Cardio Metabolic Health Congress – Official Blog

Updated Physical Activity Guidelines for Americans

Recently released by the U.S. Department of Health and Human Services, the second edition of the Physical Activity Guidelines for Americans offers recommendations for children and adolescents between 3 and 17 years of age: outlining the importance of regular exercise, and “moving more and sitting less.” Described as a critical resource for not only health professionals & practitioners but also policymakers, the guidelines serve as a supplementary resource in the ongoing effort to combat the high rates of chronic diseases—many of which are related to low rates of physical activity.

While the first edition of the guidelines was originally released a decade ago, and physical activity overall has generally improved since its release, the guidelines report that only 26% of men, 19% of women, and 20% of adolescents report sufficient amounts of physical activity. During a press conference, Brett P. Giroir, MD, assistant secretary for health for HHS emphasized the importance of the applications in the guidelines. “Inactivity causes 10% of premature mortality in the United States,” he stated. If only one quarter of inactive people could meet the guidelines and recommendations, approximately 25,000 deaths would be prevented in the country.

While physical activity can demonstrate immediate benefits including improvement in sleep hygiene, anxiety & blood pressure reduction, and improved insulin sensitivity—as shown in the report’s presentation of scientific evidence—the recommendations included in the guidelines reinforce more long-term benefits. Physical activity can improve cognition in children, mitigate the risk of postpartum depression, and help stave off dementia, Alzheimer’s disease, and excessive weight gain. Additionally, physical activity helps aid in the prevention of certain types of cancer.

The guidelines recommend specific amounts of exercise, including at least 60 minutes of ‘moderate-to-vigorous activity’ for children and adolescents between 6 and 17. Suggestions for adults recommend at least 150 to 300 minutes per week of moderate-intensity aerobic activity, coupled with muscle-strengthening activity 2 days per week. Moreover, the guidelines stress that adults should “move more and sit less,” since findings indicate that increased sedentary behavior has a strong correlation with cardiovascular disease, high blood pressure, and overall mortality. While the first guidelines recommended 10 minutes of physical activity per day, this edition states that Americans should simply move more frequently throughout the entire day, and that health benefits can be accrued from even small amounts of exercise.

In a related viewpoint published in JAMA, Giroir and Don Wright, MD, MPH from the HHS Office of Disease Prevention and Health Promotion write that these strategies could potentially yield “tangible increases in physical activity levels in the United States, and, as a result, reduce ever-increasing rates of chronic disease and burgeoning health care spending.” They further highlight the importance of physicians, health care professionals, and community & national leaders to take action in “this important call to Americans to make simple lifestyle changes that will improve longevity and quality of life.”

Nevertheless, given that an estimated 80% of adults do not currently meet the standards for sufficient physical activity, the guideline-recommended levels will remain a challenge, and require a comprehensive, coordinated approach from several sectors of society.

Pate RR. Department of Health and Human Services’ Physical Activity Guidelines for Americans. All presented at: American Heart Association Scientific Sessions; Nov. 10-12, 2018; Chicago.


Why Stress May Raise Type 2 Diabetes Risk in Women

Traditional risk factors like obesity, high blood pressure, and a sedentary & nonactive lifestyle may not be the sole risk factors that can predict type 2 diabetes, as newly emerging research highlights the critical role that stress may play in the development of the condition: specifically in women.

The study, which will be presented on November 10th at the American Heart Association’s Scientific Sessions conference in Chicago, found that increasing stress stemming from traumatic events—in addition to long-term situations at home or work—was associated with ‘an almost two-fold higher risk of new type 2 diabetes cases among older women.’

Jonathan Butler, the study’s lead researcher and a postdoctoral scholar at the University of California, San Francisco’s Center for the Study of Adversity and Cardiovascular Disease, stressed the importance of taking psychosocial stressors as risk factors for diabetes “as seriously as other embraced diabetes risk factors.” Given the fact that diabetes has rapidly become one of the most serious public health issues, impacting approximately 30.3 million Americans according to data from the Centers for Disease Control and Prevention, it becomes even more imperative to “better understand risk factors for diabetes in this group,” said Butler: particularly given the fact that a majority of these people are older women.

Dr. Sherita Hill Golden, professor of medicine at the Johns Hopkins University School of Medicine in Baltimore, echoed Butler’s sentiments regarding looking beyond traditional physiological risk factors. “We’ve been trying to understand the relationship between stress, mental health and diabetes risk for a while,” as additional evidence suggests that psychosocial stress, and the ways in which people cope with stressors, may impact overall cardiometabolic health.

While previous studies focused on the relationship and correlation between stress and diabetes have focused on individual stressors, i.e. work, or symptoms of depression or anxiety, Butler and his colleagues designed a study that investigated “the joint relationship of multiple stressors with diabetes risk among women over time.”

The data included 22,706 female health professionals, all of whom who did not have cardiovascular disease; the average age of the participant was 72. Researchers collected information regarding “acute and chronic stressors and then followed the women for an average of three years.” The definitions of acute stress included both negative and traumatic life events, while chronic stress was generally related to family, work, finances, relationship, discrimination, etc. The women that had the highest levels of both acute and chronic stress presented with nearly double the risk for diabetes.

Dr. Michelle A. Albert, the study’s senior author and a professor of medicine at the University of California, San Francisco, states that the next steps will be to not only confirm the findings, but also to determine specific techniques & strategies “targeted at psychosocial stressors” that could potentially lessen, or decrease, diabetes risk in older women. She additionally communicated the importance of health care providers and clinicians inquiring about psychosocial stressors, as part of their assessment of diabetes risk, from a public health perspective.

Golden additionally stated that the new findings highlight the importance of considering the role of non-traditional risk factors, such as stress, in the development of diabetes. “We know that lifestyle intervention works for diabetes prevention, but that can be challenging if people experience cumulative stressors, like losing a job or caring for a family member, that hinder them from engaging in healthy behaviors like exercising, eating right or smoking cessation,” she said. “It’s important to assess and understand a patient’s social history. They may need a referral to a counselor or social worker.”