Getting More Exercise than Guidelines Suggest May Further Lower Death Risk

Doubling to quadrupling the minimum amount of weekly physical activity recommended for U.S. adults may substantially lower the risk of dying from cardiovascular disease and other causes, new research finds.

The study, published in the American Heart Association journal Circulation, found people who followed the minimum guidelines for moderate or vigorous long-term, leisure physical activity lowered their risk of dying from any cause by as much as 21%. But adults who exercised two to four times the minimum might lower their mortality risk by as much as 31%.

“Our study provides evidence to guide individuals to choose the right amount and intensity of physical activity over their lifetime to maintain their overall health,” study author Dong Hoon Lee said in a news release. Lee is a research associate in the department of nutrition at the Harvard T.H. Chan School of Public Health in Boston.

“Our findings support the current national physical activity guidelines and further suggest that the maximum benefits may be achieved by performing medium to high levels of either moderate or vigorous activity or a combination.”

The American Heart Association recommends adults get at least 150 minutes per week of moderate-intensity aerobic exercise, 75 minutes per week of vigorous aerobic exercise, or a combination of both. That advice is based on federal guidelines for physical activity.

For the new research, a team analyzed 30 years of medical records and mortality data for over 100,000 adults enrolled in two large studies: the all-female Nurses’ Health Study and all-male Health Professionals Follow-Up Study. The data included self-reported measures of leisure time physical activity intensity and duration. Participants were an average 66 years old.

In the study, moderate physical activity was defined as walking, lower-intensity exercise, weightlifting and calisthenics. Vigorous activity included jogging, running, swimming, bicycling and other aerobic exercises.

Going above and beyond the recommended minimums reaped greater longevity rewards, especially for moderate physical activity. Extra moderate-intensity exercise – 300 to 600 minutes per week – was associated with a 26%-31% lower risk of death from any cause compared with almost no long-term moderate-intensity exercise. By comparison, people who hit just the minimum goals for moderate physical activity had a lower risk of 20%-21%.

For vigorous physical activity, getting 150 to 300 minutes a week was linked to a 21%-23% lower risk of death from any cause compared to getting none. That compared to a 19% lower risk for people who just met the minimum exercise target.

People who reported meeting the recommendation for moderate physical activity had a 22%-25% lower risk of dying from cardiovascular disease, while those who exercised two to four times the recommendation had a 28%-38% lower risk, the analysis found. Those reporting the recommended amount of vigorous physical activity were 31% less likely to die from cardiovascular disease, while those who doubled to quadrupled the recommended target had a 27%-33% lower risk.

Engaging in more than 300 weekly minutes of vigorous or 600 weekly minutes of moderate physical activity did not provide any further reduction in death risk, the study found. But it also did not harm cardiovascular health. Prior research has suggested long-term, high-intensity endurance activities – such as marathons, triathlons and long-distance bicycle races – may increase the risk for cardiovascular problems, including sudden cardiac death.

“This finding may reduce the concerns around the potential harmful effect of engaging in high levels of physical activity observed in several previous studies,” Lee said.

Donna K. Arnett, incoming executive vice president for academic affairs and provost at the University of South Carolina, said in the release that the findings fit with what is already known about the heart health benefits of regular physical activity.

“We have known for a long time that moderate and intense levels of physical exercise can reduce a person’s risk of both atherosclerotic cardiovascular disease and mortality,” said Arnett, who helped write guidelines for cardiovascular disease prevention from the AHA and American College of Cardiology. She was not involved in the new research.

“We have also seen that getting more than 300 minutes of moderate-intensity aerobic physical activity or more than 150 minutes of vigorous-intensity aerobic physical exercise each week may reduce a person’s risk of atherosclerotic cardiovascular disease even further, so it makes sense that getting those extra minutes of exercise may also decrease mortality,” she said.

Source: American Heart Association

 

 

 

 

Survival Tip: Start at Normal Weight and Slowly Add Pounds

Jeff Grabmeier wrote . . . . . . . . .

People who start adulthood with a body mass index (BMI) in the normal range and move later in life to being overweight – but never obese – tend to live the longest, a new study suggests.

Adults in this category lived longer than even those whose BMI stayed in the normal range throughout their life. Those who started adulthood as obese and continued to add weight had the highest mortality rate.

“The impact of weight gain on mortality is complex. It depends on both the timing and the magnitude of weight gain and where BMI started,” said Hui Zheng, lead author of the study and associate professor of sociology at The Ohio State University.

“The main message is that for those who start at a normal weight in early adulthood, gaining a modest amount of weight throughout life and entering the overweight category in later adulthood can actually increase the probability of survival.”

Similar results were found in two generations of mostly white participants in the Framingham Heart Study, which followed the medical histories of residents of one city in Massachusetts and their children for decades.

But the study showed worrying trends for the younger generation, who are becoming overweight and obese sooner in their lives than their parents did and are more likely to have deaths linked to increasing obesity.

The study was published recently online in the journal Annals of Epidemiology.

The researchers used data on 4,576 people in the original cohort of the Framingham Heart Study, and 3,753 of their children. The heart study started in 1948 and followed participants through 2010. Their children were followed from 1971 to 2014.

The members of the original cohort had almost all died by the end of the study, so the results can uncover how BMI evolves over all of adulthood and provide a more accurate estimate than previous studies of how obesity is linked to mortality, Zheng said.

In both generations, the researchers looked at data from those aged 31 to 80. The main measure was BMI, which is based on a person’s height and weight and is used as a rule of thumb to categorize a person as underweight, normal weight, overweight or obese.

After analyzing data on how the participants’ BMI changed over the years, the researchers found that the older generation generally followed one of seven BMI trajectories throughout their lives.

The younger generation had six trajectories – there were not enough people who lost weight through their lives to have a downward weight trajectory as was present in their parents’ generation.

After controlling for a variety of factors that have been found to influence mortality, including smoking, gender, education, marital status and disease, the researchers calculated how each BMI trajectory was related to mortality rates.

In both generations, those who started at normal weight and moved to being overweight later in life – but never obese – were the most likely to survive.

Those who stayed at normal weight throughout life were the next most likely to survive, followed by those who were overweight but stayed stable and then those who were at the lower level of normal weight. In the older generation, those who were overweight and lost weight came next.

The least likely to survive were two trajectories involving those who started as obese and continued to gain weight.

While both generations showed the same basic results, the researchers discovered some worrying trends in the younger cohort.

“The higher BMI trajectories in the younger generation tend to shift upward at earlier ages relative to their parents,” Zheng said.

Moreover, the proportion of the sample in higher BMI trajectories systematically increased from the parental generation to their children.

Medical advances mean that people are more likely to survive with obesity now than in the past, Zheng said. But there’s a problem for the younger generation in the study.

“Even though the mortality risks associated with obesity trajectories have decreased across the generations, their contributions to population deaths increased from 5.4% in the original cohort to 6.4% in the offspring cohort,” Zheng said.

“That’s because more people are in the obesity trajectories in the offspring cohort.”

This study supports and extends findings from a 2013 study, published in the American Journal of Epidemiology, by Zheng and colleagues that found people who were slightly overweight in their 50s but kept their weight relatively stable were the most likely to survive over the next 19 years.

“Now, with this study, we know more about weight trends earlier in life and how they are related to mortality,” Zheng said.

Source: The Ohio State University


Read also at JAMA Network:

Association of Body Mass Index in Midlife With Morbidity Burden in Older Adulthood and Longevity . . . . .

Life Span After Alzheimer’s Diagnosis: What Factors Matter Most

After a diagnosis of Alzheimer’s disease, families have much to worry about. They wonder what’s next and how long their loved one has left to live.

A new study from UT Southwestern Medical Center in Dallas addresses those questions, finding that mental (cognitive) decline, age and other factors affect life expectancy after an Alzheimer’s diagnosis.

The study authors say the findings could help improve planning for patients and their families.

“Life expectancy for patients with Alzheimer’s disease typically ranges from three to 12 years but can be longer in some cases. Families are anxious to know what to expect and how to best plan for the time ahead in terms of finances, family caregiving, and how they want to live out their lives,” said study co-author C. Munro Cullum, a professor of psychiatry, neurology, and neurological surgery.

“We’re trying to get them better answers,” Cullum explained in a UT Southwestern news release.

Cullum’s team analyzed data from 764 U.S. patients with autopsy-confirmed Alzheimer’s who died from the disease between 2005 and 2015. Their life expectancy after diagnosis ranged from one month to about 11 years.

The researchers determined that cognitive decline accounted for about 20% of the variance in patients’ life expectancy. Cognitive functioning includes memory, attention, decision-making and problem-solving.

“We found that beyond global cognitive function, patients who were older, non-Hispanic, male, and who had more motor and psychiatric symptoms had a significantly shorter life expectancy,” said study co-author Jeffrey Schaffert, a postdoctoral fellow in clinical neuropsychology.

The study was published recently in the Journal of Alzheimer’s Disease.

Prediction of life expectancy in Alzheimer’s patients is complex and affected by many factors, the researchers noted. They plan to further investigate the link between cognitive decline and life expectancy, and also hope to study a more diverse group of patients.

“This dataset was largely derived from well-educated white patients who donated their brains to research. We would like to extend this work to better reflect our more diverse patient population,” Cullum said.

Source: HealthDay

An Hour of Weight Training Per Week Can Extend Your Life

Steven Reinberg wrote . . . . . . . . .

Adding regular strength training to your exercise routine may not only make you stronger, but let you live longer, too, researchers in Japan report.

Their new study says 30 to 60 minutes a week of muscle strengthening may reduce your risk of dying early from any cause, and from heart and blood vessel disease, diabetes or cancer by up to 20%.

“Doing muscle-strengthening activities has a health benefit independent of aerobic activities,” said lead researcher Haruki Momma, a lecturer in medicine and science in sports and exercise at Tohoku University Graduate School of Medicine in Sendai.

Strengthening exercises include lifting weights, using resistance bands and doing pushups, situps and squats. It can also include heavy gardening, such as digging and shoveling, researchers said.

“Although several physical activity guidelines recommend that adults perform muscle-strengthening activities based on musculoskeletal health benefits, our findings support this recommendation in terms of preventing premature death and major chronic diseases,” Momma said. “Also, our findings suggest that optimal doses of muscle-strengthening activities for the prevention of all-cause death, cardiovascular and cancer may exist.”

For the study, Momma and his colleagues pooled data from 16 published studies. The studies, which included both men and women, ranged in size from nearly 4,000 participants to almost 480,000.

The analysis found that muscle strengthening was linked with a 10% to 17% lower risk of premature death from any cause, as well as from heart and blood vessel disease, stroke, diabetes, lung cancer and cancer as a whole.

They found no link between muscle strengthening and any reduced risk of colon, kidney, bladder or pancreatic cancer.

The greatest benefit was seen when strength training was done up to an hour a week.

But more wasn’t necessarily better. After 60 minutes of strengthening exercise in a week, no further benefit in preventing premature death was seen.

Even better than strength training alone was combining it with aerobic exercise. (Aerobic exercises include swimming, cycling, walking and rowing.)

The combo reduced the risk of dying prematurely from any cause by 40%; heart and blood vessel disease by 46%, and cancer by 28%, the researchers found.

The findings were published online in the British Journal of Sports Medicine.

Dr. Russell Camhi, a sports medicine specialist at Northwell Health in Great Neck, N.Y., reviewed the new study.

“There’s good evidence that people should be incorporating strength training as part of their workout regimen,” Camhi said.

For men, strength training increases testosterone. For both men and women, it helps keep bone density up and decreases the risk of falls and fractures, he said.

“Strength training has also been shown to help with mental health and mood,” Camhi said. “There’s a lot of benefits that come from the muscular system being activated.”

Camhi recommends starting with weight-bearing exercise and gradually working up to using weights or other equipment. Weight-bearing exercises include walking, dancing and stair-climbing.

“Start with simple weight-bearing exercise, and then start adding in small weights as tolerated,” Camhi advised.

“You don’t want to go into strength training too quickly, because that can lead to some overuse and sometimes injury if not done correctly,” he added.

Camhi noted that videos and other instructional materials are easy to find online, and classes and personal trainers can also get you going.

It’s never too late to start a strength-training regimen, he said.

“There’s always benefits that can be gained. We cannot always undo all the loss from chronic disease, but there’s always benefit that can be gained from exercise,” Camhi said.

Source: HealthDay

Feelings of Fatigue Predict Death in Older Adults

How fatigued certain activities make an older person feel can predict the likelihood death is less than three years away, according to research published today in the Journal of Gerontology: Medical Sciences by University of Pittsburgh epidemiologists. It is the first study to establish perceived physical fatigability as an indicator of earlier mortality.

Older people who scored the highest in terms of how tired or exhausted they would feel after activities were more than twice as likely to die in the following 2.7 years compared to their counterparts who scored lower. Fatigability was assessed for a range of activities using the novel Pittsburgh Fatigability Scale.

“This is the time of year when people make—and break—New Year’s resolutions to get more physical activity,” said lead author Nancy W. Glynn, Ph.D., associate professor in the Department of Epidemiology at Pitt’s Graduate School of Public Health. “I hope our findings provide some encouragement to stick with exercise goals. Previous research indicates that getting more physical activity can reduce a person’s fatigability. Our study is the first to link more severe physical fatigability to an earlier death. Conversely, lower scores indicate greater energy and more longevity.”

Glynn and her colleagues administered the Pittsburgh Fatigability Scale to 2,906 participants aged 60 or older in the Long Life Family Study, an international study that follows family members across two generations. Participants ranked from 0 to 5 how tired they thought or imagined that certain activities—such as a leisurely 30-minute walk, light housework or heavy gardening—would make them.

Follow-up for this work concluded at the end of 2019, to avoid any increased mortality impact from the COVID-19 pandemic, which gave the team an average of 2.7 years of data on each participant. After accounting for a variety of factors that influence mortality, such as depression, pre-existing or underlying terminal illness, age and gender, the team found that participants who scored 25 points or higher on the Pittsburgh Fatigability Scale were 2.3 times more likely to die in the 2.7 years after completing the scale, compared to their counterparts who scored below 25.

“There has been research showing that people who increase their physical activity can decrease their fatigability score,” said Glynn, a physical activity epidemiologist. “And one of the best ways to increase physical activity—which simply means moving more—is by setting manageable goals and starting a routine, like a regular walk or scheduled exercise.”

Beyond tying high fatigability to an earlier death, Glynn said the study demonstrates the value of the Pittsburgh Fatigability Scale, which she and colleagues created in 2014. It has since been translated into 11 languages.

“While the Pittsburgh Fatigability Scale has been widely adopted in research as a reliable, sensitive way to measure fatigability, it is underutilized in hospital settings and clinical trials,” Glynn said. “My ultimate goal is to develop a physical activity intervention targeting a reduction in fatigability as a means to stem the downward spiral of impaired physical function common with the aging process. By reducing fatigability, one can change how they feel, potentially motivating them to do more.”

Source: University of Pittsburgh