Walking Pace Addresses Fit versus Fat Debate

MedicalResearch.com Interview with:
sneakers-walkingFrancesco Zaccardi, MD, PhD

Clinical Epidemiologist
Assistant Director Leicester Real World Evidence Unit
Leicester Diabetes Centre
UK

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

Response: The role of excess body weight on mortality has been extensively investigated during the last decades. Studies from several countries have also shown, however, that the risk of death in persons who are overweight or obese is lower if their fitness, a parameter indicating cardio-pulmonary health, is higher.

Most of these studies reported the beneficial effect of fitness in terms of relative risk reduction, for example 20% reduction of risk of death. Relative estimates, though, are difficult to interpret. Continue reading

Effects of Morning Exercise With/Without Breaks in Sitting on Blood Pressure

MedicalResearch.com Interview with:

Michael J. Wheeler  Baker Heart and Diabetes Institute Melbourne, Victoria, Australia

Michael J. Wheeler

Michael J. Wheeler
Baker Heart and Diabetes Institute
Melbourne, Victoria, Australia

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

Response: We conducted this study because separate lines of inquiry have determined that a bout of exercise can acutely lower blood pressure, and more recently that prolonged sitting can increase blood pressure over the space of a day. We wanted to know whether the blood pressure lowering effects of an exercise bout would be diminished by a subsequent period of prolonged sitting or enhanced by a subsequent period of sitting that is regularly interrupted with short walking breaks.

We found an additive blood pressure lowering effect when exercise was combined with breaks in sitting as opposed to exercise plus prolonged sitting. However, this was only true for women. Men had equal blood pressure lowering effects following exercise regardless of whether-or-not subsequent sitting was interrupted Continue reading

Poor Fitness and Obesity in Early Life Linked to Greater Disability as Adult

MedicalResearch.com Interview with:

Pontus Henriksson | PhD and Registered Dietitian Postdoctoral Researcher | SFO-V Fellow Department of Biosciences and Nutrition Karolinska Institutet

Dr. Henriksson

Pontus Henriksson | PhD and Registered Dietitian
Postdoctoral Researcher | SFO-V Fellow
Department of Biosciences and Nutrition
Karolinska Institutet 

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

Response: In many countries, disability pensions are granted to working-aged persons who are likely to never work full-time again because of a chronic disease or injury diagnosed by a physician. In addition to serving as an important indicator of chronic disease, disability pensions are associated with high societal costs.

Hence, we examined whether cardiorespiratory fitness and obesity (two potentially modifiable factors) were associated with disability pension later in life.

Our main findings were that low physical fitness and/or obesity during adolescence, were strongly associated with disability pension later in life due to a wide range of diseases and causes.  Continue reading

Endurance Athletes May Have More Coronary Artery Calcification But No Greater Risk

MedicalResearch.com Interview with:

Laura DeFina, MD President and Chief Executive Officer Chief Science Officer The Cooper Institute 

Dr. DeFina

Laura DeFina, MD
President and Chief Executive Officer
Chief Science Officer
The Cooper Institute

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

Response: Several studies suggest that endurance athletes may be at higher risk for asymptomatic hardening of the coronary arteries.  These studies, however, have been done on small numbers of endurance athletes (ie – marathon runners) and do not show whether this increase in hardening actually leads to increase in heart attacks or death of cardiovascular disease.

In our population of 21,758 generally healthy individuals (average age 52 years) who presented for a preventive medicine examination, we were able to evaluate for the presence of hardening and cardiovascular events in individuals who exercised high volumes (≥3000 MET·minutes/week or comparable to running 6 miles/hour for an hour 5 days a week) versus those exercising less. Continue reading

Mortality Decreases with Increased Aerobic Fitness

MedicalResearch.com Interview with:
"treadmill" by Jeff Blackler is licensed under CC BY 2.0Wael A. Jaber, MD FACC, FESC
Professor of Medicine
Cleveland Clinic Lerner College of Medicine
Fuad Jubran Endowed Chair in Cardiovascular Medicine
Heart and Vascular Institute 

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

Response: We evaluated treadmill tests on over 122, 000 patients between 1991 and 2014. We aimed to evaluate impact of functional capacity (time on treadmill) on all cause mortality.

We found that there is a gradual and incremental reduction in mortality with increased exercise capacity/aerobic fitness in all age groups, sexes, and in patients with and without history of heart disease.

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

Response: Maintaining a high aerobic functional class is associated with greater risk reduction than absence of many known traditional risk factors such as hypertension, diabetes, prior history of CAD.

The risk reduction appears to follow a dose response pattern with no upper limits of benefits; patients with highest functional class benefits most. 

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

Response: We need to test whether an improvement in functional class over time with training can move an individual patients from one mortality curve to a better one. 

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

Response: Maintaining a high functional aerobic class appears to be associated with low mortality in all age groups. Patients appear to derive gain in survival even with the smallest improvement in functional class. However, when it comes to aerobic functional class as measured by treadmill exercise testing, more appears to be better.

Of course, patients should always check with their healthcare provider before starting an exercise program.

No disclosures 

Citation:

Mandsager K, Harb S, Cremer P, Phelan D, Nissen SE, Jaber W. Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing. JAMA Network Open.2018;1(6):e183605. doi:10.1001/jamanetworkopen.2018.3605

Oct 20, 2018 @ 8:30 pm

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How Fit You Are May Depend On The Bacteria in Your Gut

MedicalResearch.com Interview with:

James R. Bagley, PhD Assistant Professor of Kinesiology Director, Muscle Physiology Lab Co-Director, Exercise Physiology Lab Research Director, Strength & Conditioning Lab San Francisco State University

Dr. Bagley

James R. Bagley, PhD
Assistant Professor of Kinesiology
Director, Muscle Physiology Lab
Co-Director, Exercise Physiology Lab
Research Director, Strength & Conditioning Lab
San Francisco State University

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

Response: The human body contains many billions of bacteria cells, and the type of bacteria in your gastrointestinal tract (termed gut microbiota) has been linked to certain diseases.

Most of your gut microbiota falls into two categories: Firmicutes (F) or Bacteroidetes (B). The relative gut F/B ratio has been used to assess microbiota health. Our study was the first to examine potential relationships among F/B ratio and cardiorespiratory fitness, body composition, and diet in healthy young men and women

We recruited 37 healthy adults to undergo a battery of physiological tests and collected stool samples to analyze their gut F/B ratio using qPCR.

We found that F/B ratio was significantly correlated with cardiorespiratory fitness, but with no other variables. In fact, this correlation was so strong that a person’s fitness level explained ~22% of the variance in their gut bacteria composition. Continue reading

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

Pokémon Go! Promotes Walking and Decreases Sitting Time

MedicalResearch.com Interview with:

Jacob Barkley, Ph.D., College of Education, Health and Human Services Kent State

Dr. Barkley

Jacob Barkley, Ph.D.,
College of Education, Health and Human Services
Kent State 

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

Response: Our group has demonstrated that cellular telephone (cell phone) use is positively associated with sedentary behavior (i.e., sitting). To that end, high cell phone users sit for 80 to 100 minutes longer than their lower-use peers. We have also shown that cell phone use during exercise decreases exercise intensity and slows free-living walking speed. In other words, cell use may be comparable to traditional sedentary screen use in that it promotes sitting and may interfere with physical activity. However, some cell phone functions may actually promote positive health behaviors.

Fitness apps, connecting with active peers and administering health recommendations via the cell phone all may have utility in promoting physical activity and reducing sedentary behavior. While not well studied, novel physically-interactive cell phone games may also promote physical activity. One such game, Pokémon Go! requires users to walk through real environments and locate avatars in the game using GPS. The purpose of the game is to find these avatars. In order to find more avatars, the player will need to walk to more areas. Therefore, playing Pokémon Go! may promote walking.

Continue reading

More Adults Walking For Transportation or Leisure, But Demographic Deparities Remain

MedicalResearch.com Interview with:

Emily Neusel Ussery, MPH PhD Epidemiologist, Physical Activity and Health Branch CDC

Dr. Ussery

Emily Neusel Ussery, MPH PhD
Epidemiologist, Physical Activity and Health Branch
CDC

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

Response: Walking is an easy way for most people to start and maintain a physically active lifestyle. Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities identifies walking as an important public health strategy to increase physical activity levels in the U.S. A previous report found that the percentage of adults who reported walking for transportation or leisure increased by 6 percentage points between 2005 and 2010, but it is unknown if this increase has continued. This report examined trends in the proportion of U.S. adults who reported walking for transportation or leisure for at least one 10-minute period in the past week, using nationally representative data from the 2005, 2010, and 2015 National Health Interview Surveys. We also examined differences in walking trends by sociodemographic characteristics. If you take walking seriously, make sure you invest in some custom boots to make sure you don’t damage your feet.

Continue reading

Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults?

MedicalResearch.com Interview with:

Dennis T. Villareal, MD Professor of Medicine Division of Endocrinology, Diabetes & Metabolism Baylor College of Medicine Staff Physician, Michael E DeBakey VA Medical Center

Dr. Villareal

Dennis T. Villareal, MD
Professor of Medicine
Division of Endocrinology, Diabetes & Metabolism
Baylor College of Medicine
Staff Physician, Michael E DeBakey VA Medical Center

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

Response: The prevalence of obesity in the elderly is rapidly increasing, given that the baby boomers are becoming senior citizens, but we do not know how best to manage obesity in the elderly population. Weight loss is the cornerstone of management for obesity but weight loss in the elderly is controversial because weight loss could cause not only fat loss but also muscle mass and bone mass losses, that could worsen rather than improve frailty.

We tested the hypothesis that weight loss plus exercise training, especially resistance training, would improve physical function the most compared to other types of exercise (aerobic training or combined aerobic and resistance training added to diet-induced weight loss).

Previous studies especially in younger adults have shown that combining aerobic with resistance exercise could lead to interference to the specific adaptations to each exercise, and thus less gain in strength with combined exercise compared to resistance training alone.

On the other hand, contrary to our hypothesis, we found that there was no interference between aerobic and resistance exercise, and the most effective mode to improve physical function and thus reverse frailty was in fact weight loss plus the combination of aerobic and resistance exercise, which was also associated with some preservation of muscle and bone mass.

Continue reading

Physical Activity and Abnormal Blood Glucose Among Healthy Weight Adults

MedicalResearch.com Interview with:

Arch G. Mainous III, PhD  HSRMP Department Chair Florida Blue Endowed Professor of Health Administration University of Florida Health

Dr. Arch G. Mainous III

Arch G. Mainous III, PhD
HSRMP Department Chair
Florida Blue Endowed Professor of Health Administration
University of Florida Health

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

Response: As our post-industrial society becomes more and more sedentary, there is a concern that a lack of activity is associated with poor health outcomes like diabetes. At the same time, the medical community has a strong focus on determining whether patients are overweight or obese as a way to classify them as  being at higher risk for poor health outcomes. However, individuals at a “healthy weight” in general, are considered to be at low risk. Some recent studies have shown that many individuals at “healthy weight” are not metabolically healthy. How then might we predict who at “healthy weight” would be unhealthy? We hypothesized that individuals at “healthy weight” who had a sedentary lifestyle would be more likely to have prediabetes or undiagnosed diabetes.

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Fewer Workout Repetitions May Be At Least As Beneficial For Health Benefits

MedicalResearch.com Interview with:

Dr Niels Vollaard Lecturer in Health and Exercise Science Faculty of Health Sciences and Sport Scotland's University

Dr Niels Vollaard

Dr Niels Vollaard
Lecturer in Health and Exercise Science
Faculty of Health Sciences and Sport
Scotland’s University

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

Response: Although the health benefits of regular exercise are undisputable, many people do not manage to achieve the minimum recommended amount of exercise. Because lack of time is a commonly identified reason for not doing enough exercise, over the past decade researchers have increasingly focussed on sprint interval training (SIT) as a time-efficient alternative to aerobic exercise. However, while most SIT protocols do indeed only include a short duration of sprint exercise, they also require recovery periods after each sprint. Therefore, the total training time commitment per session tends to be close to half an hour, which is no less than what is recommended for less strenuous moderate intensity exercise.

To date, most sprint interval training studies have used the protocol that was employed in one of the first studies to look at aerobic adaptations following repeated sprints. This protocol consists of 6 repetitions of 30-second ‘all-out’ sprints. Very few studies have attempted to justify why this number of sprint repetitions would be optimal or even appropriate. Nonetheless, the number of sprint repetitions is of clear importance, as fewer sprints would result in more time-efficient training sessions. Thus, recent years have seen increasing interest in the benefits of SIT protocols with fewer sprints, which makes the protocol shorter and easier. However, up to now it remained unclear what the impact is of the number of sprint repetitions on key markers of health, such as maximal aerobic fitness (VO2max). This is of importance, as VO2max is the best predictor of risk of future disease and premature death.

Continue reading

45 Minutes of Exercise Per Week Maintains Function in Adults With Arthritis

MedicalResearch.com Interview with:

Dorothy D. Dunlop Ph.D. Professor of Medicine and Preventive Medicine Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine Center for Healthcare Studies Chicago, IL 60611

Dr. Dorothy Dunlop

Dorothy D. Dunlop Ph.D.
Professor of Medicine and Preventive Medicine
Northwestern University Feinberg School of Medicine
Institute for Public Health and Medicine
Center for Healthcare Studies
Chicago, IL 60611 

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

 

  • We know is being active is good for health.
  • Good evidence supports the current federal guidelines of doing 150 minutes of moderate physical activity each week to prevent serious conditions such as heart disease
  • But only 1 in 10 older US adults with arthritis in their lower limb joints (e.g., knees) meet federal physical activity guidelines
  • Inadequate physical activity is a major public health concern because It can lead to poor function, which threatens a person’s ability to live independently.

These issues motivated our study to investigate the minimum time commitment needed to improve function (or sustain high function) for adults with lower joint osteoarthritis.

Continue reading

“Weekend Warriors” Reduce Mortality From Heart Disease and Cancer

MedicalResearch.com Interview with:

Gary O’Donovan, Ph.D. Research Associate: Exercise as Medicine School of Sport, Exercise and Health Sciences National Centre for Sport and Exercise Medicine Loughborough University

Dr. Gary O’Donovan,

Gary O’Donovan, Ph.D.
Research Associate: Exercise as Medicine
School of Sport, Exercise and Health Sciences
National Centre for Sport and Exercise Medicine
Loughborough University

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

Response: This study was inspired by the classic Harvard University study of weekend warriors. It was a privilege to work with Professor I-Min Lee, one of the authors of the classic study. Our study was much larger than the classic study.

With greater statistical power, we found that, compared with inactive adults, all-cause mortality, cardiovascular disease mortality, and cancer mortality risks were significantly lower in weekend warriors who performed the recommended amount of 150 minutes of moderate or 75 minutes of vigorous activity in one or two sessions per week. Our study extends the classic study by showing that the benefits of the weekend warrior physical activity pattern are much the same in men and women.

Continue reading

Non-Exercise Algorithm Predicts Fitness and Lifestyle-Related Disease

MedicalResearch.com Interview with:
Bjarne M. Nes, PhD
K.G. Jebsen Center for Exercise in
Medicine, Department of Circulation and Medical Imaging
Norwegian University of Science and Technology
Trondheim, Norway.

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

Response: It is well known that cardiorespiratory fitness is an important predictor of future cardiovascular disease risk. Still, fitness levels are rarely measured in clinical practice, likely because of costly and time-consuming procedures that requires quite a lot of training.

Therefore, we wanted to test the ability of a simple estimation of fitness, from a so-called non-exercise algorithm, to identify individuals at high and low risk of cardiovascular mortality. We tested fitness alone and in combination with traditional risk factors such as high blood pressure, cholesterol, smoking and family history of heart disease and diabetes, among 38,480 men and women from the Nord-Trondelag Health Study in Norway. We found that estimated fitness strongly predicts premature deaths from all causes and that traditional clinical risk factors added little above and beyond fitness in terms of predicting risk.

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High Fitness Level Can Reduce Cardiovascular Risk of Prolonged Daily Sitting

MedicalResearch.com Interview with:

Ulrik Wisløff, PhD Professor, Head of K.G. Jebsen Center for Exercise in Medicine Department of Circulation and Medical Imaging Norwegian University of Science and Technology Norway

Dr. Ulrik Wisløff

Ulrik Wisløff, PhD
Professor, Head of K.G. Jebsen Center for Exercise in Medicine
Department of Circulation and Medical Imaging
Norwegian University of Science and Technology
Norway

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

Response: Prolonged time spent sedentary on a daily basis is detrimental for general health and is associated with increased risk of developing and dying from lifestyle related diseases such as cardiovascular disease – even in those following todays advice for physical activity given by health authorities worldwide. Number of hours spent inactive tend to increase with increased age. A person’s fitness level is regarded the best predictor of future health. We tested, in older adults (aged 70-77 years old) whether meeting physical activity recommendations and/or having high age-specific fitness level attenuated the adverse effect of prolonged sedentary time on cardiovascular risk factor clustering.

Main finding was that high age-specific fitness level fully attenuated the adverse effect of prolonged sedentary time on clustering of cardiovascular risk factors, independent of meeting the physical activity recommendation in older adults.

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Exercise and Pregnancy in Recreational and Elite Athletes Reviewed

MedicalResearch.com Interview with:

Prof. Kari Bø PhD Norwegian School of Sport Sciences Oslo, Norway

Prof. Kari Bø

Prof. Kari Bø PhD
Norwegian School of Sport Sciences
Oslo, Norway

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

Response: The background is that more and more female elite athletes continue to exercise into their 30s and beyond and more want to become pregnant and some to continue to compete at the same level after giving birth.

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

Response: To date there is little scientific knowledge on elite athletes and others who perform strenuous exercise (eg women in the military) during pregnancy and after childbirth and we therefore have to be cautious when recommending intensity levels of both endurance and strength training exercise. However, given the knowledge we have now.

  • Elite athletes planning pregnancy may consider reducing high impact training routines in the week after ovulation and refraining from repetitive heavy lifting regimens during the first trimester as some evidence suggests increased miscarriage risk.
  • There is little risk of abnormal fetal heart rate response when elite athletes exercise at <90% of their maximal heart rates in the second and third trimesters.
  • Baby birthweights of exercising women are less likely to be excessively large (>4000g) and not at increased risk of being excessively small (<2500g).
  • Exercise does not increase the risk of preterm birth.
  • Exercise during pregnancy does not increase the risk of induction of labour, epidural anesthesia, episiotomy or perineal tears, forceps or vacuum deliveries.
  • There is some encouraging evidence that the first stage of labour (before full dilatation) is shorter in exercising women.
  • There is also some encouraging evidence that exercise throughout pregnancy may reduce the need for caesarean section.

Continue reading

Do People Wearing Activity Trackers Really Exercise More?

MedicalResearch.com Interview with:
Aarti Sahasranaman, PhD
Duke-NUS Gradaute Medical School
Singapore

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

Response: More than half of adults in developed countries do not achieve recommended levels of physical activity. Despite the popularity of activity trackers as a tool for motivating and monitoring activity levels, little research exists on whether they can help people lead healthier lives, or if financial incentives could encourage people to wear them for longer and achieve higher fitness levels. One in ten US adults owns an activity tracker but research suggests that about a third of people abandon them within 6 months of purchase.

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Poor Fitness Second Only To Smoking As Mortality Risk

MedicalResearch.com Interview with:

Dr Per Ladenvall Department of Molecular and Clinical Medicine Sahlgrenska Academy University of Gothenburg Sweden

Dr. Ladenvall

Dr Per Ladenvall
Department of Molecular and Clinical Medicine
Sahlgrenska Academy
University of Gothenburg
Sweden

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

Response: Aerobic capacity has been shown in other studies with shorter duration to be of importance for mortality. In the 1963 a population based study including every third man living in Gothenburg started. These men have since been followed up repeatedly until 100 years. For the present analysis men were invited to do a bicycle exercise test in 1967 and were followed up to 99 years.

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Maintaining Aerobic Fitness Linked Decreased Risk of Premature Death

MedicalResearch.com Interview with:

Jari Laukkanen MD, PhD Cardiologist Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland

Dr. Jari Laukkanen

Jari Laukkanen MD, PhD
Cardiologist
Institute of Public Health and Clinical Nutrition
University of Eastern Finland
Kuopio Finland

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

Response: In this population-based study we found a strong inverse association between long-term change in directly measured cardio-respiratory fitness (CRF), using maximal oxygen uptake (VO2peak) and all-cause mortality. A small decrease in CRF over 11-years was associated with a lower risk of all-cause death in a graded fashion. The observed association was independent of risk factors. This population-based study with repeated and direct assessment of CRF using a very similar time-interval for all participants, whereas some previous studies showing the value of CRF were constructed on participants referred to exercise testing at varying time-intervals between two repeated tests using only indirect cardio-respiratory fitness assessment or other exercise scores.

Cardiorespiratory fitness was assessed at baseline and follow-up using respiratory gas analyzer which is a golden standard for assessing aerobic fitness level. A single assessment of CRF predicts outcomes, however, no previous studies using directly measured VO2max have shown the association between long term changes in VO2max (i.e. 10 years) and its association with mortality. In the recent study VO2max defined from respirator gases with similar time-interval between two separate assessments of VO2max (=directly measured). This is a very novel finding in the field of exercise sciences, as well as in cardiovascular prevention and rehabilitation.

Although cardio-respiratory fitness is recognized as an important marker of functional ability and cardiovascular health, it is currently the major risk factor that is not routinely and regularly assessed in either the general or specialized clinical setting, although it is suggested that an individual’s CRF level has been even a stronger or similar predictor of mortality than the traditional risk factors, including smoking, hypertension, high cholesterol, and type 2 diabetes mellitus.

Continue reading

Children With Atopic Diseases Are Less Physically Active

MedicalResearch.com Interview with:

Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois

Dr. Jonathan Silverberg

Dr. Jonathan L. Silverberg MD PhD MPH
Assistant Professor in Dermatology
Medical Social Sciences and Preventive Medicine
Northwestern University, Chicago, Illinois 

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

Dr. Silverberg: We previously demonstrated that children with atopic disease have higher cardiovascular risk. One possible explanation for this association is that children with atopic disease are more sedentary. Indeed, children with atopic disease have a number of risk factors for sedentary behavior, including poor sleep and flaring of asthma and eczema from vigorous activity.

MedicalResearch.com: What are the main findings?

Dr. Silverberg: We found that children with asthma had decreased vigorous physical activity and less sports participation. In particular, severe atopic disease and atopic disease accompanied by sleep disturbance were associated with less vigorous physical activity or participation in sports and more time watching television and playing video games.

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

Dr. Silverberg: Asthma, atopic dermatitis and hay fever are chronic diseases can negatively impact children’s health behaviors. This study demonstrates that children with atopic disease are less physically active and more sedentary. It is important for clinician’s to recognize the effects of these disorders.

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

Dr. Silverberg: Asthma, atopic dermatitis and hay fever are chronic diseases can negatively impact children’s health behaviors. This study demonstrates that children with atopic disease are less physically active and more sedentary. It is important for clinician’s to recognize the effects of these disorders.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Associations of Physical Activity and Sedentary Behavior with Atopic Disease in United States Children

Strom, Mark A. et al.
The Journal of Pediatrics , Volume 0 , Issue 0

DOI: http://dx.doi.org/10.1016/j.jpeds.2016.03.063

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Matching Genotype to Training Program Improves Performance

MedicalResearch.com Interview with:
Nicholas Jones BSc (Hons) MSc ISAK CSCS ASCC
DNA Sports Performance Ltd Director

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

Response: Coaches and trainers all know that individuals can respond differently to the same stimulus. One person may be a super responder to X training method, another may be a none-responder to the very same training method. The reasons for this have never been fully explained, however genetics have been discussed and thought to play a role for some time.

MedicalResearch.com: What are the main findings?

Response: At the beginning of the eight weeks of training, the participants were set two fitness tests to measure their power and endurance. Power was measured by a countermovement jump (CMJ) and endurance by an aerobic three minute cycle test (known as Aero3).

After eight weeks, those whose training had been matched to their genes improved their CMJ power test of 7.4% compared to just a 2.6% increase in the mismatched group. In the cycle endurance test, those who trained to their genetic strengths saw an average 6.2% improvement compared to 2.3% for the mismatched group.

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High Fitness Level May Reduce Mortality After First Heart Attack

MedicalResearch.com Interview with:
Gabriel E. Shaya MS

University of Miami Miller School of Medicine
MD/MPH Candidate 2016

Medical Research: What is the background for this study?

Response: High exercise capacity has been established as an important protective factor against a wide array of poor health indicators and outcomes including cardiovascular morbidity and mortality. Most of the studies assessing the association of exercise capacity and cardiovascular outcomes have done so over an extended period of followup, however, whether high exercise capacity may influence the risk of early mortality following a first myocardial infarction has not been investigated. This is the question that we sought to answer in our study.

Medical Research: What are the main findings?

Response: Our study found that high exercise capacity was associated with statistically significant and clinically meaningful risk reductions in mortality in the short-term following a first myocardial infarction. Achieving the highest category of fitness in our cohort was associated with as much as a 60% mortality risk reduction relative to those in the least fit category, and similar magnitudes of benefit were observed to persist up to 1 year after a myocardial infarction. Importantly, the greatest risk reductions were observed when comparing the least fit patients to those with moderate fitness, suggesting that those with relatively low fitness may stand to benefit most from even just modest fitness improvements.

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Vigorous Exercise Linked To Lower All-Cause Mortality

Klaus Gebel GradDipExRehab, MExSc, MAppSc, PhD Senior Research Fellow Centre for Chronic Disease Prevention College of Public Health, Medical & Veterinary Sciences James Cook University Cairns AUSTRALIAMedicalResearch.com Interview with:
Klaus Gebel
GradDipExRehab, MExSc, MAppSc, PhD
Senior Research Fellow
Centre for Chronic Disease Prevention
College of Public Health, Medical & Veterinary Sciences
James Cook University
Cairns Australia

Medical Research: What is the background for this study?

Response: The physical activity guidelines in most countries recommend for adults to accumulate at least 150 minutes of moderate physical activity (e.g. brisk walking) or 75 minutes of vigorous activity (e.g. jogging or cycling) or an equivalent combination of moderate and vigorous activities where 2 minutes of moderate-intensity activity counts the same as 1 minute of vigorous-intensity activity. However, there have only been a few studies that examined the health benefits of different proportions of moderate and vigorous activity in the composition of total activity. The objective of this study was to examine whether the proportion of total moderate-to-vigorous activity that is achieved through vigorous activity is associated with all-cause mortality, independently of the total amount of moderate-to-vigorous activity. Data were used from the 45 and Up study from the state of New South Wales in Australia, the largest cohort study ever conducted in the Southern hemisphere.

Medical Research: What are the main findings?

Response: During 1,444,927 person-years of follow-up, 7,435 deaths were registered. Compared with those who reported no moderate-to-vigorous activity (crude death rate=8.34%), the adjusted hazard ratios for all-cause mortality were 0.66 (95% CI 0.61-0.71; crude death rate=4.81%), 0.53 (0.48-0.57; 3.17%), and 0.46 (0.43-0.49; 2.64%) for reporting 10-149, 150-299, and for ≥300 minutes of activity per week respectively. Among those participants who reported any moderate-to-vigorous physical activity, the proportion of vigorous activity showed a dose-response relationship with all-cause mortality: compared with those reporting no vigorous activity (crude death rate=3.84%) the fully-adjusted hazard ratio was 0.91 (95% CI=0.84-0.98; crude death rate=2.35%) in those who reported some vigorous activity (but <30% of total activity); and 0.87 (0.81-0.93; 2.08%) among those who reported ≥30% of activity as vigorous. These associations were consistent in men and women, across categories of body mass index and volume of moderate-to-vigorous physical activity, and in those with and without existing cardiovascular disease or diabetes mellitus.

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Cardiorespiratory Fitness May Decrease Cancer Risk and Improve Survival

cdc-cardiorespiratory-fitness

CDC Image: Cardiorespiratory Fitness

MedicalResearch.com Interview with:

Susan G. Lakoski, M.D.

Assistant Professor of Medicine, Hematology/Oncology DivisionDepartment of Medicine Director, Cardiovascular Prevention Program for Cancer PatientsVermont Cancer Center, Division of Hematology/OncologyUniversity of Vermont, BurlingtonCo-Investigators from Cooper Center Longitudinal Study
Cooper Institute in Dallas, Texas

Medical Research: What is the background for this study? What are the main findings?


Dr. Lakoski:

  • High cardiorespiratory fitness (CRF) is associated with 55% reduction in lung cancer and 44% reduction in colorectal cancer in white men. These results were similar even among non-smokers.
  • High cardiorespiratory fitness is associated with a one-third risk reduction in all cancer-related deaths among men who developed lung, colorectal, or prostate cancer at age 65 years or older compared with low cardiorespiratory fitness.
  • High cardiorespiratory fitness is associated with a two-thirds reduction in cardiovascular death compared with low cardiorespiratory fitness among men who developed cancer at age 65 years or older.
  • There is an strong inverse relationship association between fitness and subsequent diagnosis of incident lung and colorectal cancer, but not prostate cancer, in white men.

MedicalResearch.com: What should patients and clinicians take away from this report:

Dr. Lakoski:

A) The relationship between fitness and prostate cancer risk is controversial. It is possible that men with higher cardiorespiratory fitness may be more likely to undergo more frequent preventive health care screening and/or detection visits and, thus, had greater opportunity to be diagnosed as having localized prostate cancer relative to men of lower cardiorespiratory fitness. Importantly, men who developed prostate cancer in the current study, had a lower risk of ultimately dying of cancer or cardiovascular disease if ‘fit’ prior to disease onset. This speaks to the importance of being ‘fit’ in mid-life to improve survival even if a man ultimately develops lung, prostate, or colorectal cancer later in life.

B). Among the men who developed cancer, those who were more fit at middle age had a lower risk of dying from all the three cancers studied, as well as cardiovascular disease. Even a small improvement in fitness (by 1-MET) made a significant difference in survival ─ reducing the risks of dying from cancer and cardiovascular disease by 10 and 25 percent, respectively.

EXAMPLE of what a 1-MET difference equates to:
Running, 5 mph (12 min/mile)  = 8 METs
Running, 5.2 mph (11.5 min/mile) = 9 MET

C) Our findings indicate that cardiorespiratory fitness provides cancer risk prediction information beyond these established lifestyle risk factors. These findings provide support for the utility of cardiorespiratory fitness assessment (via a maximal exercise treadmill test) in preventive health care settings and possibly following a diagnosis of cancer.

The benefits of measuring fitness include:

1) Provide accurate and stable marker of exercise exposure and dose.

2) Measurements can be reproducibly measured over time.

3) Normative values are available to compare fitness levels of patients to the general population for counseling.

4) Allows clinicians to prescribe personalized exercise training goals for patients.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Lakoski: Future studies are needed to test these results across all major cancers in men and women and also address how much an individual must change their fitness to see cancer prevention benefit.

Citation:

Lakoski SG, Willis BL, Barlow CE, et al. Midlife Cardiorespiratory Fitness, Incident Cancer, and Survival After Cancer in Men: The Cooper Center Longitudinal Study. JAMA Oncol. Published online March 26, 2015. doi:10.1001/jamaoncol.2015.0226.

 

MedicalResearch.com Interview with: Susan G. Lakoski, M.D. (2015). Cardiorespiratory Fitness May Decrease Cancer Risk and Improve Survival

Dark Chocolate May Improve Exercise Capacity and Metabolic Parameters

Pam R. Taub, MD, FACC Assistant  Professor of Medicine UC San Diego Health System Division of Cardiology Encinitas, CA 92024MedicalResearch.com Interview with:
Pam R. Taub, MD, FACC
Assistant  Professor of Medicine
UC San Diego Health System
Division of Cardiology Encinitas, CA 92024

Medical Research: What is the background for this study?

Dr. Taub: Epidemiological studies indicate that the consumption of modest amounts of dark chocolate (DC), which contains the natural cacao flavanol (-)-epicatechin (Epi,) is associated with reductions in the incidence of cardiovascular diseases (CVD). The health benefits of dark chocolate have been attributed to Epi. Clinical studies using cocoa and/or DC in normal volunteers or subjects with CVD have reported improvements in peripheral and coronary vascular endothelial function, blood pressure, lipids, insulin resistance, and inflammatory markers. The mechanism underlying these improvements is thought to be due to increased nitric oxide levels and improved endothelial function. We have also shown that capacity of Epi to favorable impact mitochondria under normal and disease states.

We previously conducted pilot study in five patients with heart failure and type II diabetes, and showed that in skeletal muscle (SkM) biopsies there is a severe reduction in mitochondrial volume and cristae, as well as, in structural/functional proteins. After treatment with Epi rich dark chocolate , there was a significant recovery of SkM mitochondrial cristae, structural/functional proteins (e.g. mitofilin), as well as in regulators of mitochondrial biogenesis. However, no studies have examined the capacity of Epi rich dark chocolate to enhance exercise capacity in normal subjects and assess its impact on mitochondrial and oxidative control systems.

Medical Research: What are the main findings?

Dr. Taub: Seventeen subjects were randomized to placebo (n=8) or DC groups (n=9) and consumed 2 squares of chocolate (20 g, provided by Hershey) for 3 months.

We showed in the chocolate group subjects had improved levels of HDL cholesterol and enhanced exercise capacity that is linked to the stimulation of SkM metabolic control endpoints which enhance mitochondrial function.

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Pedometers Motivated Patients To Increase Physical Activity And Weight Loss

MedicalResearch.com Interview with
Christopher C. Imes, PhD, RN
Assistant Professor, Acute and Tertiary Care
University of Pittsburgh, School of Nursing

MedicalResearch: What is the background for this study?

Dr. Imes: Increased physical activity (PA) with reduced energy intake is the key strategy to achieve weight loss. However, in research, there are challenges to obtaining accurate PA data. Many studies rely on self-report, which is easily accessible and inexpensive but is known to have numerous limitations. Pedometers are a relatively inexpensive and accessible method to objectively measure certain aspects of physical activity. The purpose of this analysis was to examine the associations between self-reported physical activity, pedometer step count data and weight loss during the first 6-months of the Self-Efficacy Lifestyle Focus (SELF) trial. All participants in this trial were instructed to reduce their calorie and fat intake, were encouraged to engage in at least 150 minutes of moderately intense PA/week or 7500 steps/day, and to self-monitor their diet and physical activity.

MedicalResearch: What are the main findings?

Dr. Imes: Change in self-reported physical activity from baseline to 6 months was not associated with weight change. However, average daily step count, derived from pedometers given to participants during the same time period, was associated with weight loss. More daily steps results in more weight loss. The participants who averaged over 7500 steps/day lost about 9.5% of their initial body weight; whereas, the participants who averaged less than 5000 steps/day only lost about 5.0%.

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Diet and Exercise Offer Some Protection Against Knee Pain in Obese Diabetics

Dan White PT , ScD, Msc University of DelawareMedicalResearch.com Interview with:
Dan White PT , ScD, Msc

University of Delaware

Medical Research: What is the background for this study? What are the main findings?

Dr. White: We know that diet and exercise are beneficial to reduce knee pain, however it is not known whether diet and exercise can actually prevent the development of knee pain in people at high risk.  We found that an intensive program of diet and exercise had a small but statistically significant protective effect with preventing the development of knee pain in overweight and obese people with diabetes.
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Cardiorespiratory Fitness May Slow Memory Loss In Older Adults

Scott M. Hayes, Ph.D. Associate Director Neuroimaging Research for Veterans Center Memory Disorders Research Center VA Boston Healthcare System Assistant Professor of Psychiatry Boston University School of MedicineMedicalResearch.com Interview with:
Scott M. Hayes, Ph.D. Associate Director

Neuroimaging Research for Veterans Center
Memory Disorders Research Center
VA Boston Healthcare System
Assistant Professor of Psychiatry
Boston University School of Medicine

Medical Research: What is the background for this study? What are the main findings?

Dr. Hayes:   Studies with rodents have demonstrated that physical activity positively impacts memory, whereas human studies have tended to emphasize a relationship with executive function—which refers to one’s ability to plan, organize, and manipulate information in one’s mind.  To clarify the relationship between fitness, cognition, and aging, we directly assessed cardiorespiratory fitness (heart and lung function) using the gold standard in the field, a graded treadmill test, and assessed both memory and executive functions in young and older adults.  Our results showed that cardiorespiratory fitness was positively associated with memory and executive functions in older adults, but not young adults.  In fact, on tests of executive functions, older adults with higher levels of cardiorespiratory fitness performed as well as younger adults. The impact of cardiorespiratory fitness may be age-dependent.  Young adults, who are at their peak in terms of memory performance, may exhibit minimal associations with cardiorespiratory fitness.  In contrast, cardiorespiratory fitness likely has a larger impact in older adults by attenuating age-related decline in memory.

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Fitness An Important Predictor of Heart Failure

Carl "Chip" Lavie MD, FACC Medical  Director, Cardiac  Rehabilitation and Prevention Director, Exercise Laboratories John Ochsner Heart and Vascular Institute Professor of Medicine Ochsner Clinical  School-UQ School of Medicine Editor-in-Chief, Progress in Cardiovascular DiseasesMedicalResearch.com Interview with:
Carl “Chip” Lavie MD, FACC
Medical  Director, Cardiac  Rehabilitation and Prevention
Director, Exercise Laboratories
John Ochsner Heart and Vascular Institute
Professor of Medicine
Ochsner Clinical  School-UQ School of Medicine
Editor-in-Chief, Progress in Cardiovascular Diseases

Medical Research: What are the key points of your editorial?

Dr. Lavie:

1) The importance of higher fitness to predict a lower rate of developing Heart Failure;

2) improvements in fitness over  time  predict a lower rate of developing  Heart Failure, and

3) Once Heart Failure develops, higher fitness predicts a more favorable prognosis.

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