Low physical activity responsible for 17 percent of cardiovascular deaths

A recent study investigated the impact of various levels of physical activity on death from ischaemic heart disease (IHD) and stroke and on total cardiovascular mortality in people aged 30 years and older. Data on physical activity was obtained from the Argentinian national survey of risk factors in 2013. Numbers of disease-specific deaths in 2010 came from the Ministry of Health in Argentina. Physical activity was categorised by metabolic equivalent tasks per minute per week (MET/minute/week), with 600 MET/min/week being equivalent to 30 minutes of brisk walking five days a week (ie 2.5 hours per week).

Guidelines recommend that healthy adults of all ages should spend 2.5 to 5 hours a week on physical activity or aerobic exercise training of at least moderate intensity, or 1 to 2.5 hours a week on vigorous intense exercise.

During 2010 there were 43 796 deaths from cardiovascular disease in the population aged 30 years and above, including 25 142 deaths from IHD and 18 654 deaths from stroke.

The researchers found that engaging in less than 600 MET/min/week (ie the minimum recommended level of physical activity) was responsible for 17% (7 278) of total cardiovascular deaths in Argentina in 2010, of which 3 941 occurred in men and 3 337 in women. Doing less than 600 MET/min/week was responsible for 20% (4 907) of deaths from IHD and 13% (2 371) of stroke deaths.

Dr Poggio said: "We found that low levels of physical activity had a big impact on cardiovascular deaths in Argentina, which suggests that interventions promoting exercise should be a priority. The effects were greater in women of all ages because they exercise less than men."

She continued: "Our analysis suggests that engaging in at least 30 minutes of brisk walking 5 days a week would reduce cardiovascular mortality at any age, especially in women and those younger than 70 years of age. Our findings have public health implications and emphasise the importance of women in particular being more physically active."

High cholesterol linked to heightened risk of tendon abnormalities and pain

High levels of total cholesterol are linked to a heightened risk of tendon abnormalities and pain, reveals a pooled analysis of the available evidence published online in the British Journal of Sports Medicine.

Chronic low level inflammation, prompted by cholesterol build-up in immune system cells, may have a key role, the findings suggest.

Tendons are the tough fibres connecting muscles and bones in the body. Mechanical stress as a result of obesity or excess body fat distribution, and overuse during the course of exercise or work, are thought to be among the leading causes of tendon injuries (tendinopathy). But these factors don't explain a significant proportion of cases, say the researchers.
 
People with genetically determined very high cholesterol levels (familial hypercholesterolaemia) seem to be at greater risk of tendon pain, but it's not clear if those with lower, but still high levels, might also be vulnerable to tendon injuries.

The authors therefore trawled six medical research databases, looking for studies investigating links between blood fats and tendon abnormalities/pain.

They came up with 1607 relevant articles, of which 17, involving 2612 participants, and published between 1973 and 2014, were suitable for inclusion in the analysis.

The results showed that compared with people whose tendon structure was normal, those with abnormal tendon structure had a significantly more unfavourable blood fat (lipid) profile.
They had significantly higher total cholesterol, including higher low density ('bad') cholesterol and lower high density ('good') cholesterol, and higher triglyceride levels.

Furthermore, people with an unfavourable lipid profile were much more likely to have tendon injuries and higher levels of pain associated with musculoskeletal problems in their arms.

And two of the three studies, which looked at Achilles tendon thickness, found that people with an unfavourable lipid profile had thicker tendons than those with lipid levels in the normal range.

"Together, these findings provide significant support for a metabolic hypothesis of tendon injury and implicate lipid parameters as a potential link," write the researchers.

But they point out that as this was an observational study no definitive conclusions can be drawn about cause and effect, especially as the findings might have been the result of reverse causation--whereby those with tendon injuries did less exercise, so raising their cholesterol levels.

Nevertheless, there is good evidence to suggest that a poor blood lipid profile may be harmful to tendons, they say, as people with familial hypercholesterolaemia have altered tendon structure throughout childhood and adolescence, while aggressive lipid lowering treatment reduces tendon thickness.

High cholesterol levels are also known to stimulate the build-up of cholesterol in immune system cells, which in turn leads to low level chronic inflammation. Compared with people without tendon injuries, those with tendinopathy have increased numbers of these immune cells in their tendons.

Sitting for long periods not bad for health

New research from the University of Exeter and University College London has challenged claims that sitting for long periods increases the risk of an early death even if you are otherwise physically active.

The study, which is published in the International Journal of Epidemiology, followed more than 5000 participants for 16 years (making it one of the longest follow-up studies in this area of research) and found that sitting, either at home or at work, is not associated with an increased risk of dying.

These findings challenge previous research suggesting that the act of sitting itself causes harm even when people routinely walk a lot or do other exercise. Importantly, the findings contradict NHS recommendations which state that remaining seated for too long is bad for your health, regardless of how much exercise you do.

Dr Melvyn Hillsdon from Sport and Health Sciences at the University of Exeter said: "Policy makers should be cautious in recommending a reduction in the time spent sitting without also promoting increased physical activity".

"Our study overturns current thinking on the health risks of sitting and indicates that the problem lies in the absence of movement rather than the time spent sitting itself. Any stationary posture where energy expenditure is low may be detrimental to health, be it sitting or standing.

"The results cast doubt on the benefits of sit-stand work stations, which employers are increasingly providing to promote healthy working environments."

Lead author Dr Richard Pulsford from Sport and Health Sciences at the University of Exeter said: "Our findings suggest that reducing sitting time might not be quite as important for mortality risk as previously publicised and that encouraging people to be more active should still be a public health priority."

The study participants provided information on total sitting time and on four other specific types of sitting behaviour (sitting at work; during leisure time; while watching TV; and sitting during leisure time excluding TV) as well as details on daily walking and time spent engaged in moderate to vigorous physical activity. Age, gender, ethnicity, socioeconomic status, general health, smoking, alcohol consumption and diet were all taken into account. The study showed that over the 16 year follow-up period none of these five sitting measures influenced mortality risk.

Future work will consider whether long periods of sitting are associated with increased incidence of diseases such as heart disease and type II diabetes, and will investigate the biological mechanisms that underpin previously observed associations between sitting time and health outcomes.

The participants included 3720 men and 1412 women drawn from the Whitehall II study cohort which is supported by grants from the Medical Research Council, British Heart Foundation, Stroke Association, National Heart Lung and Blood Institute and the National Institute on Aging.

Drinking cranberry juice may protect the heart

Results from a new study presented at the Cranberry Health Research Conference preceding the annual Berry Health Benefits Symposium 2015 in Madison, WI, revealed that cranberry juice consumption may play a role in protecting against cardiovascular disease. Presented by principal investigator, Ana Rodriguez-Mateos, PhD, from the Division of Cardiology, Pulmonology and Vascular Medicine at the University Duesseldorf, Germany, the research uncovered a potent, dose-dependent relationship between cranberry juice and improved vascular function. Because vascular dysfunction, including limitations in blood flow, is a central feature in the development of atherosclerosis - improving vascular function can have a powerful, beneficial effect on a person's cardiovascular health.

"Cranberry juice is a rich source of phytonutrients, including proanthocyanidins, anthocyanins and phenolic acids," explains Dr. Rodriguez-Mateos. "Due to this robust profile of polyphenols, our team sought to evaluate the immediate vascular impact of drinking one, 450 ml (or 16 ounces) glass of cranberry juice with a different range of concentrations of cranberry-polyphenols."

In a randomized, controlled crossover trial, researchers gave ten healthy male subjects, between the ages of 18-40 years, 450 ml (just under 2 cups) of sweetened cranberry juice made from concentrate. The cranberry concentrate was prepared with water to concentrations ranging from 0 to 117%. The amount of cranberry-polyphenols increased with the concentration. Non-invasive measurements of vascular function including flow-mediated vasodilation (FMD), blood pressure and arterial stiffness were performed at baseline and at one, two, four, six and eight hours post-consumption. Blood and urine samples were collected for 24 hours following consumption to detect changes in plasma and urinary cranberry-derived polyphenols. Across the board, all of the cranberry juices benefited FMD - including 25% cranberry juice, equivalent to the commonly consumed cranberry juice cocktail (25-27%). The highest concentration of cranberry-polyphenol juice also showed improvements in systolic blood pressure.

Defending the health of the circulatory system - and improving vascular function - not only reduces the chance of developing atherosclerosis, but plays an important role in kidney function, hormone delivery and waste filtration.

"Our results lay the groundwork to better understand the array of potential vascular and cardiovascular health benefits of cranberry polyphenols," notes Dr. Rodriguez-Mateos. "Significant improvements in vascular function from drinking two cups of cranberry juice suggest an important role for cranberries in a heart-healthy diet."

Varying walking pace burns more calories

Looking for a simple way to burn more calories while walking? Change up your pace.

In a study published in the September 2015 issue of the journal Biology Letters, engineering researchers at The Ohio State University found that walking at varying speeds can burn up to 20 percent more calories compared to maintaining a steady pace.

The study is one of the first to measure the metabolic cost, or calories burned, of changing walking speeds.

"Most of the existing literature has been on constant-speed walking. This study is a big missing piece," said Manoj Srinivasan, co-author of the study and professor of mechanical and aerospace engineering. "Measuring the metabolic cost of changing speeds is very important because people don't live their lives on treadmills and do not walk at constant speeds. We found that changing speeds can increase the cost of walking substantially."

Their results show that by using traditional methods, people may be underestimating the number of calories burned while walking in daily life or playing sports. The very act of changing speeds burns energy, Srinivasan explained, but that cost is not generally accounted for in calorie-burning estimations. The researchers found that up to eight percent of the energy we use during normal daily walking could be due to the energy needed to start and stop walking.

"Walking at any speed costs some energy, but when you're changing the speed, you're pressing the gas pedal, so to speak. Changing the kinetic energy of the person requires more work from the legs and that process certainly burns more energy," explained Nidhi Seethapathi, first author of the study and doctoral fellow in mechanical engineering.

The researchers measured the cost of changing walking speeds by having people change their walking pace on a treadmill while its speed remained steady. Participants alternated between walking quickly to move to the front of the treadmill belt, or slowly to move to the back of the treadmill (watch a video demonstration). Prior experiments by other researchers changed the treadmill speed directly, which, it turns out, makes such experiments not applicable to real-world walking, Srinivasan explained. When the treadmill speed is changing, the treadmill itself is doing some of the work, instead of the person walking.

The study also confirmed the researchers' prediction that people walk slower when covering shorter distances and increase their pace as distance increases. This finding could have implications for the field of physical therapy and rehabilitation, where measuring the speed it takes to cover a certain distance is used as an indicator of a patient's progress.

"What we've shown is the distance over which you make them walk matters," said Seethapathi. "You'll get different walking speeds for different distances. Some people have been measuring these speeds with relatively short distances, which our results suggest, might be systematically underestimating progress."

For more tips on how to burn more calories when walking, Srinivasan, who leads the Movement Lab at Ohio State, offers some simple advice: walk in a way that feels unnatural.

"How do you walk in a manner that burns more energy? Just do weird things. Walk with a backpack, walk with weights on your legs. Walk for a while, then stop and repeat that. Walk in a curve as opposed to a straight line," he said.

Physical activity: More is better for heart failure prevention

\Doubling or quadrupling the minimum federally recommended levels of physical activity lowered the risk of developing heart failure by 20 percent and 35 percent, respectively, according to research published in the American Heart Association's journal Circulation.

"Walking 30 minutes a day as recommended in the U.S. physical activity guidelines, may not be good enough -- significantly more physical activity may be necessary to reduce the risk of heart failure" said Jarett D. Berry, M.D., senior author of the study and an associate professor of internal medicine and clinical sciences at the University of Texas Southwestern Medical School in Dallas, Texas.

Heart failure occurs when the heart is not able to supply adequate amounts of blood to the rest of the body and is characterized by shortness of breath and a reduced ability to exercise.

The researchers found that the current U.S. physical activity guidelines recommendation of a minimum of at least 150 minutes of moderate intensity physical activity a week was associated with only a modest reduction in heart failure risk, and suggest that higher levels of physical activity, up to twice the minimum recommended dose, is needed to reduce the risk of heart failure, according to Berry.

They also found a "dose-dependent" inverse association between physical activity and heart failure, that is, higher levels of physical activity were associated with a lower risk of heart failure. This relationship was consistent across all age, sex, race, and geographic location based subgroups studied.

Although the role of physical activity in coronary heart disease - the narrowing of the arteries that causes heart attacks - has been comprehensively studied, this study focused exclusively on the quantitative relationship between the amount, or specific "dose" of regular physical activity and the risk of heart failure.

The researchers pooled data from 12 studies from United States and Europe that collectively included 370,460 individuals with varying levels of physical activity at baseline and 20,203 heart failure events over a mean follow-up of 15 years. Physical activity was measured by self-reported levels of activity by study participants using standard questionnaires. This, they say, gave them the opportunity to assess the dose-response relationship between physical activity and heart failure risk in the general population.

Current U.S. and American Heart Association physical activity guidelines for adults recommend a minimum of at least 150 minutes (2 hours and 30 minutes) per week of moderate-intensity aerobic physical activity such as brisk walking, however, both the federal guidelines and the American Heart Association suggest that more physical activity is even better.

"Future physical activity guidelines should take these findings into consideration, and potentially provide stronger recommendations regarding the value of higher amounts of physical activity for the prevention of heart failure," said Ambarish Pandey, M.D., lead author of the study and a cardiology fellow at University of Texas Southwestern Medical School in Dallas, Texas.

"If you look at the general population," Berry said, "we've had tremendous success in reducing coronary heart disease over the last 30 years. But heart failure rates have not declined enough. The findings from the present study suggest that higher levels of physical activity may help combat this growing burden of heart failure."

Mindfulness while washing dishes reduces stress

Washing those dreadful dishes after a long day seems like the furthest thing from relaxation. Or is it?

Student and faculty researchers at Florida State University have found that mindfully washing dishes calms the mind and decreases stress.

Published in the journal Mindfulness, the study looked at whether washing dishes could be used as an informal contemplative practice that promotes a positive state of mindfulness -- a meditative method of focusing attention on the emotions and thoughts of the present moment.

"I've had an interest in mindfulness for many years, both as a contemplative practitioner and a researcher," said Adam Hanley, a doctoral candidate in FSU College of Education's Counseling/School Psychology program and one of the study's authors. "I was particularly interested in how the mundane activities in life could be used to promote a mindful state and, thus, increase overall sense of well-being."

After conducting a study with 51 students, the researchers found that mindful dishwashers -- those who focused on the smell of the soap, the warmth of the water, the feel of the dishes -- reported a decrease in nervousness by 27 percent and an increase in mental inspiration by 25 percent. The control group, on the other hand, didn't experience any benefits.