Tag: physical activity

Twin Study Offers New Insights into Whether Exercise Extends life

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In a decades-long study following twins, researchers from the University of Jyväskylä, Finland, investigated the links between long-term leisure-time physical activity and mortality. They also sought to determine whether physical activity can mitigate the increased risk of mortality due to genetic predisposition to diseases. Moreover, they examined the relationship between physical activity and later biological aging. 

The study included 22 750 Finnish twins born before 1958 whose leisure-time physical activity was assessed in 1975, 1981 and 1990. Mortality follow-up continued until the end of 2020.

Moderate activity yields maximum longevity benefits

Four distinct sub-groups were identified from the data, which was based on leisure-time physical activity over the 15-year follow-up: sedentary, moderately active, active and highly active groups. When the differences in mortality between the groups were examined at the 30-year follow-up, it was found that the greatest benefit – a 7% lower risk of mortality – was achieved between the sedentary and moderately active groups. A higher level of physical activity brought no additional benefit. 

When mortality was examined separately in the short and long term, a clear association was found in the short-term: the higher the level of physical activity, the lower the mortality risk. In the long term, however, those who were highly active did not differ from those who were sedentary in terms of mortality.

“An underlying pre-disease state can limit physical activity and ultimately lead to death, not the lack of exercise itself.”

“This can bias the association between physical activity and mortality in the short term”,  says Associate Professor Elina Sillanpää from the Faculty of Sports and Health Sciences. 

Meeting physical activity guidelines does not guarantee a lower mortality risk

The researchers also investigated whether following the World Health Organization’s physical activity guidelines affects mortality and genetic disease risk. The guidelines suggest 150 to 300 minutes of moderate or 75 to 150 minutes of vigorous activity weekly. The study found that meeting these guidelines did not lower mortality risk or alter genetic disease risk. Even for twins who met the recommended levels of PA over a 15-year period, no statistically significant difference in mortality rates was found compared to their less active twin pair.

“The widely observed favorable association between physical activity and mortality are based on observational studies that are prone to bias from different sources.” 

“In our studies, we aimed to account for various sources of biases, and combined with the long follow-up period, we could not confirm that adhering to physical activity guidelines mitigates genetic cardiovascular disease risk or causally reduces mortality”, says postdoctoral researcher Laura Joensuu from the Faculty of Sports and Health Sciences.  

Link between physical activity and biological aging is U-shaped

For the subsample of twins, biological aging was determined from blood samples using epigenetic clocks. Epigenetic clocks allow a person’s biological aging rate to be estimated based on methyl groups that regulate gene expression and are linked to aging process. 

“We found that the association between leisure-time physical activity and biological aging was U-shaped: Biological aging was accelerated in those who exercised the least and the most,” says Sillanpää.

Other lifestyles, such as smoking and alcohol consumption, largely explained the favourable associations of physical activity with biological aging. 

Genetic data were available for 4897 twins. The genetic susceptibility of twins to coronary artery disease, as well as systolic and diastolic blood pressure was assessed using new polygenic risk scores, which sum the genome-wide susceptibility to morbidity. In addition, all-cause and cardiovascular mortality was followed in 180 identical twin pairs. The biological aging rate of 1153 twins was assessed from a blood sample.

Source: University of Jyväskylä

Moderate Exercise Keeps Appetite at Bay

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A recent study involving researchers at Murdoch University’s Health Futures Institute has revealed that moderate-intensity exercise can significantly influence appetite-related hormones and perceptions in males with obesity.

The study, titled “Acute effect of exercise on appetite-related factors in males with obesity,” provides new insights into how exercise can aid appetite control and weight management. 

One of the study authors, Associate Professor Timothy Fairchild from Murdoch’s School of Allied Health, said the study confirms their previous work showing the benefits of incorporating regular exercise into daily routines for individuals looking to manage their weight and improve their overall health. 

“People understand that exercise helps ‘burn energy’. A lot of people assume that exercise also increases hunger and energy intake afterwards,” Associate Professor Timothy Fairchild said.  

“We have previously shown, using high-intensity exercise, that this is not the case. 

“This latest study shows that even moderate-intensity exercise can have immediate and beneficial effects on appetite control in males with obesity.” 

The study not only assessed food intake and appetite, but also measured changes in hormones which help to regulate appetite.  

“Despite a strong focus on weight loss drugs in society at present, this study shows that lifestyle factors still have a strong and relevant role in helping people to live their healthiest life,” Associate Professor Fairchild said. 

“In fact, the hormones which have been shown to increase after exercise, are the same hormones which the most successful weight loss drugs are mimicking.”  

“The added benefit of exercise is that you also receive the additional physical and mental health benefits of exercise”.  

The full study can be found in Physiological Reports journal.  

Source: Murdoch University

Bursts of Activity could Cut Heart Risk in Women

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An average of four minutes of incidental vigorous physical activity a day could almost halve the risk of major cardiovascular events, such as heart attacks, for middle-aged women who do not engage in structured exercise, according to new research from the University of Sydney, published in the British Journal of Sports Medicine.

“We found that a minimum of 1.5 minutes to an average of 4 minutes of daily vigorous physical activity, completed in short bursts lasting up to 1 minute, were associated with improved cardiovascular health outcomes in middle-aged women who do no structured exercise,” said lead author Professor Emmanuel Stamatakis, Director of the Mackenzie Wearable Hub at the Charles Perkins Centre and the Faculty of Medicine and Health.

High-intensity physical activity that forms part of a daily routine is known as “vigorous intermittent lifestyle physical activity” (VILPA). Physical activity is incidental such as walking to the shops, vs exercise, which is structured, eg going to the gym. Longer sessions of VILPA are linked to significantly lower cardiovascular disease risk.

The researchers say that, given fewer than 20% of middle-aged or older adults engage in regular structured exercise, engaging in VILPA could be a good alternative.

“Making short bursts of vigorous physical activity a lifestyle habit could be a promising option for women who are not keen on structured exercise or are unable to do it for any reason. As a starting point, it could be as simple as incorporating throughout the day a few minutes of activities like stair climbing, carrying shopping, uphill walking, playing tag with a child or pet, or either uphill or power walking,” said Professor Stamatakis.

The study drew on UK Biobank data from 22 368 participants (13 018 women) aged 40–79 who reported they did not engage in regular structured exercise and who wore physical activity trackers for almost 24 hours a day for 7 days.

Cardiovascular health was monitored through hospital and mortality records, tracking major adverse cardiovascular events (MACE), such as heart attack, stroke, and heart failure, until November 2022.

After adjusting for factors such as lifestyle, socioeconomic position, cardiovascular health, co-existing conditions, and ethnicity, the researchers found that the more VILPA women did, the lower their risk of a major cardiovascular event.

Women who averaged 3.4 minutes of VILPA daily were 45 percent less likely to experience a major cardiovascular event. They were also 51% less likely to have a heart attack and 67 percent less likely to develop heart failure than women who did no VILPA.

Even when amounts of daily VILPA were lower than 3.4 minutes they were still linked to lower cardiovascular event risk. A minimum of 1.2 to 1.6 minutes of VILPA per day was associated with a 30 percent lower risk of total major cardiovascular events, a 33 percent lower risk of heart attack, and a 40 percent lower risk of heart failure.

However, men reaped fewer benefits from tiny bursts of VILPA. Those who averaged 5.6 minutes daily were only 16% less likely to experience a major cardiovascular event compared with men who did none. A minimum of 2.3 minutes per day was associated with only an 11% risk reduction.

Professor Stamatakis said more testing was needed to understand how VILPA may improve cardiovascular health.

“To date, it hasn’t been clear whether short bursts of VILPA lower the risk of specific types of cardiovascular events, like heart attack or stroke. We aimed to identify minimum daily thresholds and feasible amounts for testing in community programs and future trials,” he said.

“Importantly, the beneficial associations we observed were in women who committed to short bursts of VILPA almost daily. This highlights the importance of habit formation, which is not always easy. VILPA should not be seen as a quick fix – there are no magic bullets for health. But our results show that even a little bit higher intensity activity can help and might be just the thing to help people develop a regular physical activity – or even exercise – habit,” he said.

For the purposes of this story, physical activity is incidental, eg carrying shopping or briefly power walking, and exercise is structured, eg going to the gym or playing sport.

Source: University of Sydney

Many Could Easily Add Five Years to Their Lifespan

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If everyone was as active as the top 25% of the population, individuals over the age of 40 could add five years to their life, according to a new study led by Griffith University researchers. 

Physical activity has long been known to be good for health, however estimates have varied regarding how much benefit could be gained from a defined amount of activity, both for individuals and for populations. 

This latest study, published in the British Journal of Sports Medicine, used US-based accelerometer data to gain an accurate view of a population’s physical activity levels instead of relying on survey responses as per other studies, and found the benefits were around twice as strong as previous estimates.  

It found the most active quarter of people in the community had a 73% lower risk of death than their least active counterparts. For that least active quartile, a single one-hour walk could potentially return a benefit of around six additional hours of life.  

Lead researcher Professor Lennert Veerman said this cohort had the greatest potential for health gains.  

“If you’re already very active or in that top quartile, an extra hour’s walk may not make much difference as you’ve, in a sense, already ‘maxed out’ your benefit,” he said.   

“If the least active quartile of the population over age 40 were to increase their activity level to that of the most active quartile however, they might live, on average, about 11 years longer.

“This is not an unreasonable prospect, as 25 per cent of the population is already doing it.  It can be any type of exercise but would roughly be the equivalent of just under three hours of walking per day.” 

The research team suggested low levels of physical activity could even rival the negative effects of smoking, with other research finding each cigarette could take 11 minutes from a smoker’s life.  

By extension, a more active lifestyle could also offer protective effects against heart disease, stroke, certain cancers and other chronic illnesses, with the study’s findings highlighting a need for national physical activity guidelines to be revisited using these methods.  

Dr Veerman said physical activity had been vastly underestimated in its capacity to improve health outcomes, suggesting even modest increases in movement could lead to significant life-extension benefits.  

“If there’s something you could do to more than halve your risk of death, physical activity is enormously powerful,” he said.  

“If we could increase investment in promoting physical activity and creating living environments that promote it such as walkable or cyclable neighbourhoods and convenient, affordable public transport systems, we could not only increase longevity but also reduce pressure on our health systems and the environment.”  

Source: Griffith University

Workouts – or Disturbed Sleep – Impact Brain Activity Weeks Later

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In a rare, longitudinal study, researchers from Aalto University and the University of Oulu tracked one person’s brain and behavioural activity for five months using brain scans and data from wearable devices and smartphones. The results appear in PLOS Biology.

“We wanted to go beyond isolated events,” says research leader (and study participant) Ana Triana. “Our behaviour and mental states are constantly shaped by our environment and experiences. Yet, we know little about the response of brain functional connectivity to environmental, physiological, and behavioural changes on different timescales, from days to months.”

The study found that the brain does not respond to daily life in immediate, isolated bursts. Instead, brain activity evolves in response to sleep patterns, physical activity, mood, and respiration rate over many days. This suggests that even a workout or a restless night from last week could still affect the brain – and therefore attention, cognition and memory – well into next week.

The research also revealed a strong link between heart rate variability – a measure of the heart’s adaptability – and brain connectivity, particularly during rest. This suggests that impacts on the body’s relaxation response, like stress management techniques, could shape brain wiring even when not actively concentrating on a task. Physical activity was also found to positively influence the way brain regions interact, potentially impacting memory and cognitive flexibility. Even subtle shifts in mood and heart rate left lasting imprints for up to 15 days.

Study goes beyond a snapshot

The research is unusual in that few brain studies involve detailed monitoring over days and weeks. “The use of wearable technology was crucial,” says Triana. “Brain scans are useful tools, but a snapshot of someone lying still for half an hour can only show so much. Our brains do not work in isolation.”

Triana was herself the subject of the research, monitored as she went about her daily life. Her unique role as both lead author and study participant added complexity, but also brought firsthand insights into how best to maintain research integrity over several months of personalised data collection.  Data from the devices and twice-weekly brain scans were complemented by qualitative data from mood surveys. 

The researchers identified two distinct response patterns: a short-term wave lasting under seven days and a long-term wave up to 15 days. The former reflects rapid adaptations, like how focus is impacted by poor sleep, but it recovers quickly. The long wave suggests more gradual, lasting effects, particularly in areas tied to attention and memory. 

Single-subject studies offer opportunities for improving mental health care 

The researchers hope their innovative approach will inspire future studies that combine brain data with everyday life to help personalise mental health treatment. 

“We must bring data from daily life into the lab to see the full picture of how our habits shape the brain, but surveys can be tiring and inaccurate,” says study co-author, neuroscientist and physician Dr Nick Hayward. “Combining concurrent physiology with repeated brain scans in one person is crucial. Our approach gives context to neuroscience and delivers very fine detail to our understanding of the brain.”

The study is also a proof-of-concept for patient research. Tracking brain changes in real time could help detect neurological disorders early, especially mental health conditions where subtle signs might be missed.

“Linking brain activity with physiological and environmental data could revolutionise personalised healthcare, opening doors for earlier interventions and better outcomes,” says Triana.

Source: Aalto University

Among Cancer Survivors, Physical Activity is Linked to Reduced Pain

Study shows that higher levels of physical activity are linked with less pain, and to a similar extent in adults with and without a history of cancer.

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People who have had cancer often experience ongoing pain, but a new study reveals that being physically active may help lessen its intensity. The study is published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

Although physical activity has been shown to lessen various types of pain, its effects on cancer-related pain are unclear. To investigate, a team led by senior author Erika Rees-Punia, PhD, MPH, of the American Cancer Society, and first author Christopher T.V. Swain, PhD, of the University of Melbourne, in Australia, analysed information pertaining to 51 439 adults without a history of cancer and 10,651 adults with a past cancer diagnosis. Participants were asked, “How would you rate your pain on average,” with responses ranging from 0 (no pain) to 10 (worst pain imaginable). Participants were also asked about their usual physical activity.

US guidelines recommend 150 minutes (2 hours 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour 15 minutes) to 150 minutes (2 hours 30 minutes) a week of vigorous-intensity aerobic physical activity.

Based on participants’ responses, the investigators found that, for individuals who had cancer in the past as well as for those without a history of cancer, more physical activity was linked with lower pain intensity. The extent of the association was similar for both groups of individuals, indicating that exercise may reduce cancer-related pain just as it does for other types of pain that have been studied in the past.

Among participants with a past cancer diagnosis, those exceeding physical activity guidelines were 16% less likely to report moderate-to-severe pain compared to those who failed to meet physical activity guidelines. Also, compared with people who remained inactive, those who were consistently active or became active in older adulthood reported less pain.

“It may feel counterintuitive to some, but physical activity is an effective, non-pharmacologic option for reducing many types of pain. As our study suggests, this may include pain associated with cancer and its treatments,” said Dr Rees-Punia. 

Source: Wiley

Anything is Better than Sitting for Cardiovascular Health – Including Sleeping

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Replacing sitting with as little as a few minutes of daily moderate exercise measurably improves heart health, according to new research from the University of Sydney and UCL.

The study, published in the European Heart Journal, is the first to assess how different movement patterns throughout the 24-hour day are linked to cardiovascular health. Although it was an observational study and could not attribute causation, it added to the growing body of evidence surrounding inactivity, especially sitting.

It is the first evidence to emerge from the international Prospective Physical Activity, Sitting and Sleep (ProPASS) consortium.

In this British Heart Foundation (BHF)-supported study, researchers at UCL analysed data from six studies, including 15 246 people from five countries, to see how movement behaviour across the day is associated with heart health, as measured by six common indicators. Each participant used a wearable device on their thigh to measure their activity throughout the 24-hour day and had their heart health measured.

The researchers identified a hierarchy of behaviours that make up a typical 24-hour day, with time spent doing moderate-vigorous activity providing the most benefit to heart health, followed by light activity, standing and sleeping compared with the adverse impact of sedentary behaviour.

The team modelled what would happen if an individual changed various amounts of one behaviour for another each day for a week, in order to estimate the effect on heart health for each scenario. When replacing sedentary behaviour, as little as five minutes of moderate-vigorous activity had a noticeable effect on heart health.

For a 54-year-old woman with an average BMI of 26.5, for example, a 30-minute change translated into a decrease in BMI of 0.64 (2.4%) Replacing 30 minutes of daily sitting or lying time with moderate or vigorous exercise could also translate into a 2.5cm (2.7%) decrease in waist circumference or a 1.33 mmol/mol (3.6%) decrease in HBa1c.

Dr Jo Blodgett, first author of the study from UCL Surgery & Interventional Science and the Institute of Sport, Exercise & Health, said: “The big takeaway from our research is that while small changes to how you move can have a positive effect on heart health, intensity of movement matters. The most beneficial change we observed was replacing sitting with moderate to vigorous activity – which could be a run, a brisk walk, or stair climbing – basically any activity that raises your heart rate and makes you breathe faster, even for a minute or two.”

The researchers pointed out that although time spent doing vigorous activity was the quickest way to improve heart health, there are ways to benefit for people of all abilities – it’s just that the lower the intensity of the activity, the longer the time is required to start having a tangible benefit. Using a standing desk for a few hours a day instead of a sitting desk, for example, is a change over a relatively large amount of time but is also one that could be integrated into a working routine fairly easily as it does not require any time commitment.

Those who are least active were also found to gain the greatest benefit from changing from sedentary behaviours to more active ones.

Professor Emmanuel Stamatakis, joint senior author of the study from the Charles Perkins Centre and Faculty of Medicine and Health at the University of Sydney, said: “A key novelty of the ProPASS consortium is the use of wearable devices that better differentiate between types of physical activity and posture, allowing us to estimate the health effects of even subtle variations with greater precision.”

Though the findings cannot infer causality between movement behaviours and cardiovascular outcomes, they contribute to a growing body of evidence linking moderate to vigorous physical activity over 24 hours with improved body fat metrics. Further long-term studies will be crucial to better understanding the associations between movement and cardiovascular outcomes.

Professor Mark Hamer, joint senior author of the study from UCL Surgery & Interventional Science and the Institute of Sport, Exercise & Health, said: “Though it may come as no surprise that becoming more active is beneficial for heart health, what’s new in this study is considering a range of behaviours across the whole 24-hour day. This approach will allow us to ultimately provide personalised recommendations to get people more active in ways that are appropriate for them.”

James Leiper, Associate Medical Director at the British Heart Foundation, said: “We already know that exercise can have real benefits for your cardiovascular health and this encouraging research shows that small adjustments to your daily routine could lower your chances of having a heart attack or stroke. This study shows that replacing even a few minutes of sitting with a few minutes of moderate activity can improve your BMI, cholesterol, waist size, and have many more physical benefits.

“Getting active isn’t always easy, and it’s important to make changes that you can stick to in the long-term and that you enjoy – anything that gets your heart rate up can help. Incorporating ‘activity snacks’ such as walking while taking phone calls, or setting an alarm to get up and do some star jumps every hour is a great way to start building activity into your day, to get you in the habit of living a healthy, active lifestyle.”

Source: University of Sydney

Mediterranean Lifestyle Linked to Lower Risk of All-cause and Cancer Mortality

in Mayo Clinic Proceedings.

People who adhere to a Mediterranean lifestyle, which involves a plant-rich diet, adequate rest, physical activity and socialisation, have a lower risk of all-cause and cancer mortality, according to a new study in Mayo Clinic Proceedings. People who adhered to the lifestyle’s emphasis on rest, exercise, and socialising with friends had a lower risk of cardiovascular disease mortality.

While many studies have established the health benefits of a Mediterranean diet and lifestyle, there are few studies on the diet outside of its region of origin. “This study suggests that it’s possible for non-Mediterranean populations to adopt the Mediterranean diet using locally available products and to adopt the overall Mediterranean lifestyle within their own cultural contexts,” said lead author Mercedes Sotos Prieto, Ramon y Cajal research fellow at La Universidad Autónoma de Madrid and adjunct assistant professor of environmental health at Harvard Chan School. “We’re seeing the transferability of the lifestyle and its positive effects on health.”

Led by La Universidad Autónoma de Madrid and Harvard T.H. Chan School of Public Health, the study analysed the habits of 110,799 members of the UK Biobank cohort, a population-based study across England, Wales, and Scotland using the Mediterranean Lifestyle (MEDLIFE) index, which is derived from a lifestyle questionnaire and diet assessments. Participants, who were between the ages of 40 and 75, provided information about their lifestyle according to the three categories the index measures: “Mediterranean food consumption” (intake of foods part of the Mediterranean diet such as fruits and whole grains); “Mediterranean dietary habits” (adherence to habits and practices around meals, including limiting salt and drinking healthy beverages); and “physical activity, rest, and social habits and conviviality” (adherence to lifestyle habits including taking regular naps, exercising, and spending time with friends). Each item within the three categories was then scored, with higher total scores indicating higher adherence to the Mediterranean lifestyle.

The researchers followed up nine years later to examine participants’ health outcomes. Among the study population, 4247 died from all causes; 2401 from cancer; and 731 from cardiovascular disease. Analysing these results alongside MEDLIFE scores, the researchers observed an inverse association between adherence to the Mediterranean lifestyle and risk of mortality. Participants with higher MEDLIFE scores were found to have a 29% lower risk of all-cause mortality and a 28% lower risk of cancer mortality compared to those with lower MEDLIFE scores. Adherence to each MEDLIFE category independently was associated with lower all-cause and cancer mortality risk. The “physical activity, rest, and social habits and conviviality” category was most strongly associated with these lowered risks, and additionally was associated with a lower risk of cardiovascular disease mortality.

Source: Harvard T.H. Chan School of Public Health

Physical Activity may Reduce Bleed Volume of Intracerebral Haemorrhages

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Regular physical activity and exercise may reduce bleeding in individuals with intracerebral haemorrhage, a University of Gothenburg study shows. The study, published in the journal Stroke and Vascular Neurology, analysed data on 686 people treated for intracerebral haemorrhage at Sahlgrenska University Hospital in Gothenburg during the years 2014 to 2019.

The study was a retrospective analysis and could not determine causation. Nonetheless, it was clear that those who reported regular physical activity had smaller haemorrhages than those who reported being inactive.

Physically active was defined as engaging in at least light physical activity, such as walking, cycling, swimming, gardening, or dancing, for at least four hours weekly.

50 percent less bleeding volume

The main author of the study is Adam Viktorisson, a PhD student in clinical neuroscience at Sahlgrenska Academy, University of Gothenburg, and doctor in general practice at Sahlgrenska University Hospital.

“We found that individuals who engage in regular physical activity had, on average, bleeding volumes that were 50 percent smaller upon arriving to the hospital. A similar connection has previously been seen in animal studies, but no prior study has demonstrated this in humans.”

Everyone who comes to the hospital with a suspected intracerebral haemorrhage undergoes a computerized tomography (CT) scan of the brain. Depending on the severity of the haemorrhage, neurosurgery may be required. However, in most cases, non-surgical methods and medications are used to manage symptoms and promote patient recovery.

Intracerebral haemorrhage is the most dangerous type of stroke and can lead to life-threatening conditions. The risk of severe consequences from the haemorrhage increases with the extent of the bleeding.

“In cases of major intracerebral haemorrhages, there is a risk of increased pressure within the skull that can potentially lead to fatal outcomes” says Thomas Skoglund, associate professor of neurosurgery at the University of Gothenburg, neurosurgeon at the University Hospital, and one of the study’s co-authors.

Better understanding of intracerebral hemorrhages

The findings were significant regardless of the location within the cerebrum. Physically active individuals exhibited reduced bleeding in both the deep regions of the brain, which are often associated with high blood pressure, and the surface regions, which are linked to age-related conditions like dementia.

The study creates scope for further research on intracerebral haemorrhages and physical activity. Katharina Stibrant Sunnerhagen, professor of rehabilitation medicine at the University of Gothenburg and senior consultant physician at Sahlgrenska University Hospital, oversees the study.

“We hope that our findings contribute to a deeper understanding of intracerebral haemorrhages and aid in the development of more effective preventive measures” she concludes.

Source: University of Gothenburg

Study Finds Healthy Diet is Independently Linked to Fitness

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A healthy diet is associated with greater physical fitness in middle-aged adults, according to research published in the European Journal of Preventive Cardiology.

“This study provides some of the strongest and most rigorous data thus far to support the connection that better diets may lead to higher fitness,” said study author Dr Michael Mi of Beth Israel Deaconess Medical Center. “The improvement in fitness we observed in participants with better diets was similar to the effect of taking 4000 more steps each day.”

Cardiorespiratory fitness reflects the body’s ability to provide and use oxygen for exercise, and it integrates the health of multiple organ systems, such as the heart, lungs, blood vessels and muscles. It is one of the most powerful predictors of longevity and health. While exercise increases cardiorespiratory fitness, it is also the case that among people who exercise the same amount, there are differences in fitness, suggesting that additional factors contribute. A nutritious diet is associated with numerous health benefits, but it has been unclear whether it is also related to fitness.

This study examined whether a healthy diet is associated with physical fitness in community-dwelling adults. The study included 2380 individuals in the Framingham Heart Study. The average age was 54 years and 54% were women. Participants underwent a maximum effort cardiopulmonary exercise test on a cycle ergometer to measure peak VO2. This is the gold standard assessment of fitness and indicates the amount of oxygen used during the highest possible intensity exercise.

Participants also completed the Harvard semi-quantitative food frequency questionnaire to assess intake of 126 dietary items during the last year ranging from never or less than once per month to six or more servings per day. The information was used to rate diet quality using the Alternative Healthy Eating Index (AHEI; 0 to 110) and Mediterranean-style Diet Score (MDS; 0 to 25), which are both associated with heart health. Higher scores indicated a better quality diet emphasising vegetables, fruits, whole grains, nuts, legumes, fish and healthy fats and limiting red meat and alcohol.

The researchers evaluated the association between diet quality and fitness after controlling for other factors that could influence the relationship, including age, sex, total daily energy intake, body mass index, smoking status, cholesterol levels, blood pressure, diabetes and routine physical activity level. The average AHEI and MDS were 66.7 and 12.4, respectively. Compared with the average score, an increase of 13 points on the AHEI and 4.7 on the MDS was associated with a 5.2% and 4.5% greater peak VO2, respectively.

Dr Mi said: “In middle-aged adults, healthy dietary patterns were strongly and favourably associated with fitness even after taking habitual activity levels into account. The relationship was similar in women and men, and more pronounced in those under 54 years of age compared to older adults.”

To discover the potential mechanism linking diet and fitness, the researchers performed further analyses. They examined the relationship between diet quality, fitness and metabolites, which are substances produced during digestion and released into the blood during exercise. Researchers measured 201 metabolites (eg amino acids) in blood samples collected in a subset of 1154 study participants. Some 24 metabolites were associated with either poor diet and fitness, or with favourable diet and fitness, after adjusting for the same factors considered in the previous analyses. Dr Mi said: “Our metabolite data suggest that eating healthily is associated with better metabolic health, which could be one possible way that it leads to improved fitness and ability to exercise.”

“This was an observational study and we cannot conclude that eating well causes better fitness, or exclude the possibility of a reverse relationship, i.e. that fit individuals choose to eat healthily.”

Dr Mi concluded: “There are already many compelling health reasons to consume a high-quality diet, and we provide yet another one with its association with fitness. A Mediterranean-style diet with fresh, whole foods and minimal processed foods, red meat and alcohol is a great place to start.”

Source: European Society of Cardiology