirty-one study participants completed 25 minutes of Hatha yoga, 25 minutes of mindfulness meditation, and 25 minutes of quiet reading – a control task – in randomized order. Following both the yoga and meditation activities, participants performed significantly better on executive function tasks compared to the reading task. “This finding suggests that there may be something special about meditation – as opposed to the physical posing – that carries a lot of the cognitive benefits of yoga,” added Kimberley Luu, lead author on the paper.

The study also found that mindfulness meditation and Hatha yoga were both effective for improving energy levels, but Hatha yoga had significantly more powerful effects than meditation alone. “There are a number of theories about why physical exercises like yoga improve energy levels and cognitive test performance,” Luu said. “These include the release of endorphins, increased blood flow to the brain, and reduced focus on ruminative thoughts. Though ultimately, it is still an open question.”

Combining Yoga And Medical Studies To Connect, Recharge, Remember

Yoganatomy is a class at the Perelman School of Medicine that combines traditional yoga practice with reinforcement of lessons in gross anatomy. By mindfully moving and breathing with the body parts that earlier in the day they had learned about in lectures and examined up-close in donated cadavers in the lab, first-year medical students at Penn gain a deeper appreciation of these structures in a living body.

“The primary goal of Yoganatomy is to give the students an outlet to help them with their stress,” said Nikki Robinson, the yoga instructor who developed and leads these classes, which began last fall. “The demands on medical students’ time are so intense that this class offers students a way to unwind and exercise easily on the medical school campus when they otherwise might not find the time to seek that out. Here’s an hour when they’re going to move, breathe, talk about things we learned in the anatomy lab, and then rest, so they’re recharged to go about the rest of their day.”

Going All In For The Med Students

Robinson made the unusual educational twist from yoga teaching into the medical school classroom through a connection with Mitchell Lewis, DPhil, a professor of Biochemistry and Biophysics. Lewis teaches the first-year medical students intermediary metabolism with a level of dedication to education that is hard to understate. Though Lewis is a basic scientist whose professional life is in a lab, a number of years ago he took a sabbatical and audited the first-year medical school curriculum at Penn in order to get a better understanding of how his class fits into the broader preclinical curriculum. “Of all the preclinical courses, I found anatomy the most fascinating,” he said. “I visit and spend several hours in the gross labs with every new class.”

A few years ago, Lewis started attending yoga classes at the Yoga Garden, where Robinson leads classes that have a strong anatomical bent. The idea soon came to life when Lewis approached Neal Rubenstein, MD, PhD, the gross anatomy course director, about the possibility of integrating yoga with gross anatomy. Together, the three devised a plan to augment traditional medical education with anatomically-based yoga. Rubenstein even suggested that Robinson attend and learn firsthand what medical students experienced in the gross labs.

Yoganatomy

“I love this, and it is really important for me to be able to accurately reflect and represent what the students are taught,” Robinson said. “If they’re going to be in my care, I want to reinforce what they’re learning on the table, and then take that and interpret it in an accurate way, to physically put it in their body.”

This summer, Robinson completed a gross anatomy course at Rowan University, taught in part by James White, PhD, one of Penn Med’s most esteemed teachers. This fall, Robinson will assist the first-year students in gross lab and continue teaching Yoganatomy to the new crop of students.

Yoganatomy runs in many ways as a typical yoga class, except for the parts that sound more like a gross anatomy study session. When students are in plank pose — which is essentially holding the “up” position of a push-up — Robinson might say, “Now retract the scapula.” Students are forced to think about the muscles connected to the scapula and to recall the distinction between protraction and retraction. “I try to straddle keeping it really serious and medically accurate and just giving them something fun to do,” Robinson said.

Medically-Informed Yoga

After gross anatomy and the end of the first semester, medical education with a yogic corollary isn’t over for Penn medical students. The leader of the next yoga class in the sequence is an inversion of Robinson: instead of a yoga instructor-turned-part-time-med-school-attendee, Sila Bal is a full-time medical student who became certified as a yoga instructor. Now a fifth-year MD/MPH student at Penn, Bal incorporates her knowledge of anatomy and physiology into teaching yoga classes.

But soon after she began teaching, she got to thinking, “Wouldn’t it have been cool if when I was an MS1 or MS2, someone had gone through what is or isn’t physiologically plausible that’s taught in yoga classes?” She also thought back on the experience she had working as a research assistant on a study of yoga breathing as a tool to help patients with depression.

When the paper resulting from that study was published, Bal decided to connect it with the brain and behavior curriculum taught as part of Mod 2, a preclinical learning block focused on organ systems and disease that spans from January of medical students’ first year through December of their second year. Over the course of the last spring semester, Bal developed and taught multiple classes connected to the topics in Mod 2 and called them Medically-Informed Yoga.

Evidence Through The Ages

“I pick a paper from a reputable journal with trustworthy results and use that as a starting point for our discussions,” Bal said. In the brain and behavior module, “we went through depression and the physiology behind depression, the results of the paper, and physiological bases of the use of yoga in depression. Depression has a lot of research behind it. For example, we know yoga stimulates the parasympathetic nervous system.”

After a brief discussion, Bal leads the students through a 45-minute sequence of the asanas, or physical postures that yoga teachers recommend for the organ system under discussion, to practice what they learned. Bal points out that in some organ systems, the connection with these asanas has not necessarily been demonstrated through medical research, but often yogic knowledge, honed through thousands of years of practice and experience, reflects a different type of “evidence through the ages.”

Creating Connection

The two yoga class sequences – Yoganatomy for first-semester medical students in gross anatomy, and Medically-Informed Yoga for second, and third-semester medical students in Mod 2 — arose independently by luck or chance last year. This year, the two programs are coming into alignment. Bal and Robinson are working together to develop a coordinated curriculum of yoga classes to complement the full span of the three semesters of preclinical medical education that can be standardized and repeated in future years.

Already this year, yoga as a study enhancement is front and center for new students. During their orientation to medical school, new first-year students received an introduction to Yoganatomy and Medically-Informed Yoga, and participated in a brief demo. Bal, Lewis, and Robinson believe that all medical students can benefit from yoga through integrating stress relief, exercise, and connection into their often high-stress learning experience. “I encouraged all of the students in my biochemistry class to participate in Yoganatomy,” Lewis said. “This past year our Yoganatomy attracted many medical students that have never been exposed to yoga.”

“Attendance was highest last fall at the sessions when Lewis participated,” Robinson said. “The students wanted to see their professor’s moves, including an impressive handstand.” The sessions also lured more senior medical students — some of whom said that Robinson’s Yoganatomy quizzes helped them study for board exams. Yoganatomy also attracted faculty and graduate students from other schools at Penn.“This year we hope to encourage more medical faculty to participate in Yoganatomy,” Lewis said. “We are open to any and everyone who wants to join,” Bal added.

Yoga More Risky For Causing Musculoskeletal Pain Than You Might Think

Yoga causes musculoskeletal pain in 10 percent of people and exacerbates 21 percent of existing injuries, University of Sydney research shows. Published recently in the Journal of Bodywork and Movement Therapies, the findings come from the first prospective study to investigate injuries caused from recreational participation in yoga. Yoga is an increasingly popular complementary or alternative therapy for musculoskeletal disorders, with millions of people practicing worldwide.

“While yoga can be beneficial for musculoskeletal pain, like any form of exercise, it can also result in musculoskeletal pain,” said lead researcher Associate Professor Evangelos Pappas from the University’s Faculty of Health Sciences, who conducted the study with Professor Marc Campo from Mercy College, New York.

“Our study found that the incidence of pain caused by yoga is more than 10 percent per year, which is comparable to the injury rate of all sports injuries combined among the physically active population. However, people consider it to be a very safe activity. This injury rate is up to 10 times higher than has previously been reported.

“We also found that yoga can exacerbate existing pain, with 21 percent of existing injuries made worse by doing yoga, particularly pre-existing musculoskeletal pain in the upper limbs,” Pappas added. “In terms of severity, more than one-third of cases of pain caused by yoga were serious enough to prevent yoga participation and lasted more than three months.”

The study found that most ‘new’ yoga pain was in the upper extremities – shoulder, elbow, wrist, hand – possibly due to downward dog and similar postures that put weight on the upper limbs. It’s not all bad news, however, as 74 percent of participants in the study reported that existing pain was improved by yoga, highlighting the complex relationship between musculoskeletal pain and yoga practice.

Conscientious Practice

“These findings can be useful for clinicians and individuals to compare the risks of yoga to other exercise enabling them to make informed decisions about which types of activity are best. Pain caused by yoga might be prevented by careful performance and participants telling their yoga teachers of injuries they may have prior to participation, as well as informing their healthcare professionals about their yoga practice.

“We recommend that yoga teachers also discuss with their students the risks for injury if not practiced conscientiously, and the potential for yoga to exacerbate some injuries,” Pappas added. “Yoga participants are encouraged to discuss the risks of injury and any pre-existing pain, especially in the upper limbs, with yoga teachers and physiotherapists to explore posture modifications that may results in safer practice.”

Another study published in a recent issue of the Journal of Clinical Sleep Medicine indicates that yoga and aerobic exercise interventions did not significantly reduce objectively measured sleep disturbances among midlife women who were experiencing hot flashes.

Secondary analyses of a randomized controlled trial showed that neither 12 weeks of yoga nor 12 weeks of aerobic exercise had a statistically significant effect on objective measures of sleep duration or sleep quality recorded by actigraphy. Although the women had no difficulty falling asleep, disturbed sleep was common at baseline and remained after each intervention, with women in all groups waking during the night for an average of more than 50 minutes.

According to the authors, previously published analyses of the same trial had found that the yoga and aerobic exercise interventions were associated with small but statistically significant improvements in subjective, self-reported sleep quality and insomnia severity. The primary findings were that the two study interventions had no significant effects on objective sleep outcomes in midlife women with hot flashes.

Examining Other Treatments

The main implication of this finding is that other behavior treatments with the potential for effectively improving sleep in this population should be examined,” says lead author Diana Taibi Buchanan, associate professor of Bio-Behavioral Nursing and Health Informatics at the University of Washington in Seattle.

The authors analyzed data from the Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) network. The study involved 186 late transition and postmenopausal women with hot flashes who were between 40 and 62 years of age. Study subjects had an average of 7.3 to 8 hot flashes per day. Participants were randomized to 12 weeks of yoga, supervised aerobic exercise, or usual activity.

Sleep measures were evaluated using wrist actigraphy, and bedtimes and rise times were determined primarily from the participants’ sleep diaries. Mean sleep duration at baseline and after each intervention was less than the seven or more hours of nightly sleep that is recommended by the American Academy of Sleep Medicine for optimal health in adults.

Future research should explore other approaches for improving sleep quality in midlife women, such as cognitive behavioral therapy for insomnia.

Why Quality Of Diet Means More In Adulthood

There has been a recent steady incline in the number of people that struggle with obesity and weight-related issues like diabetes and heart disease. This shift can be intrinsically linked to certain lifestyle practices and diet choices. A recent study which questioned the importance of diet quality found that a substantial and healthy diet should be measured by four different variables. It was found that maintaining a diet high in quality helps to prevent certain weight issues and troublesome illnesses such as fatty liver disease.

This study took a group of individuals over a wide spectrum and had them go through various body scans, complete various tests and pinpoint their level of health. It found that those with long-term access to healthier foods are at less of a risk of developing cardio metabolic conditions that can be very debilitating and potentially dangerous. The researchers explained that it is quality of diet, not quantity, that matters most. It was found that healthcare providers should continually advocate their patients incorporate a quality healthy diet that they follow for the long haul, for the majority of their lives.

Fat Distribution

The study also found that the distribution of fat that occurs in certain places on the body is indicative of specific  diseases and precursors for more health trouble in the future. Gone are the days when we would take into consideration the Body Mass Index, BMI, on a person as some specific indicator of health when it actually isn’t. One of the most critical features of developing a metabolic issue or chronic consequence is fat distribution. Fat that accumulates in the midsection and around the liver can contribute to the diseases mentioned above. These diseases are some of the leading causes of death in our society.

This also speaks to the prevalence and popularity of organic foods in recent years. While the product itself matters tremendously, how it was farmed and raised matters a lot too. There are so many different additives and chemicals that are used in our food supply system that we are not often cognizant of. This can be incredibly damaging to the body. It’s the difference between knowing that certain types of fish are great for you and provide a tremendous source of healthy fats, but then realizing that there is a staunch difference between fish that is farm raised and fish that is wild.

High-Quality Foods

Quality over quantity is usually a saying that is geared toward other issues but the prevalence of health changes on a national level cannot be ignored. While we live in the land of excess, we have so much access to foods that are simply no good for us. Fried, battered, sugared-up dishes can be found on almost every street corner. Snacking becomes an easy way to manage and stuff down feelings yet what many people don’t understand is that they are bargaining with their health when they partake in these practices so readily. Start to take your health seriously and understand what you need to do to change the course of what might happen next.

As our bodies and metabolism shifts, we need to be mindful of how to also shift our diets to reflect that change. Protect your heart, blood, organs and mind by eating a balanced and nutrient-rich diet of high quality.

Get Those Steps In: Climbing Stairs Is A Practical Fitness Boost

Ensuring that you are getting the necessary amounts of exercise can sometimes seem difficult. Especially if you are leading a very busy life. Remaining active is imperative and some simply felt that they don’t have the time to  hit the gym as they would like. There is a solution to this issue as researchers have found that stair climbing is a great way to maintain heart health and boost overall fitness. This is a great option as stairs are everywhere and can be used at any time.

Having no time or zero access to a gym is no longer a viable excuse as climbing stairs in intense bursts can get the job done. This helps to elevate the heart rate and gives the body a way to work through activating important and vital muscle groups. This is a great option for those who have to sit at a desk all day or who have sedentary jobs. “Stair climbing is a form of exercise anyone can do in their own home, after work or during their lunch hour. This research takes interval training out of the lab and makes it accessible to everyone,” says Martin Gibala, who is a professor of kinesiology at McMaster and who also lead the study.

Research And Benefits

Researchers took 31 sedentary individuals with otherwise healthy profiles and split them into two groups. Each group had a different exercise protocol and a 10-minute time commitment that included a warm-up, cool down and recovery time period. The sessions were done over the course of a six-week period at three times a week. The first group did 20 second intervals of climbing as fast as they could while the second group climbed up and down a flight of stairs for at least 60 seconds.

After the six-week period had elapsed, results showed that by doing this type of activity, cardiorespiratory fitness was increased. This has imperative benefits for the overall framework of health and wellness. Keeping your body in motion will do tremendous things for your heart, brain and other organs as well. Using a portion of your lunch break to climb stairs to get your steps in is a great use of your time. If you can take 15 to 20 minutes after your work day to go up and down some stairs nearby it will do well for your joints and muscles. It will also help you maintain a healthy weight.

Exercise is an integral part of life and a healthy existence. It is a false notion that you need to slave away tirelessly at the gym or in an aerobics class to have a specific level of fitness. You only need to walk. With the added dimension of climbing, you are elevating your body and heart rate to another level. One that it desperately needs to keep functioning at its optimal level. It’s also important to note that simply taking the stairs instead of an escalator or elevator is also a great option for increased health and fitness. Even if you don’t have the full 20 to 30 minutes of allotted time that is recommended, any time when you get your heart rate elevated via psychical activity is a good thing. Try it out the next time you see a set of stairs nearby.

Exercise Is Imperative: An Anti-Inflammation Key?

Unless you’ve been living under a rock for most of your life, you have likely heard of the importance of exercise and remaining as active as possible. This is because so many illnesses and ailments can be linked to things like obesity and stagnation. The body was designed to move and run and jump. When we live sedentary lifestyles without making it a point to get some exercise, our health can suffer. In a new study conducted by California State University of San Diego, it was found that just 20 minutes of moderate exercise can be a key factor in managing inflammation.

There is a cellular response that happens in the body when physical activity is performed. This has been shown to have tremendous benefits on things like the heart, bones, and muscles. In this specific study, it was found that after only one single session of exercise, inflammation markers can be decreased. This is good news for chronic conditions that result in high levels of inflammation such as obesity, fibromyaligia and arthritis.

A study that was recently seen in Brain, Behavior and Immunity, explained extensively the reason a mere 20-minute session of moderate exercise helps to promote the immune system, which in turn activates the anti-inflammatory cellular response.

Mental And Physical Health Benefits

When we think about this is a similar context, it makes perfect sense. As the saying goes, “A body at rest, stays at rest. A body in motion, stays in motion.” So each time we make concerted and conscious efforts to get our steps in or take a yoga class or go for a swim, we are doing tremendous aid to not only our mental health but our physical health as well. While some may see this information and take it at face value, it’s imperative that we can understand just how the process of exercise has this specific effect.

The brain and nervous system are obviously connected and directly impact blood pressure and heart rate. These two things are positively activated during exercise in order for the body to properly carry out the task at hand. Epinephrine and norepinephrine are hormones that trigger immune cells response after they are released into the blood stream. This immunological response is a key way that systemic inflammation is effectively regulated and lessened. Twenty minutes on the treadmill resulted in an over five percent decrease in the number of cells producing inflammatory entities.

One researcher notes: “Our study shows a workout session doesn’t actually have to be intense to have anti-inflammatory effects. Twenty minutes to half an hour of moderate exercise, including fast walking, appears to be sufficient. Feeling like a workout needs to be at a peak exertion level for a long duration can intimidate those who suffer from chronic inflammatory diseases and could greatly benefit from physical activity.”

This is precisely the reason that some people don’t work out. They think it’s too strenuous and too exhaustive when it actually doesn’t have to be. It can be enjoyable and at a pace that can be easily kept up with. This idea that exercise only matters if it’s at a high intensity is what prevents so many people from actually attempting to even get moderate exercise that would actually benefit them tremendously.

Can Yoga Reduce Symptoms Of Depression And Back Pain?

People suffering from depression are looking to yoga as a complement to traditional therapies to lessen symptoms of depression, says a study presented in July at the 125th Annual Convention of the American Psychological Association.

The research focused on the acceptability and antidepressant effects of hatha yoga – the branch of yoga that emphasizes physical exercises along with meditative and breathing exercises to enhance well-being. In the study, 23 male veterans participated in twice-weekly yoga classes for eight weeks. On a one-to-10 scale, the average enjoyment rating for the yoga classes was 9.4. All participants said they would recommend the program to other veterans – but more importantly – participants with elevated depression scores before the yoga program had a significant reduction in depression symptoms after the eight weeks.

“Yoga has become increasingly popular in the West, and many new yoga practitioners cite stress-reduction and other mental health concerns as their primary reason for practicing,” said Lindsey Hopkins, PhD, of the San Francisco Veterans Affairs Medical Center. “But the empirical research on yoga lags behind its popularity as a first-line approach to mental health.”

Hatha And Heated Yoga

Another, more specific, version of hatha yoga commonly practiced in the West is Bikram yoga, also known as heated yoga. Sarah Shallit, MA, of Alliant University in San Francisco investigated Bikram yoga in 52 women, ages 25 to 45. Just more than half were assigned to participate in twice-weekly classes for eight weeks. The rest were told they were wait-listed and used as a control condition.

All participants were tested for depression levels at the beginning of the study, as well as at weeks three, six and nine. Shallit and her co-author Hopkins, found that eight weeks of Bikram yoga significantly reduced symptoms of depression compared with the control group. In the same session, Maren Nyer, PhD, and Maya Nauphal, BA, of Massachusetts General Hospital, presented data from a pilot study of 29 adults that also showed eight weeks of at least twice-weekly Bikram yoga significantly reduced symptoms of depression and improved other secondary measures including quality of life, optimism, and cognitive and physical functioning.

“The more the participants attended yoga classes, the lower were their depressive symptoms at the end of the study,” said Nyer, who currently has funding from the National Center for Complementary and Integrative Health to conduct a randomized controlled trial of Bikram yoga for individuals with depression. Nina Vollbehr, MS, of the Center for Integrative Psychiatry in the Netherlands presented data from two studies on the potential for yoga to address chronic and/or treatment-resistant depression. In the first study, 12 patients who had experienced depression for an average of 11 years participated in nine weekly yoga sessions of approximately 2.5 hours each.

The researchers measured participants’ levels of depression, anxiety, stress, rumination and worry before the yoga sessions, directly after the nine weeks and four months later. Scores for depression, anxiety and stress decreased throughout the program, a benefit that persisted four months after the training. Rumination and worry did not change immediately after the treatment, but at follow-up rumination and worry were decreased for the participants.

Yoga And Relaxation

In another study – this one involving 74 mildly depressed university students – Vollbehr and her colleagues compared yoga to a relaxation technique. Individuals received 30 minutes of live instruction on either yoga or relaxation and were asked to perform the same exercise at home for eight days using a 15-minute instructional video. While results taken immediately after the treatment showed yoga and relaxation were equally effective at reducing symptoms, two months later, the participants in the yoga group had significantly lower scores for depression, anxiety and stress than the relaxation group.

“These studies suggest that yoga-based interventions have promise for depressed mood and that they are feasible for patients with chronic, treatment-resistant depression,” said Vollbehr.

The concept of yoga as complementary or alternative mental health treatment is so promising that the U.S. military is investigating the creation of its own treatment programs. Jacob Hyde, PsyD, of the University of Denver Hopkins, noted that the research on yoga as a treatment for depression is still preliminary. “At this time, we can only recommend yoga as a complementary approach, likely most effective in conjunction with standard approaches delivered by a licensed therapist,” Hyde said. “Clearly, yoga is not a cure-all. However, based on empirical evidence, there seems to be a lot of potential.”

Yoga Reducing Back Pain

In another study also unveiled in July, researcher Dr. Erik J. Groessl and his team from the VA San Diego Healthcare System found that veterans who completed a 12-week yoga program had better scores on a disability questionnaire, improved pain intensity scores, and a decline in opioid use. That study included 150 military veterans with chronic low back pain. Groessl is a researcher with the VA San Diego Healthcare System and the University of California, San Diego School of Medicine. The study was published in the American Journal of Preventive Medicine on July 20, 2017. The study shows promise for non-drug treatment of chronic low back pain, said Groessl.

“To be able to reduce the reliance upon opioids and other medications with side effects, it is crucial to establish evidence showing mind-body practices like yoga provide benefit in both veterans and non-veterans with chronic pain,” he said.

Yoga Intervention

Veterans in the study who were randomized to the yoga group attended a 12-week yoga program immediately after randomization. Comparison participants were invited to attend the yoga intervention only after six months. The 12-week yoga intervention consisted of two 60-minute, instructor-led yoga sessions per week, with home practice sessions encouraged. The intervention was based on the previously mentioned hatha yoga, which involves yoga postures and movement sequences, along with regulated breathing and mindfulness meditation. Outcomes were assessed at the baseline, six weeks, 12 weeks and six months.

Both study groups had reductions in disability scores after 12 weeks. However, notable differences emerged at the six-month assessment, with scores continuing to drop in the yoga group but increasing in the delayed-treatment group. Along with those improvements, pain intensity decreased in the yoga group at all three time periods, while the delayed-treatment group had negligible changes.

There was also a 20 percent drop in opioid pain medication use at 12 weeks in both groups as determined through self-report questionnaires and a review of medical records. Reductions in disability and pain intensity were found despite the reductions in opioid use and other medical and self-help pain treatments at six months. The trial confirms the findings of two prior randomized controlled trials with non-veterans showing that yoga is safe and can reduce pain and disability among adults with chronic low back pain.

Expanding Formal Yoga Programs

The study is one of the first to demonstrate the effectiveness of yoga specifically in military veterans, a population that faces more health challenges and may be harder to treat than non-VA populations, say the researchers. They point out that as with other non-drug treatments for chronic low back pain, yoga may not help everyone or may not completely eliminate chronic low back pain, but reduced pain and disability can often maintained long-term with ongoing yoga home practice.

The team says that given the results of their study, VA facilities nationwide may want to consider developing and expanding formal yoga programs to help veterans with back pain. Many VA facilities already do offer yoga classes, along with other complementary and integrative health programs.

New Health Benefits Linked To Cycling

It is well known that physical activities have a plethora of health benefits associated with them. A recent study has found that certain types are more effective. Being active is preferred over staying dormant and stagnant a hundred times over but what some people fail to realize is the type of exercise you take part in will directly affect certain health issues or concerns. A senior exercise physiologist named Deb Tregea who performed this study at Penn State found that the type of exercise performed on two wheels has a variety of positive results.

One of the benefits Tregea talks about is not simply related to the body itself but as a means of transportation. She notes that cyclists can be much more practical with their time and money. For those conscious of how car emissions harm the environment, biking is also a great option as your primary mode of transportation. This is perfect for those cities that don’t necessarily have reliable public transportation and for individuals who don’t feel like racking up Uber miles. Cycling also is associated with a ton of physical benefits like the prevention of weight accumulation as well as illnesses associated with weight issues like diabetes and heart disease.

Tregea found that the varied terrain that is often experienced by cyclists after only 20 minutes of riding is enough to allot for the recommended minutes a week of exercise an average adult needs. There are variances and specific inconsistencies when it comes to cycling that can be of benefit to those interested in their level of fitness. Due to the terrain of outdoor cycling, something like climbing a hill works and engages different muscles throughout the body in a way that requires endurance and strength. Even the routes with less strenuous terrain cause the body to react in a way it may not be used to from other forms of exercise.

Low Impact

One of the greatest benefits associated with cycling is its low impact on the body. So many serious athletes or those who take part in strenuous workouts often experience setbacks from physical injuries to their feet, ankles, and knees. This is especially true for those who enjoy running and doing marathons. While these are admirable and highly difficult practices to do on a long-term basis, it’s important to realize that injury is very common as a result of the overwhelming stress on the joints and the knees.

Due to the low impact of cycling, it’s a great option for those who want to be active but struggle with other more strenuous modes of exercise. Those individuals that suffer from conditions like osteoarthritis may find that something like cycling is the perfect option for them as it minimizes wear and tear to joints.

Cycling also has benefits as it relates to leg functionality. For those who have had strength issues with their knees and legs, Tregea says that the prospect of cycling is great for these sufferers as it helps strengthen leg muscles. It can be as easy as a few times around the block on a bike if you’re completely new to the function of cycling, but it can forever positively impact your health and your life. The exercise high often experienced by those who run is also a very common experience with cyclists. Interested in providing yourself some clarity from stress and mental health hiccups? See if cycling helps.

Even Minimal Physical Activity Can Thwart Disease

You’ve likely heard the importance of being active and exercising to promote overall physical health. The state of the body is directly connected to a few things, one of which being how active the body is. A recent study, conducted on over 60,000 adult participants showed that even minimal physical activities make a huge difference for the body. Physical activity thwarts the likelihood of issues like cancer and cardiovascular disease.

Physical Activity Study

The primary reason for the study was to see if less frequent instances of activity could still make a difference. In the cases of many individuals, sometimes adhering to a strict and habitual schedule can be difficult for those who lead a busy life. Sometimes incorporating workouts can be time consuming and simply not feasible depending on the person. It was discovered that despite former claims of almost excessive exercise, that physical activity only once or twice a week also makes a huge difference in a person’s health. “Just one or two occasions of physical activity per week is associated with a lower risk of death,” senior author, Professor Emmanuel Stamatakis, explained.

The study does also go on to say that exceeding the minimum recommendation can also be helpful to both the cardiovascular system as well as the nervous system. The World Health Organization recommends adults get at least 150 minutes per week of some type of moderately difficult physical activity. The other option, in lieu of that recommendation, is at least 75 minutes of vigorous physical activity. The best option really depends on the type of time you can allot for your own physical fitness, but making it a bit of a priority is definitely the way to go. If you don’t have your health, you have very little.

Weekend Warriors

There is a term for those who get only one to two days of physical activity. “Weekend warriors” are what they are dubbed because this is where the predominance of their free time is. During the week they typically don’t have enough time to devote to getting exercise. Those with incredibly busy lifestyles sometimes struggle to get in the amount of physical activity they think they need. This leaves time on the weekends where they can maybe take an aerobics class, go for a bike ride or try a new hiking trail they’ve been hearing about.

Various studies are still trying to figure out what the overall best weekly dose of physical exercise coupled with frequency is. This can be specific depending on the person, their health status, previous health issues, genetics and so on. Real overt vigorous exercise can’t be tolerated well by certain people. This is why the more gentle types of physical activity are generally better for various reasons. They are less likely to result in injury and more likely to be easily incorporated into life at a semi-consistent rate. When a person doesn’t feel personally pressured to work out every single day, on the days where they do, they’ll feel better, give their all and generally perform better in the long run. It’s good to ease yourself into a physical activity, especially if you have a pre-existing health condition or are older. Make sure to consult your doctor.

Don’t feel like you must push your body to the edge in order to improve your health and ward off disease.