Posts Tagged ‘exercise’

Combo Diet-Exercise Programs Trim Diabetes Risk

A combination of diet and physical activity programs offered in the community reduce the risk of type 2 diabetes in patients who are at increased risk, according to new federal data.

Programs Help Patients Revert to Normal Glycemic Levels

• Strong evidence suggests that a combination of diet and physical activity programs can reduce new-onset diabetes for persons at increased risk for type 2 diabetes.

• These programs also increase the likelihood of reversion to normal glycemic levels and improve diabetes and cardiovascular disease risk factors, including weight, blood glucose levels, blood pressure, and lipid levels.

• The US Community Preventive Services Task Force recommends the use of combined diet and physical activity promotion programs to reduce progression to type 2 diabetes in those at increased risk.

Combined Program’s Critical Components

• Critical components of a combined diet and physical activity program include trained providers in clinical or community settings who work directly with program participants for at least 3 months; some combination of counseling, coaching, and extended support; and multiple sessions related to diet and physical activity, delivered in person or by other methods.

• Programs also may use 1 or more of the following: diet counselors in various specialties (eg, nutritionists, dietitians, and diabetes educators); exercise counselors in various specialties (eg, physical educators, physiotherapists, and trainers); physicians, nurses, and trained laypersons; a range of intensity of counseling, with many or few sessions, longer- or shorter-duration sessions, and individual or group sessions; and individually tailored or generic diet or physical activity programs.

• Programs should include specific weight-loss or exercise goals and a period of maintenance sessions after the primary core period of the program.

US Task Force Conducts Systematic Review

• The task force recommendation is based on evidence from a systematic review of 53 studies that described 66 programs.

• Most programs used a combination of in-person individual and group sessions.

• Almost all programs led to weight loss, reduced risk of diabetes, or both.

• More intensive programs led to more weight loss and less development of diabetes.

Group Programs More Cost-effective

• These diet-exercise programs were cost-effective; group-based programs were the most cost-effective.

• Health care providers usually are the primary resource for patients at increased risk for type 2 diabetes.

• The task force suggests that health care providers keep informed about local prevention programs offered by community centers or run by insurers or nonprofit or other private contractors.

Take-home Message:

• A federal task force’s systematic review found combined diet and physical activity programs can help prevent or delay the development of diabetes.

Erectile, Sexual Function Better in Active Men

The more a man exercises, the better his erectile and sexual function, regardless of his race, according to a new study designed to define a minimum exercise threshold for best sexual function.

Many studies have highlighted the relationship between better erectile function and exercise, but black men have been underrepresented in the literature.

“This study is the first to link the benefits of exercise in relation to improved erectile and sexual function in a racially diverse group of patients,” said senior author Adriana Vidal, PhD, of the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute and Department of Surgery in Los Angeles.

This cross-sectional study included nearly 300 participants from a case-control study that assessed risk factors for prostate cancer conducted at the Durham Veterans Affairs Medical Center.

The men, about one-third of them black, self-reported their activity levels.

The researchers then stratified them into 4 exercise groups: sedentary, mildly active, moderately active, and highly active.

The subjects also self-reported their sexual function, including the ability to have erections and orgasms, the quality and frequency of erections, and overall sexual function.

MORE FREQUENT EXERCISE = HIGHER SEXUAL FUNCTION

A multivariate analysis showed that men who reported more frequent exercise, a total of 18 metabolic equivalents (METS) per week, had higher sexual function scores, regardless of race.

MET hours reflect both the total time of exercise and the intensity of exercise.

A score of 18 METS is the equivalent of 2 hours of strenuous exercise, such as running or swimming; 3.5 hours of moderate exercise; or 6 hours of light exercise.

“Higher exercise was associated with a better sexual function score.

Importantly, there was no interaction between black race and exercise, meaning more exercise was linked with better erectile/sexual function regardless of race,” the researchers stated.

In contrast, exercise at lower levels was not statistically or clinically associated with erectile or sexual function in men of any ethnicity.

Additional contributors to low sexual function included diabetes mellitus, older age, past or current smoking, and coronary artery disease.

LESS INTENSE EXERCISE BETTER THAN NONE

Study coauthor Stephen Freedland, MD, Director of the Center for Integrated Research in Cancer and Lifestyle in the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, cautions that exercise should be tailored for each person.

“When it comes to exercise, there is no one-size-fits-all approach,” said Dr Freedland, who also serves as codirector of the Cancer Genetics and Prevention Program.

“However, we are confident that even some degree of exercise, even if less intense, is better than no exercise at all.”

The researchers published their results online in the March 20, 2015 issue of Sexual Medicine.

Moderate Exercise Lowers Risk of Death for Older Hypertensive Men

Older men who have high blood pressure can lower their risk of death with even moderate amounts of exercise, according to a new study.

“To substantially reduce his risk of death, an elderly man needs to walk briskly for 20 to 40 minutes a day, 4 to 6 times per week,” lead author Charles Faselis, MD, Chief and Associate Professor of Medicine at George Washington University School of Medicine and Health Sciences (SMHS) in Washington, DC, said in an interview.

At the moment, only about 25% to 30% of older men engage in a brisk walk of 20 to 40 minutes most days of the week, Dr. Faselis noted.

BENEFITS OF A BRISK WALK

For the study, researchers assessed the fitness status of more than 2150 men with hypertension, aged 70 years and older, using a standard treadmill exercise test.

The researchers published their results online in the May 12, 2014 issue of Hypertension.

They used metabolic equivalents (METs)—equal to the amount of oxygen the body uses per kilogram of body weight per minute—to determine the men’s peak fitness levels.

One MET is the amount of energy expended at rest; anything above that represents work.

The researchers categorized the men as very low fitness, low fitness, moderate fitness, and high fitness.

“To put this in perspective, the peak MET level of a sedentary 50-year-old is about 5 to 6 METs,” said Dr. Faselis.

“For a moderately fit individual, it’s about 7 to 9 METS, and for a highly fit person, it’s 10 to 12 METs.”

After an average follow-up of 9 years, the researchers found that the risk of death was 11% lower for every 1-MET increase in exercise capacity.

Compared with least-fit men (up to 4 peak METs), the risk of death was 18% lower in those in the low-fit category (4.1 to 6 peak METs), 36% lower in the moderately fit men (6.1 to 8 peak METs), and 48% lower in the high-fit men (peak METs of more than 8).

“A regular brisk walk most days of the week is a safe, effective form of exercise.

Most health benefits are realized at this exercise level.

More vigorous exercise is not required,” said senior author Peter Kokkinos, PhD, Professor at Veterans Affairs Medical Center, Georgetown University School of Medicine and George Washington University SMHS.

He added that an exercise stress test is highly recommended for patients before they engage in any exercise program.

Also, doctors should check with the patient periodically and encourage him to maintain exercise, he said.

“PHYSICAL ACTIVITY AWARENESS” CAMPAIGN

“The evidence supporting exercise-related health benefits for all ages is overwhelming,” Dr Kokkinos said.

“Physical activity is an inexpensive way to improve health.

It can easily be implemented for most populations at any age.

Yet, we are in the midst of a physical inactivity epidemic.

Health-care providers can help change all this by simply taking a few minutes to discuss physical activity with their patients.”

Dr. Faselis added: “The responsibility of promoting physical activity should not stop with the health care provider.

In this digital age, where inactivity is fostered, the time has come for a ‘Physical Activity Awareness’ campaign nationwide.”

Exercise More, Sit Less to Prevent Heart Failure

Be more active and sit less and you’ll improve your chances of preventing heart failure.

That’s the message of the first study to provide evidence that high levels of sedentary time, even among physically active men, places them at risk for heart failure.

“The evidence of the effects of physical activity on heart failure is developing.

Our study adds to this by examining the associations in a large racially and ethnically diverse population.

We provide even more evidence that moving more and sitting less can lead to better health,” says lead author Deborah Rohm Young, PhD, research scientist at the Kaiser Permanente Southern California Department of Research & Evaluation, Pasadena, CA.

Dr. Young and colleagues examined the electronic health records of nearly 83,000 men aged 45 years and older who were part of the California Men’s Health Study and had enrolled in Kaiser Permanente health plans in the Northern and Southern California regions.

The researchers published their results in the January 21, 2014 issue of the journal Circulation: Heart.

After monitoring these men for more than 10 years, they found that the risk of heart failure in those who reported high levels of sedentary time and low levels of physical activity was twice that in men who reported high physical activity and low sedentary time.

Although the researchers were not able to identify the types of exercise that the men did in the study, Dr. Young suggested that “brisk walking is a great form of physical activity.

It can be done almost anywhere, it does not require equipment, and most people of all ages can do it.”

She says that a brisk walk is “as if you’re in a hurry, and is defined as a 3- to 4-mile per hour pace or a 15- to 20-minute mile.”

To prevent heart disease, Dr. Young encourages men to meet the National Physical Activity Guideline—150 minutes per week of moderate intensity physical activity.

“We are still learning about the detrimental effects of high daily sedentary time,” she says.

“At this point, there is no consensus on how much sedentary time is too much.

Plus, our study only asked about sitting time outside of work.

But given the number of health benefits from being physically active, people should find ways to put physical activity into their lives and spend less time sitting.”

At Kaiser Permanente, clinicians have initiated an “Exercise Vital Sign” program in which all members are asked about their physical activity at every outpatient visit.

“The information is recorded in their electronic health record and is available for the health care providers when they see the patient.

It provides an opportunity for the provider to counsel the patient on physical activity levels,” Dr. Young says.

She suggests that primary care physicians ask their patients about their regular physical activity.

“When it’s insufficient, patients need to hear that regular physical activity is important for their health.

Physicians can be powerful advocates in helping to promote this message.”

Exercise More, Sit Less to Prevent Heart Failure

Be more active and sit less and you’ll improve your chances of preventing heart failure.

That’s the message of the first study to provide evidence that high levels of sedentary time, even among physically active men, places them at risk for heart failure.

“The evidence of the effects of physical activity on heart failure is developing.

Our study adds to this by examining the associations in a large racially and ethnically diverse population.

We provide even more evidence that moving more and sitting less can lead to better health,” says lead author Deborah Rohm Young, PhD, research scientist at the Kaiser Permanente Southern California Department of Research & Evaluation, Pasadena, CA.

Dr. Young and colleagues examined the electronic health records of nearly 83,000 men aged 45 years and older who were part of the California Men’s Health Study and had enrolled in Kaiser Permanente health plans in the Northern and Southern California regions.

The researchers published their results in the January 21, 2014 issue of the journal Circulation: Heart.

After monitoring these men for more than 10 years, they found that the risk of heart failure in those who reported high levels of sedentary time and low levels of physical activity was twice that in men who reported high physical activity and low sedentary time.

Although the researchers were not able to identify the types of exercise that the men did in the study, Dr. Young suggested that “brisk walking is a great form of physical activity.

It can be done almost anywhere, it does not require equipment, and most people of all ages can do it.”

She says that a brisk walk is “as if you’re in a hurry, and is defined as a 3- to 4-mile per hour pace or a 15- to 20-minute mile.”

To prevent heart disease, Dr. Young encourages men to meet the National Physical Activity Guideline—150 minutes per week of moderate intensity physical activity.

“We are still learning about the detrimental effects of high daily sedentary time,” she says.

“At this point, there is no consensus on how much sedentary time is too much.

Plus, our study only asked about sitting time outside of work.

But given the number of health benefits from being physically active, people should find ways to put physical activity into their lives and spend less time sitting.”

At Kaiser Permanente, clinicians have initiated an “Exercise Vital Sign” program in which all members are asked about their physical activity at every outpatient visit.

“The information is recorded in their electronic health record and is available for the health care providers when they see the patient.

It provides an opportunity for the provider to counsel the patient on physical activity levels,” Dr. Young says.

She suggests that primary care physicians ask their patients about their regular physical activity.

“When it’s insufficient, patients need to hear that regular physical activity is important for their health.

Physicians can be powerful advocates in helping to promote this message.”

Healthy Behaviors Trim Dementia, Chronic Diseases

Five healthy behaviors — regular exercise; no smoking; and maintaining a low body weight, a healthy diet, and low alcohol intake — appear to reduce the risk of dementia and several chronic diseases significantly, according to a 35-year study that monitored men’s health habits.

The men who consistently engaged in 4 or 5 of these behaviors experienced a 60% reduction in dementia and cognitive decline — with exercise being the strongest mitigating factor — as well as 70% fewer instances of diabetes mellitus, heart disease, and stroke, compared with persons who engaged in none of them.

“Undoubtedly, these protective behaviors affect a host of biological mechanisms.

Separating out relationships between the 5 behaviors and the 4 disease outcomes we examined would be an enormous, and probably a rather fruitless, task.

It would not be helpful to the overall aim of promoting healthy lifestyles to dissect out and promote individual behaviors.

People should be urged to adopt a healthy lifestyle as a complete package,” said lead author Peter Elwood, DSc, MD of the Cochrane Institute of Primary Care and Public Health at Cardiff University.

Dr. Elwood and colleagues presented their results in the December 9, 2013 issue of PLoS One.

Researchers have known for some time that what is good for the heart is good for the head, Dr. Elwood pointed out, noting that the study provides more evidence that healthy living could significantly reduce the chances of developing dementia.

The Caerphilly Cohort Study recorded the healthy behaviors of 2235 men aged 45 to 59 years in Caerphilly, South Wales.

An important aim of the study was to examine the relationships among healthy lifestyles, chronic disease, and cognitive decline over a 35-year period.

The researchers also monitored changes in the take-up of healthy behaviors.

“The size of reduction in the instance of disease owing to these simple healthy steps is of enormous importance in an aging population,” said Dr. Elwood.

“What the research shows is that following a healthy lifestyle confers surprisingly large benefits to health. Healthy behaviors have a far more beneficial effect than any medical treatment or preventative procedure.”

However, Dr. Elwood pointed out, “our study showed that over 30 years health promotion had no detectable effect upon the prevalence of healthy living.”

Despite increasing knowledge of the relevance of lifestyle to health and to survival, the proportion of the adult Welsh population following all 5 healthy behaviors was, and remains, under 1%.

The prevalence of all 5 healthy behaviors is estimated to be only 3% in large, primary prevention studies in the United States.

“Clearly there is an urgent need for new strategies in health promotion to be developed and evaluated,” Dr. Elwood said.

He suggested that rather than talk to their patients about the benefits of a healthy lifestyle in rather vague terms, physicians should speak in precise, quantitative terms, saying something like: “People who live a truly active lifestyle experience 60% fewer heart attacks, 70% less diabetes, and a 60% reduction in dementia.

Furthermore, those who follow a healthy lifestyle and still get a disease or dementia get it when they are about 12 years older.”

Make Lifestyles Changes That Last with a Wellness Coach

A new breed of health professional – wellness coaches – appeared on the healthcare scene about a decade ago.

Thousands of wellness coaches now serve as partners with their clients to elicit agendas and co-discover solutions.

The clients of wellness coaches learn how to lose weight, exercise more, and change their lifestyles with lasting results.

Wellness coaches differ from life coaches, personal trainers, or therapists because they use science-based techniques to enhance motivation, self-confidence, and self-regulation, says Margaret Moore, founder and CEO of Wellcoaches Corporation.

“Studies show wellness coaches help instill long-lasting habits that, over time, become part of the brain’s hardwiring,” says Moore, who is also co-director of the Institute of Coaching at McLean Hospital, an affiliate of Harvard Medical School, and a founding advisor of the Institute of Lifestyle Medicine at Harvard Medical School.

With more than a dozen years’ worth of wellness coaching experience, Moore has guided thousands of coaches and hundreds of clients to make the changes toward leading healthier lives.

On a CBS TV broadcast last week, Moore said “the coach is really trained to help you take a bigger picture of you, over all aspects of your health and wellness and then come up with a formula that combines all of these things together.”

And “the coaching world has come up with skills to help people make changes that last,” she said.

The TV report noted that the National Consortium for Credentialing of Health & Wellness Coaches is currently working to develop a national certification for wellness coaches.

In collaboration with the American College of Sports Medicine, Wellcoaches is helping to lead this initiative.

How to Keep Up With New Year’s Resolution to Exercise

Why is it so hard to keep up with New Year’s resolutions to get more exercise?

One reason may be that your motivation to exercise fluctuates from week to week, and these fluctuations are linked to your behavior.

Researchers at Penn State examined college students’ intentions to be physically active as well as their actual activity levels.

They recruited 33 college students and assessed the students’ weekly intentions to be physically active and their activity levels over a 10-week period.

They found that “our motivation to be physically active changes on a weekly basis because we have so many demands on our time,” said David Conroy, professor of kinesiology, at Penn State.

“Maybe one week we’re sick or we have a work deadline — or, in the case of students, an upcoming exam.

But these lapses in motivation really seem to be destructive.

Our results suggest that people with consistently strong intentions to exercise have the best chance of actually following through on their intentions, while people with the greatest fluctuations in their motivation have the hardest time using that motivation to regulate their behavior.”

The researchers reported their results in the current issue of the Journal of Sport & Exercise Psychology.

Regarding New Year’s resolutions, Conroy advised that you focus less on making broad commitments to becoming more active and instead come up with a plan for how you are going to sustain your motivation from one week to the next.

“It is important to pay attention to how we can sustain a high level of motivation and not just let that motivation degrade in response to all the external demands we face,” said Conroy.

Crave chocolate? Take a walk

Not only can exercise help you eat a healthy diet, it can cut down on your chocolate consumption as well.

A new British study shows that even in stressful situations, workers ate only half as much chocolate as they normally would after a short burst of physical activity.

A 15-minute walk cut snacking on chocolate at work by half, according to research by the University of Exeter published in the journal Appetite.

The research suggests that a short exercise break away from your desk can help keep your mind off snacking.

“We know that snacking on high-calorie foods, like chocolate, at work can become a mindless habit and can lead to weight gain over time,” said lead researcher Professor Adrian Taylor of the University of Exeter.

“We often feel that these snacks give us an energy boost, or help us deal with the stress of our jobs, including boredom.

People often find it difficult to cut down on their daily treats but this study shows that by taking a short walk, they are able to regulate their intake by half.”

Many studies show exercise can elevate your mood and boost your energy level.

So when you feel the urge for a candy bar, take a walk instead.

Exercise Can Help You Eat a Healthy Diet

Calories in, calories out.

That’s the tried and true way to lose weight – eat less, exercise more.

A new compilation of epidemiological evidence of weight loss shows that exercise can, in fact, help you eat a more healthy diet, say Harvard researchers.

“Physical exercise seems to encourage a healthy diet.

In fact, when exercise is added to a weight-loss diet, treatment of obesity is more successful and the diet is adhered to in the long run,” says the lead Harvard researcher Miguel Alonso Alonso.

His study was published in the October issue of Obesity Reviews.

Regular physical exercise also causes changes in the working and structure of the brain, in particular, in executive functions, which include inhibitory control.

“In time, exercise produces a potentiating effect of executive functions including the ability for inhibitory control, which can help us to resist the many temptations that we are faced with everyday in a society where food, especially hypercaloric food, is more and more omnipresent,” says Alonso Alonso.

Basically, that means that exercise also helps your brain know when your belly is full so you can better control your appetite.

So go out and exercise.

Your brain, and your belly, will thank you for it.