EXERCISE

Does exercise enhance the quality of your life? Does exercise significantly increase the odds of living a healthier and longer life, from both a mental and physical perspective? Here are some of the latest scientific journal articles.

March 2023

Death and Chronic Diseases

When you can’t fit your entire workout into a busy day, do you think there’s no point in doing anything at all? You should rethink that mindset. Just 11 minutes of moderate-to-vigorous intensity aerobic activity per day could lower your risk of cancer, cardiovascular disease or premature death, a large new study has found.

Aerobic activities include walking, dancing, running, jogging, cycling and swimming. You can gauge the intensity level of an activity by your heart rate and how hard you’re breathing as you move. Generally, being able to talk but not sing during an activity would make it moderate intensity. Vigorous intensity is marked by the inability to carry on a conversation.

Higher levels of physical activity have been associated with lower rates of premature death and chronic disease, according to past research. But how the risk levels for these outcomes are affected by the amount of exercise someone gets has been more difficult to determine. To explore this impact, scientists largely from the University of Cambridge in the United Kingdom looked at data from 196 studies, amounting to more than 30 million adult participants who were followed for 10 years on average. The results of this latest study were published Tuesday in the British Journal of Sports Medicine.

The study mainly focused on participants who had done the minimum recommended amount of 150 minutes of exercise per week, or 22 minutes per day. Compared with inactive participants, adults who had done 150 minutes of moderate-to-vigorous aerobic physical activity per week had a 31% lower risk of dying from any cause, a 29% lower risk of dying from cardiovascular disease and a 15% lower risk of dying from cancer.

The same amount of exercise was linked with a 27% lower risk of developing cardiovascular disease and 12% lower risk when it came to cancer.

“This is a compelling systematic review of existing research,” said CNN Medical Analyst Dr. Leana Wen, an emergency physician and public health professor at George Washington University, who wasn’t involved in the research. “We already knew that there was a strong correlation between increased physical activity and reduced risk for cardiovascular disease, cancer and premature death. This research confirms it, and furthermore states that a smaller amount than the 150 minutes of recommended exercise a week can help.”

Even people who got just half the minimum recommended amount of physical activity benefited. Accumulating 75 minutes of moderate-intensity activity per week, about 11 minutes of activity per day was associated with a 23% lower risk of early death. Getting active for 75 minutes on a weekly basis was also enough to reduce the risk of developing cardiovascular disease by 17% and cancer by 7%.

Beyond 150 minutes per week, any additional benefits were smaller.

“If you are someone who finds the idea of 150 minutes of moderate-intensity physical activity a week a bit daunting, then our findings should be good news,” said study author Dr. Soren Brage, group leader of the Physical Activity Epidemiology group in the Medical Research Council Epidemiology Unit at the University of Cambridge, in a news release. “This is also a good starting position, if you find that 75 minutes a week is manageable, then you could try stepping it up gradually to the full recommended amount.”

The authors’ findings affirm the World Health Organization’s position that doing some physical activity is better than doing none, even if you don’t get the recommended amounts of exercise.

“One in 10 premature deaths could have been prevented if everyone achieved even half the recommended level of physical activity,” the authors wrote in the study. Additionally, “10.9% and 5.2% of all incident cases of CVD (cardiovascular disease) and cancer would have been prevented.”


June 2020

Risk for Chronic Disease Plus Your Quality of Life

Regular physical activity is one of the easiest ways to reduce your risk for chronic disease and to improve your quality of life. But most Americans do not move enough. No matter your age or ability, you can choose to move more for better health.
Make physical activity a priority to:

  1. Improve your memory and brain function (all age groups).
  2. Protect against many chronic diseases.
  3. Aid in weight management.
  4. Lower blood pressure and improve heart health.
  5. Improve your quality of sleep.
  6. Reduce feelings of anxiety and depression.
  7. Combat cancer-related fatigue.
  8. Improve joint pain and stiffness.
  9. Maintain muscle strength and balance.
  10. Increase your odds for living a longer life.

 


January 2022

What are the Mental Health Benefits of Exercise?

Exercise is not just about aerobic capacity and muscle size. Sure, exercise can improve your physical health and your physique, trim your waistline, improve your sex life, and even add years to your life. But that’s not what motivates most people to stay active.

People who exercise regularly tend to do so because it gives them an enormous sense of well-being. They feel more energetic throughout the day, sleep better at night, have sharper memories, and feel more relaxed and positive about themselves and their lives. And it’s also a powerful medicine for many common mental health challenges.

Regular exercise can have a profoundly positive impact on depression, anxiety, and ADHD. It also relieves stress, improves memory, helps you sleep better, and boosts your overall mood. And you don’t have to be a fitness fanatic to reap the benefits. Research indicates that modest amounts of exercise can make a real difference. No matter your age or fitness level, you can learn to use exercise as a powerful tool to deal with mental health problems, improve your energy and outlook, and get more out of life.

Exercise and Depression

Studies show that exercise can treat mild to moderate depression as effectively as antidepressant medication, but without the side-effects. As one example, a recent study done by the Harvard T.H. Chan School of Public Health found that running for 15 minutes a day or walking for an hour reduces the risk of major depression by 26%. In addition to relieving depression symptoms, research also shows that maintaining an exercise schedule can prevent you from relapsing.

Exercise is a powerful depression fighter for several reasons. Most importantly, it promotes all kinds of changes in the brain, including neural growth, reduced inflammation, and new activity patterns that promote feelings of calm and well-being. It also releases endorphins, powerful chemicals in your brain that energize your spirits and make you feel good. Finally, exercise can also serve as a distraction, allowing you to find some quiet time to break out of the cycle of negative thoughts that feed depression.

Exercise and Anxiety

Exercise is a natural and effective anti-anxiety treatment. It relieves tension and stress, boosts physical and mental energy, and enhances well-being through the release of endorphins. Anything that gets you moving can help, but you’ll get a bigger benefit if you pay attention instead of zoning out.

Try to notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of the wind on your skin. By adding this mindfulness element, really focusing on your body and how it feels as you exercise, you’ll not only improve your physical condition faster, but you may also be able to interrupt the flow of constant worries running through your head.

Exercise and Stress

Ever noticed how your body feels when you’re under stress? Your muscles may be tense, especially in your face, neck, and shoulders, leaving you with back or neck pain, or painful headaches. You may feel a tightness in your chest, a pounding pulse, or muscle cramps. You may also experience problems such as insomnia, heartburn, stomachache, diarrhea, or frequent urination. The worry and discomfort of all these physical symptoms can in turn lead to even more stress, creating a vicious cycle between your mind and body.

Exercising is an effective way to break this cycle. As well as releasing endorphins in the brain, physical activity helps to relax the muscles and relieve tension in the body. Since the body and mind are so closely linked, when your body feels better so, too, will your mind.

Exercise and ADHD

Exercising regularly is one of the easiest and most effective ways to reduce the symptoms of ADHD and improve concentration, motivation, memory, and mood. Physical activity immediately boosts the brain’s dopamine, norepinephrine, and serotonin levels, all of which affect focus and attention. In this way, exercise works in much the same way as ADHD medications such as Ritalin and Adderall.

Exercise and PTSD and Trauma

Evidence suggests that by really focusing on your body and how it feels as you exercise, you can actually help your nervous system become “unstuck” and begin to move out of the immobilization stress response that characterizes PTSD or trauma. Instead of allowing your mind to wander, pay close attention to the physical sensations in your joints and muscles, even your insides as your body moves. Exercises that involve cross movement and that engage both arms and legs, such as walking (especially in sand), running, swimming, weight training, or dancing, are some of your best choices.

Outdoor activities like hiking, sailing, mountain biking, rock climbing, whitewater rafting, and skiing (downhill and cross-country) have also been shown to reduce the symptoms of PTSD.

 


February 2021

Why Exercise?

Exercise is powerful medicine. Exercise is an important part of a healthy lifestyle. Exercise prevents health problems, builds strength, boosts energy, and can help you reduce stress. It can also help you maintain a healthy body weight and curb your appetite. Exercise is the path to improved health. Adding exercise to your routine can positively affect your life.

Exercise can:

  • Reduce your risk of heart disease, high blood pressure, osteoporosis, disabets, and obesity.
  • Reduce your risk of breast, colorectal, and uterine cancer
  • Keep joints, tendons, and ligaments flexible, which makes it easier to move around and decreases your chance of falling
  • Reduce some of the effects of aging, especially the discomfort of osteoarthritis.
  • Contribute to mental well-being and help treat depression.
  • Help relieve stress and anxiety
  • Increase energy and endurance
  • Improve sleep
  • Help maintain a normal weight by increasing your metabolism (the rate you burn calories)

Can anyone exercise?

Everyone can benefit from physical activity, even the elderly. For most people, it is possible to begin exercising at your own at a slow pace. If you have never exercised before, start with a 10-minute period of light exercise. A brisk walk every day is a good first exercise. Slowly increase how hard you exercise and for how long. 

Talk to your doctor before starting an exercise program. This is especially important if your doctor is already monitoring you for a health problem, such as heart disease or osteoarthritis. You should try to exercise even if you have a physical disability that limits movement. Your doctor can help you find other exercises to improve your overall health. 
How much exercise do I need?
A good goal is to exercise 5 times a week for at least 30 minutes each time. However, most people need to start gradually. Start by exercising 2 or 3 times a week for 20 minutes at a time. Once you feel comfortable, slowly increase the amount of time and the number of days a week that you exercise.
How hard do I have to exercise to gain health benefits?
Please keep in mind that even small amounts of exercise are beneficial and definitely better than none at all. Start with an activity you enjoy and can do comfortably, then gradually increase the level of activity. You can go to a gym, ride a bicycle, and always remember, that brisk walks are a great form of exercise.


You Don’t Need a Lot of Exercise to Help Prevent a Heart Attack

Article Written by Dr. Mirkin / April 23, 2023

Exercise has been shown to help prevent heart attacks (JAMA Intern Med, 2015 Jun;175(6):959–67), and a new study suggests that you can gain protection with as little as 150 minutes of moderate exercise per week, or 75 minutes per week of more vigorous activity. Pushing yourself to exercise at high intensity for many long hours did not appear to provide additional protection from heart attacks. The Master@Heart study, presented at the recent American College of Cardiology (ACC) Scientific Session/World Congress of Cardiology and written up in the European Heart Journal (March 6, 2023), found that:
• middle-aged competitive endurance athletes had more plaques in their heart arteries than similarly fit and healthy exercisers with a healthy lifestyle who did not compete
• the competitive endurance athletes had the type of plaques that appear to be just as unstable as those found in non-competitive exercisers.

This agrees with several other studies that show that competitive endurance athletes have more plaques in their heart arteries than healthy non-exercisers (Circulation 2017;136:138–148). However, previous studies have shown that the plaques in competitive endurance athletes are far more stable and therefore far less likely to break off to cause a heart attack (Circulation 2017;136:138–148). See Stable Plaques: Why Exercisers Have Fewer Heart Attacks? Competitive endurance athletes are at very low risk for heart attacks and dying of heart disease, much lower risk than that of healthy non-exercisers, but the authors note that some endurance athletes can develop heart abnormalities from exercising too much.

Details of the Study
The study evaluated heart artery plaques in:
• 191 life-long competitive master endurance athletes
• 191 athletes who started in sports competition after age 30
• 176 healthy non-competitive exercisers who engaged in no more than three hours a week of exercise.

All participants were male, average age of 55, with a low risk for heart attacks. All three groups had similar weight, blood pressure, blood cholesterol, and HBA1c tests for diabetes. The life-long athletes had higher maximal ability to take in and use oxygen. Both athletic groups had lower body fat percentage (15 percent) than the non-competitive exercisers (19 percent).

Endurance Athletes Have More Stable Plaques
Other studies show that endurance athletes have more stable plaques that are less likely to break off and cause a heart attack. The MARC-2 study followed 291 older men for 6.3 years with a test called Coronary Artery Calcification (CAC), and found that the amount of calcium in the arteries leading to the heart increased most in men who exercised at the highest intensity, even more than those who exercised the most time (Circulation, January 4, 2023). The authors said this showed that intense exercise increases the amount of plaques in arteries, which may be true. However, they would then have to explain why intense exercisers are far less likely to suffer heart attacks than non-exercisers (JAMA Cardiol, 2019;4(2):174-181). Exercise is prescribed both to treat and to prevent heart attacks (Front Cardiovasc Med, Feb 3, 2021;8:753672).
• CAC measures only the size of plaques. It does not measure obstruction of blood flow to the heart. As plaques form, the involved arteries usually widen to accommodate the plaques (JAMA Cardiol, October 27, 2021).
• Intense exercise increases the amount of calcium in plaques (Circulation, January 4, 2023). Calcium in plaques stabilizes them to help prevent plaques from breaking off, which is the cause of most heart attacks.

My Recommendations
Heart attacks have little to do with arteries being narrowed by plaques. A heart attack usually is caused by a sudden immediate complete blockage of blood flow to the heart muscle itself. First a plaque breaks off from the inner lining of an artery leading to the heart. This is followed by bleeding and clotting. Then the clot extends to block all flow of blood through that artery to deprive the heart muscle completely of oxygen, so that part of the heart muscle dies. Exercise helps to prevent heart attacks, and it appears that you may gain the protection if you follow the most recent physical activity guidelines, which recommend 150-300 minutes of moderate exercise (such as brisk walking) per week, or 75-150 minutes per week of vigorous activity (such as running).

Caution: Exercise can cause a heart attack in a person who has blocked arteries or heart damage. Check with your doctor before you start a new exercise program or increase the intensity of your existing program.