Heart Health: sports & physical activities outweigh risks

A November 2024 study by Laval University published in the Canadian Journal of Cardiology, said,

• "The unavailability of automated external defibrillators (AEDs) highlights a critical gap in emergency preparedness, especially in the context of five of the six activities with the highest death frequencies (cycling, hunting, jogging, hiking or walking, and swimming), which often occur in locations where AEDs are not readily accessible. As Québec is currently working on AED-related legislation, these results underscore the necessity for a comprehensive approach that extends beyond public places to ensure adequate (AED) coverage for activities in rural or remote areas, where the risks are pronounced and immediate access to emergency care is crucial."

• "Reducing premature mortality is a priority for most clinicians, including cardiologists, general internists, and family physicians, but certainly for those involved in the care of athletes and active individuals. While placement of AEDs in remote settings (e.g., hunting or ski cabins) or in areas with high exercise traffic, as well as drone-delivered AED networks, are intriguing strategies, maintenance requirements and financial investments may limit feasibility. While still in development and undergoing regulatory approvals in many countries, ultraportable AEDs may offer advantages in the future. However, at present, there is no convincing evidence to support device performance or clinical, or safety outcomes, calling for further research on their effectiveness, particularly in sports and recreation-related settings, before considering widespread uptake."

• "Our prior studies have shown that sudden death during sport is an extremely rare phenomenon. Diseases or conditions, for example, hypertrophic cardiomyopathy, which are often considered conditions likely to be associated with catastrophic events such as cardiac arrest, are much less dangerous than most people believe. We believe athletes should be permitted to make their own decisions about what is safe or not safe for them depending on their values and preferences, rather than be told what is ‘allowed’ versus ’not allowed.’ Overall, we think that engaging in vigorous and even competitive physical activity for most individuals with heart disease is relatively safe."

High Blood Pressure: An Extra 5 Minutes of Exercise

A November 2024 study by the University of Sydney said,

• “High blood pressure is one of the biggest health issues globally, but unlike some major causes of cardiovascular mortality there may be relatively accessible ways to tackle the problem in addition to medication.” 

• “The finding that doing as little as five extra minutes of exercise per day could be associated with measurably lower blood pressure readings emphasises how powerful short bouts of higher intensity movement could be for blood pressure management.” 

• “The good news is that whatever your physical ability, it doesn’t take long to have a positive effect on blood pressure. What’s unique about our exercise variable is that it includes all exercise-like activities, from running for a bus or a short cycling errand, many of which can be integrated into daily routines.“

• “For those who don’t do a lot of exercise, walking did still have some positive benefits for blood pressure. But if you want to change your blood pressure, putting more demand on the cardiovascular system through exercise will have the greatest effect.” 

• “Our findings show how powerful research platforms like the ProPASS consortium are for identifying relatively subtle patterns of exercise, sleep, and sedentary behaviour, that have  significant clinical and public health importance.” 

Intense exercise and the suppression of appetite

An October 2024 study by University of Virginia Health System concerning ghrelin, the “hunger hormone”, associated with perceptions of hunger, said,

• “We found that high intensity exercise suppressed ghrelin levels more than moderate intensity exercise,”

• “In addition, we found that individuals felt ‘less hungry’ after high intensity exercise compared to moderate intensity exercise.”

• “We found that moderate intensity either did not change ghrelin levels or led to a net increase,”

• [that exercise above the lactate threshold] “may be necessary to elicit a suppression in ghrelin.”

• “Exercise should be thought of as a ‘drug,’ where the ‘dose’ should be customized based on an individual’s personal goals,”

• “Our research suggests that high-intensity exercise may be important for appetite suppression, which can be particularly useful as part of a weight loss program.”

Snacking and Exercise

An August 2024 study by ETH Zurich said,

• “… many people manage to resist the constantly present temptations and get enough exercise,”

• “We wanted to know what it is in our brain that helps us make these decisions.”

• “In neuroscience, dopamine is a popular explanation for why we choose to do some things but avoid others,”

• “However, our current knowledge about dopamine does not easily explain why we decide to exercise instead of eating,”

• “Our brain releases dopamine both when we eat and when we exercise, which does not explain why we choose one over the other.”

• “Mice like a milkshake for the same reason people do: it contains lots of sugar and fat and tastes good,”

• “This means that the primary role of the orexin system is not to control how much the mice move or how much they eat,”

• “Rather, it seems central to making the decision between one and the other, when both options are available.”

• “It will now be a matter of verifying our results in humans”

• “If we understand how the brain arbitrates between food consumption and physical activity, we can develop more effective strategies for addressing the global obesity epidemic and related metabolic disorders.”

For Bigger Muscles

A July 2024 study by Florida Atlantic University said,

• “If you’re aiming for muscle growth, training closer to failure might be more effective. In other words, it doesn’t matter if you adjust training volume by changing sets or reps; the relationship between how close you train to failure and muscle growth remains the same,”

• “For strength, how close you push to failure doesn’t seem to matter as much.”

• “Training closer to failure enhances the accuracy of self-reported repetitions in reserve,”

• “When people estimate how many reps they have left, this perception influences the weights they choose. If the estimation is off, they might use lighter weights than needed, which could limit strength gains. On the flip side, our meta-analysis shows that training closer to failure also leads to greater muscle growth. So, for the average individual, training close to failure may be the best option – as it seems to improve the accuracy of our perception of effort as well as gains in muscle size.”

• “As the load increases, motor patterns change, which means performing sets closer to failure can more closely mimic the demands of max strength assessments,”

• “This approach aligns with the principle of specificity by exposing you to similar motor patterns and psychological challenges. Moreover, training near failure may also improve psychological factors like visualization, which are important for achieving maximal strength.”

More benefits of walking for Over-50s

A June 2024 study by the University of Barcelona said,

• “[The Project called] Every Walk You Take aims to empower citizens to experience an active and healthy ageing process through scientifically proven tools”

• “This project has allowed us to interact with many agents in the Trinitat Vella and Bon Pastor neighbourhoods through the adult education centres in both areas. The active collaboration of teachers and students from these centres has been decisive in testing the prototype of the application in this participatory science initiative”,

• “In the future, the idea is to expand the project in a phase in which more municipalities from all over Spain and Europe will participate, to create a real network that gives citizens a voice to identify barriers and obstacles on routes to improve their health.”

Aerobic Exercise by the Elderly with Hypertension: morning or evening?

A May 2024 study by University of São Paulo said,

• “There are multiple mechanisms to regulate blood pressure, and although morning training was beneficial, only evening training improved short-term control of blood pressure by enhancing baroreflex sensitivity. This is important because baroreflex control has a positive effect on blood pressure regulation, and there aren’t any medications to modulate the mechanism,”

• “Evening training was more effective in terms of improving cardiovascular autonomic regulation and lowering blood pressure. This can be partly explained as due to an improvement in baroreflex sensitivity and a reduction of muscle sympathetic nerve activity, which increased in the evening. For now, all we know is that baroreflex control is the decisive factor, from the cardiovascular standpoint at least, to make evening training more beneficial than morning training, since it induces the other benefits analyzed. However, much remains to be done in this regard in order to obtain a better understanding of the mechanisms involved,”

• “It’s a mechanism that involves sensitive fibers and deformations in the walls of arteries in specific places, such as the aortic arch and carotid body. When blood pressure falls, this region warns the brain region that controls the autonomic nervous system, which in turn signals the heart to beat faster and tells the arteries to contract more strongly. If blood pressure rises, it warns the heart to beat more slowly and tells the arteries to contract less. In other words, it modulates arterial pressure beat by beat,”

• “Replication of the results obtained in previous studies and in different groups of hypertensive patients, associated with the use of more precise techniques to evaluate the main outcomes, has strengthened our conclusion that aerobic exercise performed in the evening is more beneficial to the autonomic nervous system in patients with hypertension. This can be especially important for those with resistance to treatment with medication,”

Exercise Goals: Steps or Minutes?

A May 2024 report by Brigham and Women’s Hospital

• “We recognized that existing physical activity guidelines focus primarily on activity duration and intensity but lack step-based recommendations,”

• “With more people using smartwatches to measure their steps and overall health, we saw the importance of ascertaining how step-based measurements compare to time-based targets in their association with health outcomes – is one better than the other?”

• "For some, especially for younger individuals, exercise may involve activities like tennis, soccer, walking, or jogging, all of which can be easily tracked with steps. However, for others, it may consist of bike rides or swimming, where monitoring the duration of exercise is simpler. That's why it's important for physical activity guidelines to offer multiple ways to reach goals. Movement looks different for everyone, and nearly all forms of movement are beneficial to our health,”

• "The next federal physical activity guidelines are planned for 2028. Our findings further establish the importance of adding step-based targets, in order to accommodate flexibility of goals that work for individuals with differing preferences, abilities and lifestyles."

Exercise short-term leading to long-term

In an April 2024 study published by the National Heart, Lung and Blood Institute said,

• “Even moderate exercise can drastically reduce cardiovascular risk, so finding low-cost ways to get people moving and stay in a fitness program that they can do at home is a huge win for public health,”

• “Research shows it’s easier to think about today instead of the future, whether it’s exercising more to support long-term heart health or saving for a future goal, like college or retirement.”

New "Steps" Target

A February 2024 study by New York University at Buffalo said,

• “In ambulatory older women, higher amounts of usual daily light and moderate intensity activities were associated with lower risk of developing heart failure with preserved ejection fraction independent of demographic and clinical factors associated with heart failure risk,”

• “Accumulating 3,000 steps per day might be a reasonable target that would be consistent with the amount of daily activity performed by women in this study.”

• “This is a major, unique finding of our study because there is very little published data on physical activity and HFpEF, so we are providing new information upon which other studies can build,”

• “More importantly, [in] the most common form of heart failure seen in older women and among racial and ethnic minority groups, and at present there are few established treatment options, which makes primary prevention all the more relevant…. The potential for light intensity activities of daily life to contribute to the prevention of [this type of heart failure] in older women is an exciting and promising result for future studies to evaluate in other groups, including older men,”

• “…conveying how much activity is always a challenge to incorporate as part of clinical and public health recommendations,”

• “Steps per day is easily understood and can be measured by a variety of consumer-level wearable devices to help people monitor their physical activity levels.”

• “It appeared that intensity of stepping did not influence the lower risk of heart failure as results were comparable for light intensity steps and for more vigorous steps,”

• “Our results showing heart failure prevention in older women might be enhanced through walking around 3,000 steps or so per day at usual pace is very relevant given the current emphasis at the federal level on identifying an amount of daily physical activity that can be referenced against steps per day for cardiovascular health and resilience to incorporate in future public health guidelines.”

Exercise and Depression

A February 2024 study in the BMJ said,

• Walking or jogging, yoga, and strength training “could be considered alongside psychotherapy and drugs as core treatments for depression.”

• “Our findings support the inclusion of exercise as part of clinical practice guidelines for depression, particularly vigorous intensity exercise,”

• “Health systems may want to provide these treatments as alternatives or adjuvants to other established interventions, while also attenuating risks to physical health associated with depression.”

• “Primary care clinicians can now recommend exercise, psychotherapy, or antidepressants as standalone alternatives for adults with mild or moderate depression,”

7500+ steps prior to surgery

An October 2023 study said that,

• “Fitbits and other wearable devices could potentially be linked to Electronic Health Records (EHRs) and have that data be something that surgeons consider when planning perioperative care for their patients,”

• “This could really come to fruition to improve postoperative outcomes.” 

• “We used the combination of EHRs and Fitbit data to uncover how to potentially improve surgical outcomes. In our study, we looked at how many steps patients recorded on any given day, which is a proxy for physical activity,”

• “However, the fitness data wasn’t limited to the immediate preoperative period. The length of their activity record could be six months or several years before surgery. This is more reflective of chronic physical activity habits, versus the physical activity in the immediate preoperative period.” 

• “If we find people who are at high risk, using these Fitbit tools, we could monitor them more closely following their procedure because that allows us to catch problems before they progress beyond control,”

• “Another goal of our research is to modify physical activity in the preoperative period and improve postoperative outcomes. We need more studies and evidence to answer that question.” 

Weight Lifting: Compliance is the Key

A July 2023 study by McMaster University said that, 

• “There are a dizzying number of factors and combinations to consider when creating a weightlifting program to maximize strength and muscle growth,” 

• “This is an age-old debate among athletes and strength and conditioning coaches: what combination leads to the best gains?”

• “Our analysis shows that every resistance training prescription resulted in strength and muscle mass gains. Complex prescriptions are sufficient but unnecessary to gain strength and muscle. Simple programs are extremely effective, and the most important result is that people can benefit from any weightlifting program,” 

• “Seek guidance if you are unsure where to begin and how to progress, but it doesn’t need to be complicated.”

• “The biggest variable to master is compliance,”

• “Once you’ve got that down, then you can worry about all of the other subtle nuances, but our analysis clearly shows that many ostensibly important variables just aren’t that essential for the vast majority of people.”

Exercise and Cognitive Function

A July 2023 study by the University of Tsukuba suggests, according to Eureka Alert that

• “…even brief sessions of mild exercise, such as walking and yoga, can stimulate the brain and yield temporary improvements in cognitive performance. 

• “… the exercise group exhibited significant improvement in executive function compared to the control group.

• “… even three months of mild exercise can strengthen the brain's functional networks

• “…the positive impact of stress-free mild exercise over a three-month period in strengthening the prefrontal cortex and enhancing cognitive function among older adults.”

Exercise: How many days week?

July 2023 research by Edith Cowan University said 

• Our previous work has shown regular, shorter exercise is more beneficial than a one or two big training sessions in a week.

• Now, we have a clearer idea of where the tipping point is where you start to see meaningful benefits from such a minimal exercise.

• These new results suggest at least three days a week are required.

• However, it may be that exercising once a week for 2 hours is less effective than exercising every day for 20 minutes.

• If it is not possible to have 20 minutes a day for exercise, even five minutes a day makes a difference for fitness and health.

• It is important to note that even a very small amount of exercise can make a difference to our body, if it is performed regularly.

The Soleus muscle, glucose and fat burning, metabolism while sitting

A September 2022 study by the University of Houston on the soleus muscle in the calf and its development of  the “soleus pushup” (SPU) which effectively elevates muscle metabolism for hours, even when sitting.  The researchers said, 

• “We never dreamed that this muscle has this type of capacity. It's been inside our bodies all along, but no one ever investigated how to use it to optimize our health, until now,” 

• “When activated correctly, the soleus muscle can raise local oxidative metabolism to high levels for hours, not just minutes, and does so by using a different fuel mixture.”  

• “The soleus’ lower-than-normal reliance on glycogen helps it work for hours effortlessly without fatiguing during this type of muscle activity, because there is a definite limit to muscular endurance caused by glycogen depletion,”

•  “As far as we know, this is the first concerted effort to develop a specialized type of contractile activity centered around optimizing human metabolic processes.” 

Eureka notes

“The Soleus Pushup 

While seated with feet flat on the floor and muscles relaxed, the heel rises while the front of the foot stays put. When the heel gets to the top of its range of motion, the foot is passively released to come back down. The aim is to simultaneously shorten the calf muscle while the soleus is naturally activated by its motor neurons.”

The University of Houston added, 

• “The soleus pushup looks simple from the outside, but sometimes what we see with our naked eye isn't the whole story. It’s a very specific movement that right now requires wearable technology and experience to optimize the health benefits,” 

• “All of the 600 muscles combined normally contribute only about 15% of the whole-body oxidative metabolism in the three hours after ingesting carbohydrate. Despite the fact that the soleus is only 1% the body weight, it is capable of raising its metabolic rate during SPU contractions to easily double, even sometimes triple, the whole-body carbohydrate oxidation.” 

• “We are unaware of any existing or promising pharmaceuticals that come close to raising and sustaining whole-body oxidative metabolism at this magnitude.” 

Daily Step Count and Longevity

A May 2021 study by the University of North Carolina, said,

• “Technological advances made in recent decades have allowed researchers to measure short spurts of activity. Whereas, in the past we were limited to only measuring activities people could recall on a questionnaire,” 

• “With the help of wearable devices, more research is indicating that any type of movement is better than remaining sedentary.”

• “Our current results indicate that this finding holds even for women who did not engage in any uninterrupted bouts of walking. Taking 2,000 or more additional steps during bouts was associated with further benefits for longevity,”

• “Older adults face many barriers to participating in structured exercise programs, so some may find it more convenient and enjoyable to increase everyday walking behaviors, like parking slightly further from their destination or doing some extra housework or yardwork,”

Weight-loss, obesity and sitting

A May 2021 study by California Polytechnic State University, in San Luis Obispo said it’s findings,

• "hopefully will prompt future weight maintenance intervention research testing the effects of and optimal approaches for reducing sedentary behavior, including non-work-related computer and video game usage. Future research should include objective measures of sedentary behavior and activity," 

• "These findings are important for understanding behaviors that may enhance weight loss maintenance, and one of those may be to reduce sitting time and other modes of sedentary behavior. However, this study also showed that physical activity was associated with improved weight-loss maintenance. Thus, this study does not imply that simply standing more rather than sitting will contribute to weight-loss maintenance, but may suggest that less sitting that results in more movement is what is key to weight loss maintenance. Hence, sit less and move more,"

Exercise and brain insulin resistance

A November 2022 study by DZD, Tübingen University Hospital and Helmholtz Munich said, 

• "The exercise intervention increased the insulin-stimulated activity in brain regions that are responsible, among other things, for the perception of hunger and satiety and for the interaction of motivation, reward, emotion and exercise behavior," 

• "The study suggests that insulin resistance in the brain may be reversible and could be a viable therapeutic target to restore central nervous system regulation of metabolism and body weight and counteract adverse effects of obesity," 

Physical activity in the morning, lowest risk of heart disease and stroke

A November 2022 study by Leiden University Medical Centre, the Netherlands.

• “It is well established that exercise is good for heart health, and our study now indicates that morning activity seems to be most beneficial,” 

• “The findings were particularly pronounced in women, and applied to both early birds and night owls.”

• “This was an observational study and therefore we cannot explain why the associations were more marked in women. Our findings add to the evidence on the health benefits of being physically active by suggesting that morning activity, and especially late morning, may be the most advantageous. It is too early for formal advice to prioritise morning exercise as this is quite a new field of research. But we hope that one day we can refine current recommendations simply by adding one line: ‘when exercising, it’s advised to do so in the morning’.”