Every Minute Counts! Short Bursts of Physical Activity Reduces Mortality

MedicalResearch.com Interview with:

Pedro F. Saint-Maurice, Ph.D. Postdoctoral Fellow Metabolic Epidemiology Branch Division of Cancer Epidemiology and Genetics National Cancer Institute, NIH, HHS Rockville, MD 20850

Dr. Saint-Maurice

Pedro F. Saint-Maurice, Ph.D.
Postdoctoral Fellow
Metabolic Epidemiology Branch
Division of Cancer Epidemiology and Genetics
National Cancer Institute, NIH, HHS
Rockville, MD 20850

MedicalResearch.com: What is the background for this study?

 Response: The 2008 Physical Activity Guidelines for Americans recommends adults do 150 minutes/week of moderate intensity physical activity (PA) in increments of at least 10 minutes at a time. However, there is limited epidemiologic evidence supporting the use of the 10-minute increment and whether shorter increments (for instance walking up the stairs) can also be beneficial for health in adults. We looked at accelerometer-measured physical activity in roughly 5,000 adults (40 and older) representative of the US population and followed them prospectively (over 7 years) to determine whether physical activity accumulated in 10-minute increments, but also accumulated in shorter bursts, were associated with lower risk of death (mortality data came from the National Death Index). Continue reading

Tai Chi At Least As Beneficial As Standard Therapy For Fibromyalgia

MedicalResearch.com Interview with:
“tai chi 11.4.09” by Luigi Scorcia is licensed under CC BY 2.0Chenchen Wang MD, MSc
Professor of Medicine
Tufts University School of Medicine
Director, Center For Complementary And Integrative Medicine
Division of Rheumatology
Tufts Medical Center Boston, MA 02111 

MedicalResearch.com: What is the background for this study?

Response: Patients with chronic widespread pain often try many different types of pain medications, anti-depressants, physical therapy, and other approaches, and commonly find that none of these therapies work for them. Finding safe, effective approaches for pain management is an urgent priority. Previous evidence suggested that Tai Chi, a multi-dimensional mind-body practice that integrates physical, psychosocial, and behavioral elements, may be especially suited to address both chronic pain and associated psychological and somatic symptoms. In our most recent study published in the BMJ, we directly compared the effectiveness of Tai Chi versus aerobic exercise, which is a standard care non-drug treatment for fibromyalgia. Continue reading

Cardiovascular Trials Need Better Characterization of Heart Failure in Diabetics

MedicalResearch.com Interview with:

Stephen J. Greene, MD Division of Cardiology Duke University Medical Center Durham, NC

Dr. Greene

Stephen J. Greene, MD
Division of Cardiology
Duke University Medical Center
Durham, NC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In 2008, the United States FDA issued an industry guidance specifying that diabetes drugs should routinely be tested in large cardiovascular outcome trials to confirm cardiovascular safety. The guidance specifically mentioned cardiovascular safety in terms of MACE, or major adverse cardiac events, including cardiovascular death, myocardial infarction, and stroke.  Largely because of this, these trials have traditionally had a focus on cardiovascular disease in terms of atherosclerotic events. Heart failure was not mentioned in the FDA document and these trials have had a lesser focus on it.

As the years have gone by, we have learned more and more about the connection between diabetes and heart failure. There is tremendous overlap between the two patient populations. Also, as more and more of the large cardiovascular outcome trials have been completed, we have seen multiple examples of various glucose lowering therapies either increasing or decreasing risk of heart failure events. Given all these data on heart failure/ diabetes interactions, the goal of our research was to carefully examine all of the completed large cardiovascular outcome trials of diabetes therapies to systematically describe the type of heart failure-related data they capture. As an initial step in improving heart failure characterization in these trials, we wanted to first describe what trials have already been doing and where the gaps in understanding heart failure in these trials exist.

Overall, we found major gaps in the amount and quality of the heart failure data capture in these trials. We looked at 21 large trials, including over 150,000 patients. Rates of patients with baseline heart failure were inconsistently provided, and among those trials that did provide it, heart failure patients tended to be underrepresented compared to the general population. Patients with baseline heart failure were also poorly characterized, with minimal data on functional status, ejection fraction, or heart failure medications. Only 6 trials reported rates of new-onset heart failure and the definitions used were non-specific. Most trials tended to report rates of heart failure hospitalization, but did not include data on fatal or other types of heart failure events. Only 2 trials included heart failure events within the primary study endpoint. More details are included in our full manuscript, which was published in the Journal of the American College of Cardiology to coincide with our presentation at the ACC conference.

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Fit Obese Patients Can Be Healthy

MedicalResearch.com Interview with:
“Elliptical Stationary Bikes GVSU Winter Hall Exercise Center 2-4-15” by Steven Depolo is licensed under CC BY 2.0Jennifer L. Kuk, PhD

Associate Professor
York University
School of Kinesiology and Health Science
Sherman Health Science Research Centre
Toronto, Ontario  

MedicalResearch.com: What is the background for this study? What are the main findings? 

– The benefits of fitness are well know, but it was unclear whether the benefits applied to those with severe obesity.  This is even more important give that the health risks associated with severe obesity are exponentially higher than in mild obesity.  Fitness in this study was defined as the top 80% of a normal population.This means that unfit is the bottom 20%.  In the past, research has shown that this threshold of fitness is associated with the biggest health benefits.

– We see that 40% of individuals with mild obesity are fit, while 11% of those with severe obesity are fit.  Individuals with high fitness had no differences in health risk, despite the large differences in obesity (~50-100 pounds).  Conversely, those within the unfit group did have significantly higher glucose, blood pressure and lipids with higher obesity levels.

In other words, fitness was able to protect individuals with severe obesity from many of the expected negative health consequences.  Continue reading

Swearing Makes You Stronger @#%^&!

MedicalResearch.com Interview with:
“Good example of Crossfit Weight lifting - In Crossfit Always lift until you reach the point of Failure or you tear something” by CrossfitPaleoDietFitnessClasses is licensed under CC BY 2.0Dr Richard Stephens Senior Lecturer in Psychology

BSc Psychology Programme Director
Keele University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We had previously found that most people are able to tolerate having their hand in ice cold water for longer if they are repeating a swear word compared with repeating a neutral word. In these studies we have also reliably seen an increase in heart rate when swearing, indicating that activation of the fight or flight response is most likely to be what brings about the pain tolerance effects of swearing.

This latest study was designed to see if fight or flight effects of swearing would produce increase performance of physical power and strength tasks. We showed that swearing aloud can give people a boost in terms of physical performance. However, We expected that the effect would be brought about via the fight or flight response (i.e. elevated autonomic nervous system arousal), which is associated with increased adrenalin. But none of the biological measures that we took (e.g. heart rate) were  consistent with that. There was no evidence of a fight or flight response. So perhaps the effect is more psychological, perhaps associated with pain relief from swearing, or else a general disinhibition brought about by swearing in which people just “go for it” a little harder.

MedicalResearch.com: What should readers take away from your report? 

Response: People already know to turn to the register of the swear words when they really need to succeed – look at cyclists powering up hills muttering oaths under their breath! In some ways we have verified verified objectively what is a well known way to get a boost. People can partake of swearing knowing that there is evidence that it can help them with physical performance.  

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: We are currently assessing the effects of swearing on a range of common exercises such as sit ups and push ups. we also intend to assess effects of swearing on physical performance that is less dependent on strength and power such as tasks requiring dexterity or co-ordination (e.g. dancing).

MedicalResearch.com: Is there anything else you would like to add?

 Response: The research was unfunded research carried out by student volunteers at LIU Brooklyn and Keele University. I’d like to say a big thank you to the student volunteers – both investigators and participants!

Crowdfunding website address:- http://swearingmakesyoustronger.bigcartel.com/   People can buy hats and t shirts with the logo “Swearing Makes You Stronger” with the proceeds used to fund further studies in this area (and a charitable donation). 

Citations: Psychology of Sport and Exercise

Volume 35, March 2018, Pages 111-117

Effect of swearing on strength and power performance☆

https://doi.org/10.1016/j.psychsport.2017.11.014

RichardStephensaDavid K.SpiererbEmmanuelKatehisb

https://www.sciencedirect.com/science/article/pii/S1469029216301352

 

 

 

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Snowboarders Have More Upper Body Injuries Than Skiiers

MedicalResearch.com Interview with:
“First day of snowboarding” by kaolin fire is licensed under CC BY 2.0
Dr. Brett D Owens, MD
Dr. Owens is currently Team Physician for the US Lacrosse National Men’s Team, and
Team Physician for Brown University
Professor at Uniformed Services University and Professor at Brown University
Alpert School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study is a review of the literature on ski and snowboarding injuries. We summarize findings by our group and others on the injuries seen with these snow sports and report an overall increase in injuries as participation continues to increase.

Snowboarders have a higher injury rate and there are different injury patterns with skiers experiencing more lower extremity injuries (knee) and snowboarders experiencing more upper extremity injuries (wrist, shoulder, etc.).  Continue reading

Review Finds Antioxidant Supplements of Little to No Benefit in Exercise Recovery

MedicalResearch.com Interview with:
“Pills Vitamins Macro April 22, 2012 4” by Steven Depolo is licensed under CC BY 2.0
Dr Mayur Ranchordas, SFHEA
Senior Lecturer in Sport Nutrition and Exercise Metabolism
Sport Nutrition Consultant
Chair of the Sport and Exercise Research Ethics Group
Sheffield Hallam University
Academy of Sport and Physical Activity
Faculty of Health and Wellbeing
Sheffield

MedicalResearch.com: What is the background for this study? 

Response: People engaging in intense exercise often take antioxidant supplements, such as vitamin C and/or E or antioxidant-enriched foods, before and after exercise in the anticipation that these will help reduce muscle soreness. In a new review published in the Cochrane Library we looked at the evidence from 50 studies. These all compared high-dose antioxidant supplementation with a placebo and their participants all engaged in strenuous exercise that was sufficient to cause muscle soreness. Of the 1089 participants included in the review, nearly nine out of ten of these were male and most participants were recreationally active or moderately trained.

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Doing Something Is Better Than Nothing: Even Light Physical Activity Improves Health

MedicalResearch.com Interview with:

Michael J. LaMonte, PhD, MPH Research Associate Professor Department of Epidemiology and Environmental Health Co-Director, MPH Program (epidemiology) School of Public Health and Health Professions Women’s Health Initiative Clinic University at Buffalo – SUNY 

Dr. LaMonte

Michael J. LaMonte, PhD, MPH
Research Associate Professor
Department of Epidemiology and Environmental Health
Co-Director, MPH Program (epidemiology)
School of Public Health and Health Professions
Women’s Health Initiative Clinic
University at Buffalo – SUNY 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Current national public health guidelines recommend 150 minutes of moderate to vigorous physical activity a week for adults. The guidelines recommend persons 65 and older follow the adult guidelines to the degree their abilities and conditions allow. Some people, because of age or illness or deconditioning, are not able to do more strenuous activity. Current guidelines do not specifically encourage light activity because the evidence base to support such a recommendation has been lacking.

Results from the Objective Physical Activity and Cardiovascular Health (OPACH) Study, an ancillary study to the U.S. Women’s Health Initiative, recently published in the Journal of the American Geriatrics Society showed women ages 65-99 who engaged in regular light intensity physical activities had a reduction in the risk of mortality. The 6,000 women in the OPACH study wore an activity-measuring device called an accelerometer on their hip for seven days while going about their daily activities and were then followed for up to four and a half years.  Results showed that just 30 additional minutes of light physical activity per day lowered mortality risk by 12 percent while 30 additional minutes of moderate activity, such as brisk walking or bicycling at a leisurely pace, exhibited a 39 percent lower risk. 

The finding for lower mortality risk associated with light intensity activity truly is remarkable. We anticipated seeing mortality benefit associated with regular moderate-to-vigorous intensity activity, as supported by current public health guidelines. But, observing significantly lower mortality among women who were active at levels only slightly higher than what defines being sedentary was such a novel finding with important relevance to population health.

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Wearable Device Study Confirms Moderate-to-Vigorous Physical Activity Linked To Decreased Mortality

MedicalResearch.com Interview with:

I-Min Lee, MD, ScD Professor of Medicine, Harvard Medical School Professor of Epidemiology, Harvard T.H. Chan School of Public Health Brigham and Women's Hospital Boston, MA 02215

Dr. Lee

I-Min Lee, MD, ScD
Professor of Medicine, Harvard Medical School
Professor of Epidemiology, Harvard T.H. Chan School of Public Health
Brigham and Women’s Hospital
Boston, MA 02215

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The fact that physical activity lowers the risk of premature mortality is not a new fact – we have many studies showing this.  However, previous studies have primarily relied on self-reported physical activity, and self-reports tend to be imprecise.  Based on these self-report studies, we know that physical activity is associated with a 20-30% reduction in mortality rates.  And, these self-report studies also have focused on moderate-to-vigorous intensity physical activity, since they are more reliably reported than lighter intensity activity.  We have little information on whether light-intensity activities (e.g., light household chores, very slow walking such as when strolling and window shopping) are associated with lower mortality rates.

We now have “wearables” – devices that can more precisely measure physical activity at low (as well as higher) intensities, and sedentary behavior.  The present study, conducted between 2011 and 2015, investigated a large cohort of older women (n=16,741; mean age, 72 years)  who were asked to wear these devices for a week – thus, providing detailed physical activity and sedentary behavior measures.  During an average follow-up of about two-and-a-half years, 207 women died.  The study confirmed that physical activity is related to lower mortality rates.

What is new and important is how strong this association is when we have more precise measures of physical activity – the most active women had a 60-70% reduction in mortality rates, compared with the least active, during the study.  For context, non-smokers have about a 50% risk reduction, compared to smokers, which is why patients (and doctors) should pay attention to being physically active.

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Focusing on Physical Activity Can Help Avoid Unnecessary Later Life Social Care Expenses

MedicalResearch.com Interview with:
Dr. Scarlett McNally

Consultant Orthopaedic Surgeo
Eastbourne D.G.H.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are vast differences between older people in their abilities and their number of medical conditions. Many people confuse ageing with loss of fitness. Ageing has specific effects (reduction in hearing and skin elasticity for example) but the loss of fitness is not inevitable. Genetics contributes only 20% to diseases. There is abundant evidence that adults who take up physical activity improve their fitness up to the level of someone a decade younger, with improvements in ‘up and go’ times. Physical activity can reduce the severity of most conditions, such as heart disease or the risk of onset or recurrence of many cancers. Inactivity is one of the top four risk factors for most long-term conditions. There is a dose-effect curve. Dementia, disability and frailty can be prevented, reduced or delayed.

The need for social care is based on an individual’s abilities; for example, being unable to get to the toilet in time may increase the need for care from twice daily care givers to needing residential care or live-in care, which increases costs five-fold.

Hospitals contribute to people reducing their mobility, with the ‘deconditioning syndrome’ of bed rest, with 60% of in-patients reducing their mobility.

The total cost of social care in the UK is up to £100 billion, so even modest changes would reduce the cost of social care by several billion pounds a year.

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