Male Visceral Fat Leading to Cardiac Conditions

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"Males tend to suffer from obesity at a younger age than females due to the protective effect of  estrogen on the female metabolism. Males generally tend to be more obese and tend to have more visceral obesity, which is sometimes described as 'beer belly'."

"The effect of obesity on the heart has been studied previously also in population-based studies."

"Most studies predominately classified obesity according to BMI [body mass index] and they found that a high BMI is associated with cardiac dilatation."

"Fewer studies investigated 'visceral' obesity according to WHR [waist-to-hip ratio], and some did not find a different effect of visceral obesity compared to general obesity."

"Moreover, many studies used echocardiography [ultrasound test that checks the heart's structure and function] to investigate how obesity impacts the heart's anatomy, which is broadly available but does not allow for further tissue characterization."

Dr. Jennifer Erley, radiology resident, University Medical Center, Hamburg-Eppendorf, Germany

 

Men with higher waist-to-hip ratios showed early signs of heart damage even when their overall weight wasn’t very high. (iStock)

New  research now points to belly fat as being particularly problematic in the potential danger it poses to the male cardiac system. Abdominal obesity -- recognized as an unhealthy hip-to-waist ratio -- has been found to be associated with worrying patterns of 'cardiac remodelling' overturning the  assumption that overall weight alone is the culprit. This was discovered by researchers studying advanced cardiovascular MRI [magnetic resonance imaging] scans of 2,244  adults between the ages of 46 to 78 with no known heart disease.

 

According to the authors of the paper published in research presented at the annual meeting held in Chicago of the Radiological Society of North America, these findings "highlight the need for personalized risk assessment in obesity-related cardiovascular disease". An estimated 3 billion people worldwide are overweight or obese. This is an epidemic that significantly contributes to many other chronic health conditions such as high cholesterol levels, Type 2 diabetes, high blood pressure and sleep disorders, and places them at  higher risk of coronary artery disease and death from cardiovascular issues.

 

According to Statistics Canada, Canadians are experiencing "high and growing levels" of fat stored around the waist and stomach. Nearly half (49 percent) of adults in Canada aged 18 to 29 had a waist circumference greater than the threshold for abdominal obesity. In other words, higher than 102 centimetres for males and 88 cm for females.  

 

(The Image Bank, Getty Images)

"Similar to previous studies we found a high BMI is associated with bigger heart chambers, indicated by increased cardiac volumes [the amount of blood the heart holds and pumps] and an accompanying hypertrophy [thickening of the heart muscle]."

"Abdominal or visceral obesity, on the other  hand, was associated with a proportionally greater hypertrophy but smaller heart chambers."

"This form of remodelling where the heart muscle thickens but does not enlarge, is called 'concentric remodelling' and we know from previous studies that this form of remodelling is prone to lead to heart failure."

Dr. Jennifer Erley 

 

Up to three hours collectively of weekly physical activity is deemed to be sufficient to enable abdominal fat reduction. Physical exercise connected with dietary changes in some instances help to reduce abdominal obesity, even without achieving overall weight loss. Lifestyle changes leading to weight loss helps to improve blood sugar, blood pressure and cholesterol levels; factors referred to as metabolic syndrome. Inflammation is reduced, blood vessel function is improved and non-alcoholic fatty liver disease is eased.

Obesity may account for a fifth of all cases of atrial fibrillation -- quivering or irregular heartbeat. Each of the research subjects were measured for the size, thickness and volume of the heart's chambers through high-resolution MRI scans. Detailed health information, including weight, blood pressure, cholesterol, smoking status, and any history of diabetes was collected for all participants. The research conclusions led to clarification of the conundrum that some people with normal or moderately elevated BMI develop heart disease and others whose weight is considerably greater may not 

"The male heart is exposed to the effects of obesity longer than the female heart."

"The sex-specific differences suggest that male patients may be more vulnerable to the structural effects of obesity on the heart, a finding not widely reported in earlier studies."

"Rather than focusing on reducing overall weight, middle-aged adults should focus on preventing abdominal fat accumulation through regular exercise, a balanced diet and timely medical intervention, if necessary." 

"Nowadays, we have a broad variety of therapeutic strategies to tackle visceral obesity and it's important to address obesity as a 'pathology', just like arterial hypertension and diabetes."

"Patients and clinicians should  take obesity [particularly the accumulation of abdominal fat] just as seriously as those other pathologies."

Dr. Jennifer Erley

 

Cardiac MRI scans revealed thicker heart walls and smaller chamber volume in people with excess belly fat. (iStock)

 

"Our analyses suggest that increased energy intake has been roughly ten times more important than declining total energy expenditure in driving the modern obesity crisis."

"[In a sub-analysis of the diets of some of the groups from both highly and less-developed nations, the scientists found a strong correlation between the percentage of daily diets that consists of] ultra-processed foods -- [which the study's authors define as] industrial formulations of five or more ingredients -- [and higher body-fat percentages]." 

Study on Obesity Factors, Duke University, North Carolina

The research, published in PNAS, suggests diet, not inactivity, is the primary driver behind increasing obesity rates in developed countries. (Photo by Anastasia Shuraeva)

 

"Despite decades of trying to understand the root causes of the obesity crisis in economically developed countries, public health guidance remains stuck with uncertainty as to the relative importance of diet and physical activity."

"This large, international, collaborative effort allows us to test these competing ideas. It’s clear that changes in diet, not reduced activity, are the main cause of obesity in the U.S. and other developed countries."

Herman Pontzer, principal investigator with the Pontzer Lab, professor, Department of Evolutionary Anthropology, Duke University

 

"While we saw a marginal decrease in size-adjusted total energy expenditure with economic development, differences in total energy expenditure explained only a fraction of the increase in body fat that accompanied development."

"This suggests that other factors, such as dietary changes, are driving the increases in body fat that we see with increasing economic development."

Amanda McGrosky, Duke postdoctoral alumna, study lead investigator, assistant professor of biology, Elon University 

Professor Herman Pontzer and his co-authors, 80 in number, set out to gather data on obesity from labs globally. Data for 4,213 men and women representing 34 countries or cultural groups resulted, representing the full spectrum of socioeconomic groups. Total daily energy expenditures for everyone  was calculated, along with their basal energy expenditure (number of calories burned during basic biological operations and physical activity energy expenditure). 

 

Few large-scale studies have focused on comparing energy expenditure among populations among whom obesity appears common, as opposed to those resistant to obesity. Dr. Pontzer noted that understanding the relative contributions of diet and physical activity is vital if science aims at fully comprehending obesity's origins, in a bid to educate populations how best to avoid obesity and with it, the rise of diabetes, heart disease and stroke. 

 

People in traditional cultures among developing nations, do not tend to succumb to obesity. The recently published study out of Duke University sought to clarify what it was that exposed populations to greater incidents of obesity. Published in Proceedings of the National Academy of Sciences of the United States of America (PNAS), this study, using data on metabolic rates and energy expenditure among over 4,000 individuals from dozens of countries across a broad spectrum of socioeconomic conditions quantified calories that people from various cultures burn daily.

 

Common wisdom had it that people in highly developed nations are relatively sedentary, thus burn far fewer daily calories than those living in less industrialized countries, increasing the risk of obesity, and this is the message that public-health authorities have issued, in persuasive messaging on the necessity to ensure that sedentary lifestyles not take over lives, that it is critical for optimum health at all ages, to move about, exercise the body as well as consuming a healthy diet.

 

This new study finds otherwise. Concluding that Americans, Europeans and people in other developed nations expend roughly similar total calories most days, as did hunter-gatherers, herders, subsistence farmers, foragers and all those living in pre-industrialized nations. A finding that was unexpected in its conclusion that inactivity is not, after all, the major cause of obesity that it has been taken to be. 

 

It seems intuitive that comparing the energy expenditure of hunter-gatherers and farmer-herders opposite office workers would find a huge deficit on the part of the latter as opposed to the former.  It was established however that, though the hunter-gatherers and other primitive groups moved far more frequently throughout the course of a day than would a typical individual in a post-industrial society, overall daily calorie expenditure were closely analogous. 

 

A theory first proposed by Dr. Pontzer known as the constrained total energy expenditure model, posits that our brains and bodies closely monitor our total energy expenditure, keeping it within a narrow range. Should we begin consistently burning more calories for any reason for days on end, our brains slow down or shut off some tangential biological operations that sees overall daily caloric burn remaining in a consistent band.

 

The final takeaway from the study is, quite simply, the observation that within populations too much food is being consumed, in excess of the body's actual needs. As well, consuming the wrong types of food --ultra-processed, convenience and fast-food products, perhaps lacking in nutrients but packed with flavour enhancers, leading to higher body-fat outcomes. 

 

A new study concludes diet is by far the most important driver of obesity in more economically developed countries.  thebigland88/iStock

 

More than 1 billion people worldwide live with obesity, a global epidemic that health authorities have blamed on both increased consumption of calories and decreased physical activity. But which factor contributes more? After measuring the calories burned by people from different economic backgrounds and lifestyles, research published today in the Proceedings of the National Academy of Sciences concludes diet plays a far bigger role than physical inactivity in driving the epidemic—though not everyone agrees with that interpretation."

"The new study found that, when adjusted for body size, people in more economically developed societies expend relatively less energy. However, the differences are too small to explain the higher rates of obesity in these societies. Worldwide weight gains instead seem to be associated mainly with how much we consume, not how much we burn off."

"The findings align with the current conventional wisdom that increased energy intake is the primary driver of obesity and highlight the need for policies to reduce that, says Vanessa Oddo, an epidemiologist at the University of Illinois Chicago who was not involved in the work. However, she and others caution the study—which relied on computer modeling, one-off observations of study participants, and indirect measures of physical activity and diet—isn’t set up to pinpoint the epidemic’s causes."

Science Adviser 

 

Stalling the Aging Process and Dementia Onset

"We say what's good for the heart is good for the brain, so a nice balanced ... nutritious diet with ... those leafy greens, low in saturated fats, all of those things."

"I think that's really the next stage of the research is, how do we make this scalable in communities so that people can implement these things into their daily lives?"

"If [you're] frustrated by it, [you're] just going to give  up. But do something that you enjoy. Better yet, do it with somebody else or others around you because socialization is key, and lastly, something that you can adhere to, if you can schedule it. It's something that you can stay committed to." 

"[They/doctors] should be treating lifestyle intervention as they would a drug. That would mean prescribing improved exercise and eating regimens and getting insurers to cover those prescriptions."

Jessica Langbaum, senior director of research strategy, Banner Alzheimer' Institute, Phoenix, Arizona 

Illustration of dementia as memory loss due to brain degeneration and decline. Photo by wildpixel /Getty Images

 

 According to the Alzheimer's Society of Canada, by 2050, over 1.7 million Canadians are potentially likely, analyzing statistics, to be living with dementia, representing an increase of 187 percent, in comparison to 2020 when 597,000 people were documented to be living with the disease that slowly strips the brain of its mental resources, in the presence of the brain disease that commonly is the cause of dementia.

 

According to researchers, certain lifestyle changes can help to delay and even stop that mental decline. Alzheimer's researchers -- in referring to a new US. study that  focuses on what researchers into Alzheimer's now call the strongest evidence yet respecting what is involved in slowing the aging process and improving cognition -- linked that delay leading to dementia, to lifestyle changes. 

 

Three key factors have been illuminated; a diet heavy on leafy greens, berries and grains; regular moderate exercise; and ongoing social interaction. Another factor is regularly timely cardiovascular monitoring. Not directly involved in the study, Jessica Langbaum nonetheless presented the findings at an annual conference of experts who convened on Wednesday in Toronto.

 

As the largest international meeting dedicated to advancing dementia science and clinical practice,the Alzheimer's Association International Conference (AAIC) attracted 8,000 scientists and clinicians from all over the world, with the collective goal of improving diagnosis, risk reduction and treatment. Diet, exercise and socialization were pulled together in one substantial, structured study of 2,300 people in their '60s and '70s at risk of developing dementia. 

 

The study showed that bad habits "can really slow down memory and thinking" in adults at risk for cognitive impairment and dementia. The participants in the study changed their habits, from a sedentary lifestyle to an active one, improving their diet over a two-year period which resulted in cognitive function scores on par with people one or two years younger.

 

According to Ms. Langbaum, the results are significant evidence that change can occur without medication. "And so, it's showing that we can change the trajectory of aging", she said. Of the two groups involved in the study, in one, lifestyle changes were structurally presented. In the other, changes were self-directed. The results for the prescribed group were better, but both groups were shown to result in improvement. The largest challenge was sustaining a new exercise regimen for the study participants. 

 

Close to US$50 million was spent on the study by the American Alzheimer's Association. Even more was spent by the National Institutes of Health, to ensure that many of the participants underwent brain scans, blood tests and sleep studies aimed at providing additional information down the road.                                                                                              To begin implementing the lessons of the study, the American Alzheimer's Association plans to spend another US$40 million.                                                       

 

 

Life is a Learning Exercise to Lubricate the Brain

"I'm actually doing a little bit of work now on how we can get more people [children] in the United Kingdom to play chess, because it's so good for you."

"It's a great skill, and it's really good for helping you think."

U.K. Prime Minister Rishi Sunak

 

"Chess games are good for the brain as they require concentration, working memory, planning and problem solving."

"Therefore, they activate the brain regions involved in those cognitive processes."

"This is like a brain workout but also means you get better in those forms of cognition."

Barbara Sahakian, neuroscience professor, University of Cambridge

MirageC/Getty Images

"For the most part, the numbers of brain cells or neurons stay pretty stable across your lifespan, but these activities affect synapses, which are the connections between neurons."

"As we grow older, we tend to lose synapses in parts of the brain, and if you do things that are very stimulating toy our brain, you can make more connections, and you're just more resilient to the damage that's going on in the early phases of diseases like dementia."

Tara Spires-Jones, professor of neurodegeneration, University of Edinburgh

In the summer, a study that tracked over ten thousand older Australians over the course of a decade was published in the Journal of the American Medical Association (JAMA). The study concluded that chess as well as other cognitively stimulating leisure activities may help to reduce the future risk of dementia. A view shared by neuroscience professor Barbara Sahakian, who says chess players -- those in particular who play competitively in leagues and tournaments -- become fast thinkers.

 

Yet it is not chess specifically and chess alone that is highlighted as a skill found by researchers to be beneficial in later life. Included are card games like bridge or poker, games that involve many of the same calculating skills as does chess, have been found to hold benefits to maintain or improve cognition as people approach their elder decades.

 

Active mental activities including card games, crosswords, puzzles or taking adult education classes were all identified as examples of activities geared to potential helpfulness in reducing the risk of acquiring dementia in years to come. American and Canadian psychologists in 2020 published a study where they described learning a second language as being effective in delaying Alzheimer's disease. 

Illustration: Fran Pulido/The Guardian

According to Professor Tara Spires-Jones, the idea that supports all these activities as measures that people can take to ensure their brain remains in prime working order to help prevent its deterioration in years to come, can be summed up as building a strong brain network through the stimulating of various parts of the brain, simultaneously. It is generally acknowledged that physi9cal activity is associated with lowering the risk of dementia.

This is because physical activity keeps tiny blood vessels in the brain healthy. Greater rates of atrophy or brain shrinkage, which naturally occur with age, result from issues relating to the blood supply to the brain. Increasing that supply maintains the brain's integrity.

"There's the calorie burning from dancing that has an impact alone. But because it's a form of aerobic exercise, getting oxygen to the muscles, you have this increased supply of nutrients to the brain."

"This causes the brain to increase the production of a chemical called brain-derived neurotropic factor or BDNF."

"When you do aerobic exercise, your brain cells create more BDNF, which makes them healthier, and it also makes the neighbouring brain cells healthier."

"All exercise stimulates a process called neurogenesis, which is the birth of new brain cells. But if you stop running today, the benefits of that exercise decrease within just a few days."

"Yet when you build strength in your muscles, you not only give birth to new brain cells that day, but you have more and more neurogenesis even days later."

Joyce Shaffer, Psychologist, behavioural scientist, University of Washington

And there are other, alternate forms of exercising movement that occur in social settings. Dancing classes can act as one of the most beneficial forms of physical activity, according to behavioural scientist Joyce Shaffer. The BDNF increase has an essential role to play in maintaining healthy neurons, keeping the brain agile and capable of readily forming new connections; the essence of memory.

 

Back to school; learning a new skill (language) can benefit the brain. Harvard Health

And there are even more aids that have the potential in exercising the brain; another is through music performance, mastering the ability to play a musical instrument. The International Journal of Alzheimer's Disease nine years ago examined twins; one had learned to play a musical instrument, the other had not. They were followed throughout the course of their lives; the musician found to be 64 percent less likely to develop mild cognitive impairment of dementia.

Leading researchers to conclude that beginning to learn to play any kind of musical instrument in mid- or later-life was one of the most powerful tools in the maintenance of brain health. The reason: music stimulates our brain through a myriad of pathways.

"People think that sound is just relevant to your ears, but it's connected to emotions, memories, what we pay attention to, movement and even how we interact with our other senses."

"Music teaches you to make these connections between sound and meaning, and once you tune your brain that way, you carry this through the rest of your life."

Nina Kraus, professor, neuroscientist, amateur musician Northwestern University, U.S.

Finally, Dr. Shaffer discovered gym strength training to be one of the most powerful methods of preserving cognitive faculties ... more so even than other forms of exercise, such as swimming or running.

What Is Brain Health?

Brain health refers to how well a person’s brain functions across several areas. Aspects of brain health include:

• Cognitive health — how well you think, learn, and remember
• Motor function — how well you make and control movements, including balance
• Emotional function — how well you interpret and respond to emotions (both pleasant and unpleasant)
• Tactile function — how well you feel and respond to sensations of touch — including pressure, pain, and temperature

Brain health can be affected by age-related changes in the brain, injuries such as stroke or traumatic brain injury, mood disorders such as depression, substance use disorder or addiction, and diseases such as Alzheimer’s disease. While some factors affecting brain health cannot be changed, there are many lifestyle changes that might make a difference.

National Institute on Aging

Health Benefits of Strolling in Green Landscapes

"As little as five minutes of green exercise can be beneficial."

"You may experience greater mental health benefits if you are able to be active outside in a natural environment."

"But, since physical activity is extremely important for our physical and mental health no matter what you do or where you do it, just keep being active."

Claire Wicks, senior research assistant, University of Essex, Britain

Stroll in Bilberry Creek Ravine Forest, Ottawa

A short, leafy stroll improves working memory and concentration notably more than does taking an indoor walk, findings of a new, small study of the neurological effects of "green exercise"; physical activity conducted within a natural landscape. Katherine Boere, a neuroscience doctoral candidate who led the neurological study of green exercise, checked research showing that walking in an interior or out in nature generally increased blood flow, clearing people's minds.

She decided to undertake her own study which began when she and her colleagues gathered 30 college students, tested their working memory and capacity to focus and then choosing alternate days, had them walk for roughly 15 minutes both inside a building or alternately on leaf-canopied paths -- and then repeated the cognitive tests. The outside walk readily surpassed the health effects of the indoor walks. Resulting in better concentration, with students responding with greater alacrity achieving results according with scientific theories on how nature affects the human mind.

One widely held theory holds that the natural world encourages people to relax, diminishing the force of internal ruminations on pressing concerns, allowing our busy brains to experience quiet periods. Nature's effect is what scientists name "soft fascination", explained Ms.Boere, holding our attention and not demanding constant intellectual processing. The overtaxed focus can relax, reset and moving past the event -- people are able to concentrate and reason more readily.

There is, of course, the anticipated physiological effects that walking has on thinking; the augmented flow of blood and oxygen to the brain. That study Ms.Boere was involved with, was titled by herself and her co-authors: Exercising is good for the brain but exercising outside is potentially better.

Other research shows that the effects can extend beyond brief improvements in concentration, to an increase in motivation -- and in the process exercise feels less burdensome. A study published a year ago out of China saw young, inactive people with obesity begin walking in a park or gym on alternate days, reporting feeling considerably less stressed, enjoying exercise more than when they walked for exercise in interiors.

In a previous study of older men and women who wore activity trackers for a week, those who walked outside voluntarily exercised roughly 30 minutes more during the week than those who walked inside. Exercise that is strenuous can feel far easier to perform and more enjoyable within green surroundings -- a landscape can make an important difference.

Researchers found that exercising in urbanized outdoor settings -- commercial districts, downtown areas, and other cityscapes with few trees and other natural elements -- tended to be less beneficial for people's mental health than similar exercise undertaken in greener, natural environments such as community parks and urban forests. Even the unforgiving pavements can cause physical stress to feet, quite unlike walking in a green space or on a forest floor.

In a review of past research published in 2022, people reported feeling tranquil following a walk or gentle jogging for about 15 minutes through parks or similar landscapes, but less so when the exercise lasted for 40 minutes or longer, or was felt to be physically exhausting. A six-kilometre run in a park helped to calm women in one study cited by the review; doubling that distance to about 14 km turned out to be less satisfying.

Hike on Lovequist Trail, Rocky Gorge, New Hampshire

 

The Perspectives of Science and Common Sense

"Calories don't take into account the energy it takes our cells to metabolize food in order to use it. A calorie of protein makes you feel fuller than a calorie of fat, because protein is more complex to metabolize."

"You could be aiming to eat 2,000 calories a day, but how much energy your body actually absorbs will depend on whether you're eating sugar, celery or steak."

Giles Yeo, professor of molecular neuroendocrinology, University of Cambridge

 

It's all explained in Dr. Yeo's book: 'Why Calories Don't Count', which lays out the explanations of how and why it is biologically that the human body absorbs very differently calories present in various types of foods. Leading dietary experts to question the relevance of the fixation of calories in the human diet since not all calories are equal.

 

Yet people focus on the simplest of formulae, depending on the recommended daily intake of calories popularly acknowledged at 2,000 calories daily for women and 2,500 for men.We fail to consider the realities of our individualized needs that are dependent on some relevant specifics such as age, gender, height, weight and the level of our physical activity. For some there is a need to reduce, or alternately increase caloric intake purposing to maintain a moderate weight. 

And what of the widely held belief that the most important meal of the day is one that breaks the long fast between the dinner of the night before and a good night's sleep, a longer period of time between meals than any that take place during the day. There are those that call into question just how important breakfast is to the human body, but the human brain is also highly dependent on an infusion of energy to function after that long fast.

 

High Fibre Cereals

 

There are those who trace our belief in the importance of a good start to the day dependent on breakfast. In the 1920s marketing campaigns launched by cereal companies placed an emphasis on the importance of breakfast, as a marketing gambit. That, however, does not diminish the importance of breakfast in preparing the body and the mind for the coming day. More important is the observation that it is the quality of the food taken at breakfast that reflects its nutritional importance.

As for the public clasping as gospel that eight glasses of water or two litres daily represents a standard irrigation necessity, that too comes under question. Fluid requirements vary, depending on details such as the weather, climate, age, and energy expended. Those who work in hot weather may require far more water. "A lot of your water comes from the food you eat", notes Dale Schoeller, emeritus professor of nutritional sciences at University of Wisconsin-Madison. He avers that science has never supported the two-litres-a-day rule as an appropriate guideline.

 

Getty

 

Then there's the standard prescription of having eight hours of sleep nightly. During the Industrial Revolution a daily regimen was established of eight hours of labour, eight hours devoted to recreation and the third eight hour block set aside for rest. How much sleep is required for anyone is  highly individualized, dictated b a complex number of issues; genetics, age, medical condition and lifestyle. While some individuals function well on fewer than six hours, others require over ten hours of sleep.

"I think that the myth of the eight hours has actually caused quite a bit of anxiety", points out Russell Foster, professor of circadian neuroscience, University of Oxford, who compares individual sleep patterns to shoe size; fitted to the individual foot shape and size.

Healthline

Consider the advice from public health on dietary fibre, plant-based carbohydrates found in fruit, vegetables, cereals, nuts and seeds. In the late 1980s, the U.K. government encouraged people to consume more dietary fibre and they put the daily figure at five, daily. Whereas studies indicate that five a day is not likely to be a sufficient amount to render full protection against various chronic illnesses. Imperial College London produced a study finding at least seven or ten whole foods; fruits, vegetables or nuts/seeds would be required to provide the nutrients and fibre needed for optimum health.

 

 

"When the dietary recommendations were originally set, it was designed as the optimal to prevent weight gain in the first place. But now we're in a situation where two thirds of the population are already overweight", noted Charlotte Evans, researcher in nutrition and public health at University of Leeds who recommends that people make fibre the majority of their daily diet intake.

 

Then there is the thorny matter of exercise and the popular health mantra of ten thousand steps a day, adopted by the World Health Organization, the American Heart Association and many other health groups. Ten thousand steps a day is a purely arbitrary figure that originated in a Japanese boardroom in the 1950s when the company Yamasa thought up the figure to promote the world's first step counter prior to theTokyo 1964 Olympics.

 

In fact, research actually recommends between 6,000 and 8,000 steps daily could be more accurate to avoid chronic illness. Scientists at the University of Alabama at Birmingham School of Public Health found if you live a fairly sedentary life, simply adding an extra 500 steps a day would yield significant health benefits.

"People obsess over how many steps are enough, but we should be asking how many steps are too few."

"We should get people to stop taking less than 5,000 steps a day, but there seems to be an obsession with the higher number, while it's more important from a public health point of view to just get people off the couch and out the door." 

Catrine Tudor-Locke, professor and physical activity researcher University of North Carolina, Charlotte

More Sleep, Less Exercise in Retirement

"Transition to retirement is shown to affect sleep, sedentary time and physical activity, but no previous studies have examined how retirement changes the distribution of time spent daily in these movement behaviours."

"Manual workers' daytime hours were more sedentary after retirement compared to work-days before retirement."

"Thus, physical activity at work may have been partly replaced with sedentary activities like watching TV after retirement."

"Non-manual workers seemed to replace some sedentary time with sleep, which may benefit health for those with inadequate sleep before retirement."

Finnish researchers, International Journal of Behavioral Nutrition and Physical Activity

NCO

 

Some insight has been gathered into trends in activity in older adults with studies monitoring lifestyle habits of recent retires. It is well enough known that a sedentary lifestyle helps to degrade health in the long term, particularly as people age. As well known is that physical activity on a regular basis can have the effect of delaying some physical and mental decline in conjunction with aging. As well as boosting health, mood, energy levels and social engagement.

A new finding, linking work-occupation with physical activity behaviours in retirement is quite interesting. Where people engaged in manual labour employment have a tendency to become, on retirement, more sedentary while those whose workplace tended to be an office environment, become more active during the retirement years. Researchers of the newly published study in the International Journal of Behavioral Nutrition and Physical Activity evaluated lifestyle habits of 551 public-sector employees.

The study participants' average age was 63. With the use of a wrist-worn accelerometer, during the first year of retirement, subjects' movement habits were recorded 24 hours daily, for a week both before and following their last day at work, about a year apart. Data was then divided by occupation and gender. Nurses' aides, cooks, cleaners and maintenance workers were included as manual workers for the purpose of the study. While teachers, physicians, registered nurses and technicians were classified as non-manual workers.

 

The study recorded the proportion of time in a day spent on sleep, on light physical activity, on moderate-to-vigorous physical activity, and on sedentary activities; then tallied the results of the data collected by the accelerometers.

Women, who represented 86 percent of the study subjects were spending eight hours nightly before retirement, 11 hours in sedentary pursuits, four hours performing light physical activity and 50 minutes in moderate-to-vigorous activity on a daily basis. Men, on the other hand, logged 16 minutes less sleep, 60 minutes of more sedentary time, and 46 minutes of less light activity than women. Both, on the other hand, logged a similar number of minutes on moderate-to-vigorous daily activity.

Manual workers logged less sedentary time and more physical activity than desk-bound counterparts before retirement in a pattern reflecting both men and women. The first year of retirement saw this group in reversal. Non-manual workers' lifestyle habits took a different turn, where sleep improved and time being sedentary diminished, while an increase in physical activity was seen, attributable to fewer hours spend behind a desk.

The greatest change in post-retirement daily lifestyle habits was seen in women with manual occupation backgrounds, who slept 45 minutes longer and spent 64 fewer minutes in light physical activity and 17 minutes less in moderate-to-vigorous activity; seeing sedentary time increase by 36 minutes. Retired from manual occupations, men experienced a lesser increase in sleep and sedentary activities in opposition to physical activity. 

Both types of workers saw a decrease in moderate-to-vigorous activity up to 17 inutes daily. Interpreted by the researchers in relation to a change in commuting habits; no bus or train to catch and no clock to punch -- seeing retirees sleep a bit longer, enjoying a slower and less active start to their days. The gathered data indicated for a large subset of the population, retirement results in a more sedentary lifestyle with a larger drop in moderate-to-vigorous activity than in light activity, both of which changes could result in negative consequences on health.

For Optimum Health: Balance Good Diet With Habitual Exercise

"We hypothesize that physical activity and diet quality are independently associated with lower mortality risk, and that high levels of physical activity, either in total moderate-to-vigorous physical activity or vigorous physical activity, cannot offset detrimental effects of poor-quality diet."

"Sensationalized headlines and misleading advertisements for exercise regimens to lure consumers into the idea of 'working out to eat whatever they want' have fuelled the circulation of the myth about 'exercise outrunning a bad diet'."

"Our study provided important evidence for health professionals that exercise does not fully compensate for a poor diet and that we should recommend and advocate for both an active lifestyle and a healthy diet."

"[The selection of target foods reflects recommendations from the American Heart Association] These food groups were selected as markers for overall diet quality because other important dietary components and/or nutrient groups, such as whole grains and dairy, were not measured during baseline assessment."

Research conclusion, BMG Sports Medicine

One of very few research projects taking on the pairing of exercise and diet slanted toward the conviction that vigorous exercise regimens are capable of reversing the effects of poor nutrition has reached the conclusion that whatever the type of exercise that is paired with a poor diet, in the final analysis makes little difference. While exercise is beneficial and its effects are credited with healthier outcomes, this is separate and apart from the issue of a diet low in nutritional quality and high in health-harmful substances.

An international team of scientific researchers out of Australia, the U.S., Italy and Norway made use of a large sample of British adults in research to determine what impact diet has on human health that could be counteracted by a good exercise regimen. The multinational research ream reviewed exercise and diets' independent impact and in turn their joint impact on all-cause mortality, cardiovascular disease and a number of cancers.

Self-reported health histories specific to diet and exercise habits of 346,627 study subjects between the ages of 40 and 69 were cross-referenced against data on local death records in the course of a decade. The purpose: to link cause of death to baseline health records gathered a decade earlier so that the impact of diet, exercise or a combination of both on mortality could be gauged. It was the very sparcity of such studies that motivated the study as well as curiosity whether vigorous exercise did in fact offer added protection against early death risk in comparison to more moderate exercise intensity.

Study subjects were fairly representative of most societies with 40.8 percent subscribing to no vigorous exercise weekly, 26.5 percent exercising fewer than 75 minutes of high-intensity workouts each week, and the remainder devoting over 75 minutes weekly to exercising vigorously. Concerning diet, 22 percent held a poor ranking, 53.4 percent a medium rating while 24.5 percent qualified as the healthiest in the diet category.

Separately reviewed, high levels of physical activity -- 211 to 450 minutes of moderate to vigorous weekly exercise along with a high-quality diet each was seen to have a positive influence on longevity. Study participants who excelled at both diet and exercise scored the lowest mortality risk. Leaving those who count on one healthy habit correcting the unhealthy one, extremely disappointed.

Slightly greater protection was provided with vigorous physical activity against cardiovascular disease as opposed to moderate-intensity exercise; only however, for those accumulating ten to 150 minutes of vigorous exercise a week. On the other hand, those who were credited with over 150 minutes a week failed to realize the same benefit boost. 

People with the healthiest diets saw a 14 percent lower risk of cancer mortality, representing a benefit that failed to extend to those with a low- or medium-quality diet. The research results give clarity to the reality that a love of exercise cannot mitigate the negative effects of a love of fast food.

"The study results are no surprise to me. Many people have come to see me in my private practice after suffering a heart attack when training for their fourth or fifth marathon, or right after doing a CrossFit exercise."

"When I do a comprehensive evaluation of their lifestyle, it is apparent that they thought their intense daily exercise regimen would make up for their poor, unbalanced diet, and it simply doesn’t." 

Michelle Routhenstein, cardiology dietitian

More Validation of Exercise Guarding Against Ill Health

"In our study, higher levels of physical activity and fewer hours of TV watching and sitting either at work or away from home were associated with lower OSA [obstructive sleep apnea] incidence after accounting for potential cofounders."

"Our results suggest that promoting an active lifestyle may have substantial benefits for both prevention and treatment of OSA."

"We found that physical activity and sedentary behaviour are independently associated with OSA risk. That is, for people who spend long hours sitting every day, increasing physical activity in their leisure time can equally lower OSA risk."

"Those who can lower sedentary time and increase physical activity would have the lowest risk."

Tianyi Huang, associate epidemiologist, Brigham and Women's Hospital, Harvard University

Man sleeping deeply on his left side without snoring w/breathing apparatus  Getty

A wide-scale study published in the European Respiratory Journal which studied some 130,000 men and women in the United States over an extended period of ten to 18 years, highlighting the potential health hazards of a sedentary life, concluded that moving about more and being less sedentary in one's habitual behaviour to be associated with a diminished likelihood of contracting obstructive sleep apnea.

An earlier study published in 2014 reached an estimate of 5.4 million Canadians having been either diagnosed with the condition of sleep apnea or being at high risk of the disorder, as the most common type of sleep apnea occurring in any population, most commonly caused when the upper airways are blocked, consequent of the soft tissue at the back of the throat collapsing and obstructing  the flow of oxygen to the lungs.

The upper airways passage can on occasion become compromised in people with larger-than-normal tongues, those with 'relaxed' throat muscles, or narrow airways. Generally obstructed airways result in the person affected snowing loudly, followed by choking or gasping for breath during sleep. Symptoms of OSA occurrences are manifested on the following day; when a morning headache persists, fatigue, irritability of mood changes, poor concentration, memory loss, or a lowered sex drive.

In the involvement of serious cases of OSA, the risk of heart issues can increase, including heart failure. Statistical modelling was used by the researchers to compare physical activity and sedentary hours and how they impact OSA diagnoses. Moderate and vigorous physical activity were seperately examined and both found to be tied to a lower risk of acquiring OSA; no difference of note discerned between the intensity of activity.

Women were seen to have the strongest correlation, as well as adults over the age of 65, and overweight individuals. The large sample size of the study and succeeding analysis of various levels of activity gave credibility to the findings the researcher felt, though the self-reported sedentary and physical activity narrative might conceivably not have reflected the most ideal method of data collection.

A step up from reliance on self-reporting would be the use of home sleep apnea tests along with non-invasive monitoring methods in confirmation of the findings. As well, the study focused on recreational physical activity. Sedentary behaviour characterized as being seated while viewing television or sitting outside the work situation. Irrespective of which the associations were sufficiently robust for researchers to encourage doctors to emphasize to their patients the importance of physical activity as an anti-OSA lifestyle tool.

 

The new study by investigators from Brigham and Women's Hospital examined the relationship between active lifestyles and the risk of obstructive sleep apnea (OSA).   (Unsplash)

Exercise Alongside Restraint in Food Intake Equal Weight Loss

"During moderate weight loss, for example, five percent of initial body weight, the associated loss of visceral adipose tissue has been estimated at 21 percent in response to exercise and 13 percent in response to diet." 

French researchers

A French research team in the interests of casting light on exercise as a weight-loss tool, set out to review and summarize findings of 149 high-quality studies assessing physical activity effects on weight loss, fat loss, visceral fat loss, body composition and weight maintenance. The studies included in the review focused on either aerobic training, resistance training or high intensity interval training (HIIT) and making a comparison between exercise to a non-exercise control group or the inclusion of another intervention type, such as diet.

The purpose was to report on their findings in relation to either weight loss, fat loss, lean mass (muscle) loss, or weight maintenance. The studies under review had been published between 2010 and 2019, including in their focus overweight or obese adults. The results indicated regardless of the type of training, exercisers experienced a 1.5 to 3.5 kilogram greater weight loss than non-exercisers. A recognizable trend toward greater weight loss of about one kilogram was recognized, when exercise and diet were combined as opposed to dieting alone.

In making a comparison between one type of exercise as opposed to another, aerobic exercise was seen to outperform resistance exercise in most of the studies; a kilogram more weight and fat were lost in each instance. In comparing HIIT to moderate intensity aerobic exercise, high intensity interval training, saw greater weight loss when energy expenditure between the two exercise forms was matched. Without matching energy expenditure moderate intensity exercise burned more weight, but not significantly more.

Decreasing belly fat located around internal organs responded to all forms of aerobic exercise and aerobic exercise in combination with resistance training, resulting in a useful reduction of visceral fat. Resistance exercise on its own failed to exert the same effect on reducing visceral fat. What was clarified is that visceral fat stores are amenable to significant reduction even when weight loss fails to occur; exercise beats diet alone in losing deep belly fat.

Weight training was flagged as superior in stimulating muscle growth and the maintenance of increase of lean body mass. Resistance exercises were acknowledged as the most successful at reducing the loss of lean body mass. No evidence was seen that more intensive exercise is superior to moderate levels of physical activity in keeping lost weight off. Results which fall in line with other recent studies suggesting the importance of exercise in weight maintenance. 

The results confirm the advice of experts recommending regular exercise while at the same time corroborating the caution against investing all weight-loss efforts into exercise alone. Any type of aerobic exercise outperforms resistance training or diet alone in weight loss; resistance training is superior at maintaining muscle mass. 

Overall health can be improved, alongside greater longevity with even judiciously modest amounts of weight loss, giving value to exercise beyond what a weight scale informs. In long-term weight loss, maximizing results rests in combining regular aerobic exercise with dietary amendments alongside sufficient sleep and stress management in one's daily routine.

COVID Therapy: Exercise

"We found that consistently meeting physical activity guidelines was strongly associated with reduced odds for severe COVID-19 among infected adults."

"Those who were consistently meeting physical activity guidelines [150 minutes or more of exercise per week] were less likely to be hospitalized, admitted to the ICU or die related to COVID-19 than those who were consistently inactive or doing some activity."

"It is notable that being consistently inactive was a stronger risk factor for severe COVID-19 outcomes than any of the underlying medical conditions and risk factors identified by the Centers for Disease Control and Prevention except for age and a history of organ transplant."

"In fact, physical inactivity was the strongest risk factor across all outcomes, compared with the commonly cited modifiable risk factors, including smoking, obesity, diabetes, hypertension, cardiovascular disease and cancer."

Research team, Kaiser Permanente Medical Center, California

Exercise doesn’t have to mean playing sport or going to the gym – dancing, brisk walking or mowing the lawn all count. alexei_tm/Shutterstock

A study newly published in the British Journal of Sports Medicine in April has equated regular exercise with the best-advice therapy for prevention of severe COVID-19 outcomes. Exercise is well known to boost immunity, with active individuals seen to be less prone to viral infections and inflammation. These are also the hallmarks of of COVID-19 infection. The study and its conclusion provides the first real proof linking exercise to a reduced risk of the SARS-CoV-2 virus's most serious effects.

The research team, led by Robert Sallis, co-director of Kaiser Permanente's Sports Medicine Fellowship, decided to fill the gap of scant data linking exercise to reduced COVID-19 consequences risk. Dr.Sallis and his team studied health records of 48,440 people who had tested positive for COVID-19 and who happened to be patients of a Southern California health-care system routinely collecting data on exercise habits. With that collected exercise data, the researchers set out to classify the physical activity level of each patient.

The researchers made three categories; 1) consistently meeting physical activity guidelines amounting to 150 minutes or more of weekly exercise; 2) consistently inactive equating to no exercise or up to ten minutes each week; 3) some level of activity amounting to 11 up to 149 minutes weekly. Proceeding to compare exercise volume against hospitalization, admission to intensive care unit, and death (and including age, race, gender and medical history of all patients) the researchers produced a novel picture of the impact of exercise on the severity of COVID-19 symptoms.

 

(Photo: Twenty20 | Galina Zhigalova)

 

The odds of hospitalization were seen to be increased 2.26 times for the group that were consistently inactive in comparison to those who exercised 150 minutes each week -- and for those who did some level of activity, the odds of requiring treatment though higher than the most active, was still less than those in the least active category, with chances of being hospitalized, 1.89 times greater than those most active, in the study.

 

Subjects consistently exercising represented only 6.4 percent of the study subjects, while those who exercised for ten minutes or less weekly represented 14.4 percent of the study subjects, leaving the balance of the subjects in the category of "some activity". The average age of those in the study was 47, and the average body mass index of the entire group came in at 31.2, the low end of the overweight category. 61.9 percent of the study subjects were female; 8.6 percent of the total were hospitalized, 2.4 percent admitted to the ICU, and 1.6 percent died of COVID.

During the pandemic, opportunities for organized or team exercise has been badly diminished as sport clubs, gyms and golf courses have been shut down under lockdowns sporadically. Some people just gave up on their lifestyle exercise habits, others found alternate methods of exercising to ensure they remained physically active. During the sporadic lockdowns the effect has been that fewer people are now either committed to, or taking steps to continue to protect their physical health through exercise. Studies have confirmed that fewer people are now achieving 150 minutes of weekly exercise.

 

"We recommend that public health authorities inform all populations that short of vaccination and following public health safety and mask use, engaging in regular physical activity may be the single most important action individuals can take to prevent severe COVID-19 and its complications, including death."

Research team, Kaiser Permanente Medical Center, California