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Tag: physical activity

Physical Activity to Combat Cardio Risk

A study of close to 500,000 people without cardiovascular disease at baseline showed that total physical activity related to work, recreation, or utilitarian needs such as walking to do errands was associated with a lower short-term risk of developing CVD. The researchers found that there is a “clearly positive . . . dose-response relationship between levels of total activity and risks of major CVD,” senior author Dr Zhengming Chen (University of Oxford, UK) told theheart.org | Medscape Cardiology.

Lead author Dr Derrick A Bennet (Oxford University) and colleagues analyzed data from adults who participated in the China Kadoorie Biobank study, and their findings were published November 8, 2017 in JAMA Cardiology.
Compared with people in high-income countries, these participants in middle-income China had a much higher average level of physical activity: 21.5 metabolic equivalents of task (MET) hours/day, which equals 5 hours of cycling or brisk walking a day.

With each added 4 MET hours/day of physical activity—roughly equal to 1 extra hour of brisk walking per day—people had a 5% to 12% lower risk of developing different types of CVD during a 7.5-year follow-up. The association was similar in men and women, and young and old, Chen noted. However, among patients with hypertension, the benefits of physical activity in lowering risk of CVD—especially stroke—were weaker, although fewer than 10% of these patients had properly controlled hypertension.

Dr Scott A Lear (Simon Fraser University, Vancouver, BC) told theheart.org | Medscape Cardiology that this “huge study in the largest population in the world” showed that “being physically active is associated with a substantial reduction in risk for major CVD events,” which “is as good as or better than some of the most effective CVD pharmaceuticals we have.” Added to other evidence, it emphasizes that “more attention needs to be paid to prescribing physical activity as an effective and low-cost intervention with few side effects,” he said. “Public-health policy and other administrative units need to be involved (since it is rare that healthy people see a clinician) to ensure being physically active is the easy choice.”

The study also supports World Health Organization (WHO) recommendations of 20 or 30 minutes of moderate intensity exercise on most days, which would reduce the risk of premature death by 20% compared with people who do not meet this target.

“Our study is the first really large study in low- and middle-income countries of the effects of physical activity on CVD risks, and the study findings support current WHO guidelines that promote any type of activity to reduce the risk of major chronic disease,” said Chen. The challenge, say Lear and Yusuf, is for low- and middle-income countries to find ways to mitigate the decrease in occupational physical activity that follows economic prosperity and for high-income countries to find ways to increase fitness levels when most people have sedentary jobs.

On an individual level, people with sedentary jobs “can do simple things,” they advise, such as getting up every 20 to 30 minutes for a 2-minute walk, taking the stairs instead of an elevator, and parking further from their destination. However, individual changes only go so far, they note, and for substantial increases in physical activity to be achieved “national and community-level programs are needed.” Having safer neighborhoods where people can access parks and bicycle paths can help, and in China, building bike lanes would not only increase activity, but reduce traffic and air pollution, they point out.

“If the entire population met the WHO [physical activity] guidelines, whether through recreational, occupational, household, or other obligatory activities, this would prevent around one in 12 (or approximately 3.0 million) premature deaths in adults worldwide,” they conclude.

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Move — and Move Often!

While most physicians and nutritionists agree that low to moderate levels of weekly physical activity is often insufficient to significantly reduce body weight, studies indicate that those who transition from little to no daily physical activity to moderate levels have clinically meaningful reductions in cardiometabolic risk.

Scores of controlled trials over the last decade demonstrate that physical activity helps mitigate and reduce cardiometabolic risk via biologic mechanisms, which are not entirely dependent upon body weight or BMI reduction. Research increasingly supports that those who have prediabetes should consistently increase physical activity levels, despite little to no weight loss.

According to research published in the European Journal of Preventive Cardiology, the benefits of physical activity may outweigh the impact of being overweight and/or obese in middle-aged and elderly people. The observational study, conducted with a sample size of over 5,000 people aged 55 years and older, followed up with participants for 15 years. While overweightness and obesity is associated with a higher risk of cardiovascular disease, and weight loss is recommended, it is slightly different with the elderly population: weight loss, especially unintentional, is often associated with muscle loss and death.

Regardless of age, physical activity is associated with a lower risk of cardiovascular disease. Studies have further demonstrated that physical activity is protective for cardiovascular risk, playing a crucial role in the health of middle-aged and elderly people. Without adequate physical activity, those who are overweight and obese are at a significantly higher risk of developing cardiovascular disease.

The harmful effects of overweightness and obesity occur through adipose tissue, which accelerates the atherosclerotic process, thereby increasing cardiovascular risk. Exercise and physical activity lowers the harmful effects of atherosclerosis by reducing the stabilization of plagues on blood vessels, ultimately reducing the heart’s oxygen demand. Engaging in high levels of physical activity protects people from the harmful effects of adipose tissue on cardiovascular disease. The idea: move—and move often!

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