Tag: running

Categories : Exercise NeurologyTags : Leave a comment

Myelin Becomes a Nutrient of Last Resort for the Brain

On By ModernMedia
Myelin sheath damage. Credit: Scientific Animations CC4.0

According to a study published by Nature Metabolism, marathon runners experience reversible changes in their brain myelin. These findings indicate that myelin exhibits previously unknown behaviour, which contributes towards the brain’s energy metabolism when other sources of energy are running low. Understanding how myelin in the runners recovers quickly may provide clues for developing treatments for demyelinating diseases such as multiple sclerosis.

Exercise for a long period of time forces the human body to resort to its energy reserves. When running a marathon, for example, the body mainly consumes carbohydrates, such as glycogen, as a source of energy, but it resorts to fats when the glycogen in the muscles is used up. Myelin, which surrounds neurons in the brain and acts as an electrical insulator, mainly comprises lipids, and previous research in rodents suggests that these lipids can act as an energy reserve in extreme metabolic conditions.

A study conducted by researchers from the UPV/EHU, CIC biomaGUNE and IIS Biobizkaia shows that people who run a marathon experience a decrease in the amount of myelin in certain regions of the brain. According to the study, this effect is completely reversed two months after the marathon.

Carlos Matute, Professor of Anatomy and Human Embriology at the UPV/EHU and a researcher at IIS Biobizkaia, and Pedro Ramos-Cabrer, Ikerbasque Research Professor at CIC biomaGUNE, together with Alberto Cabrera-Zubizarreta, radiologist at HT Médica, used magnetic resonance imaging to obtain images of the brains of ten marathon runners (eight men and two women) before and 48 hours after the 42-kilometre race. Likewise, the researchers took images of the brains of two of the runners two weeks after the race, and of six runners two months after the race as a follow-up.

By measuring the fraction of myelin water in the brain – an indirect indicator of the amount of myelin – the authors discovered “a reduction in the myelin content in 12 areas of white matter in the brain, which are related to motor coordination and sensory and emotional integration”, explained Carlos Matute. Two weeks later, “the myelin concentrations had increased substantially, but had not yet reached pre-race levels”, added Pedro Ramos. The authors saw that the myelin content had recovered fully two months after the marathon.

Myelin, the brain’s fuel

The researchers concluded that “myelin seems to act as an energy source when other brain nutrients are depleted during endurance exercise, and that further research is needed to establish how extreme exercise is related to the amount of myelin in the brain. Trials in a larger cohort are needed”, said Ramos-Cabrer.

This study reveals that “brain energy metabolism is more complex than previously thought. The use of myelin as brain fuel opens up new insights into the brain’s energy requirements”, explained Matute. Furthermore, according to the authors, more studies are needed to assess whether these changes exert any effect on the neurophysiological and cognitive functions associated with these regions, but they point out that most of the myelin in the brain is not affected.

The results of this work break new ground in the energy role of healthy, aging and diseased myelin in the brain. “Understanding how the myelin in the runners recovers quickly may provide clues for developing treatments for demyelinating diseases, such as multiple sclerosis, in which the disappearance of myelin and, therefore, of its energy contribution, facilitates structural damage and degeneration,” said Matute. At the same time, the researchers are keen to stress that running marathons is not harmful for the brain; “on the contrary, the use and replacement of myelin as an energy reserve is beneficial because this exercises the brain’s metabolic machinery”.

Source: University of the Basque Country

Categories : Cardiovascular Disease ExerciseTags :

Preventable Cardiac Deaths during Marathons are Down

On By ModernMedia
Photo by Barbara Olsen on Pexels

While more people than ever are running marathons in the U.S., the risk of dying from a heart attack during a run has fallen dramatically in recent years. That’s a key conclusion from a new study by Jonathan Kim, associate professor in the Emory School of Medicine. Kim’s research is a follow-up to a study he published in 2012 — the first investigation into unexpected cardiac arrests during long distance running events.

The new findings, published in JAMA, indicate that, while the rate of marathon runners who suffer cardiac arrests remained unchanged, their chance for survival is twice what it was in the past. Far fewer marathon runners who suffer cardiac arrest are now dying of it.

“We continue to see media reports about unfortunate cases of cardiac arrest during long distance running events,” Kim says. “But, has the incidence of these events changed? Have there been changes in the most common causes of cardiac arrest? What are the factors associated with death and survival? It was a novel question to ask 13 years after our first analysis, and an important one because recreational running continues to increase in popularity.”

The challenge of finding data

More than 29 million people completed marathons in the U.S. between 2010 and 2023, triple the number of the previous decade, which Kim examined in his first study. There’s no central registry of race-related cardiac events, so for both studies, his team had to find their data through a range of sources, starting by contacting individual race directors.

“We leveraged a few sources including a comprehensive review of media reports,” Kim says. “We also had contact information for all race directors and were able to reach approximately 70% of them who helped and told us the number of events during this specific timeline, including if the individual died and the sex of the participant.”

The researchers used extensive public internet searches to identify and reach out to runners who survived cardiac arrests or next-of-kin to construct detailed profiles of as many cases as possible. “The vast majority of cases were identifiable by public search engines. And all of the deaths were as well,” he says.

Analyzing this extensive database, Kim found that while the rate of cardiac arrests was about the same during the two periods — .60 per 100 000 participants now versus .54 per 100 000 participants in the earlier period — the rate of deaths from these cases, however, fell by half: from .39 per 100 000 to .19 per 100 000. That’s about a 50% decline in the death rate since 2000–2009. As before, cardiac arrests remained far more common among men than among women and more common in marathons than half marathons.

The sport’s growing awareness of cardiac death risk

What led to the dramatic change in death rates? Kim thinks the whole sport has become more aware of the risks and of the need to have emergency services available to runners, a conclusion he reached after interviewing as many survivors as he could find. “What we found was that every one of those people got hands-on cardiopulmonary resuscitation, but the vast majority also had immediate access to an automated external defibrillator. That’s the difference,” he says.

That survival rate is comparable to the cardiac arrest survival rate in other public places that now make defibrillators routinely available such as airport and casinos, which have seen similar declines in deaths.

Kim says his findings offer additional evidence of how important it is to make CPR training available to race participants and to strategically place defibrillators along the racecourse. It’s also important, he says, to better identify the most vulnerable in a population before they run a race.

“These are more often potentially preventable events,” he says. “Being able to identify people, more commonly older individuals with unrecognized cardiovascular risk factors, doesn’t mean they can’t run a race. Rather, it affords the opportunity to improve primary preventive cardiovascular care and potentially further reduce the risk of cardiac arrest during these events. The incidence of sudden cardiac arrest during long-distance races hasn’t changed in over twenty years. I think this is an important arena of future research.”

Source: Emory Health Sciences

Categories : ExerciseTags :

Exercise Scientists Come up with a Simple Fix for Shin Splints

On By ModernMedia
Photo by Andrea Piacquadio on Pexels

Shin splints are a common complaint among runners, especially if they use treadmills. A randomised controlled trial found that four weeks of gait training outdoors, in addition to home exercises often prescribed for shin splints, led to improved running biomechanics even when the runners were using a treadmill. These improvements included decreasing the time the runners’ feet were in contact with the ground or treadmill, a recently identified contributor to shin splints. 

Based on the trial results, the researchers, including UVA Health sports medicine expert David J. Hryvniak, DO, are recommending that clinicians begin including outdoor gait training as part of rehabilitation programs for patients struggling with chronic shin splints.

“This is an important finding for clinicians, as this gives us a tool to use to help these runners,” said Hryvniak, a running medicine specialist who is part of UVA Health’s Runner’s Clinic. “These gait-training cues can be an easy thing to add into a rehab program to help patients improve running mechanics that can underlie many common running injuries.”

Soothing shin splints

Affecting approximately 40% of all runners, shin splints typically begin as tenderness in the lower leg that goes away after exercising. But for regular runners, this pain can worsen and become persistent. In severe cases, shin splints can even lead to stress fractures.

Prior research has found that short courses of outdoor gait training can significantly reduce shin-splint pain for outdoor runners. But experts had been uncertain if these benefits would transfer to the flat, regular surface of treadmill running. That prompted an interdisciplinary team of researchers to launch a randomised trial to find out if outdoor gait training would benefit treadmill users.

The researchers enrolled 17 treadmill runners between ages 18 and 45 who ran at least three times a week and who had been suffering lower leg pain during or after running for at least a month. The volunteers were randomly divided into two groups: One group received four weeks of outdoor gait training and performed commonly prescribed home strengthening exercises, while the other group only performed the home exercises.

During the gait training, participants were provided with “vibrotactile feedback” – meaning they felt a little vibration – when special sensors in their shoes detected their feet were in contact with the ground for too long. This helped them improve their stride and gait to reduce this potential contributor to shin splints.

At the end of the study period, both groups saw strength improvements in their legs. But the gait trainers also had improved running technique, or what the researchers call “favorable adjustments in running gait mechanics.” And, sure enough, these gait improvements were seen during both outdoor runs and treadmill runs. 

That suggests outdoor gait training could be an important new tool to help treadmill users work up a sweat pain-free, the researchers say.

“Shin splints are a very common running injury, especially with those who are new to the sport,” Hryvniak said. “These gait cues are something that have been shown to be an effective tool that patients can use literally ‘on the run.’” 

Source: University of Virginia Health

Categories : Exercise Mental HealthTags :

Can Running Beat Antidepressants as a Treatment for Depression?

On By ModernMedia
Photo by Ketut Subiyanto on Pexels

The first study to compare effects of antidepressants with running exercises for anxiety, depression and overall health shows that they have about the same benefits for mental health, with health benefits for those assigned to running.

Professor Brenda Penninx from Vrije University, Amsterdam, presented the work at the ECNP conference in Barcelona (after recent publication in the Journal of Affective Disorders). Prof Penninx said, “We wanted to compare how exercise or antidepressants affect your general health, not just your mental health.”  

The 16-week course of running over the same period scores higher in terms of physical health improvement, whereas antidepressants lead to a slightly worse physical condition, as has been suggested by previous studies.  However, the drop-out rate was much higher in the group which initially chose exercise.

The researchers studied 141 patients with depression and/or anxiety. They were offered a choice of treatment; SSRI antidepressants for 16 weeks, or group-based running therapy for 16 weeks. 45 chose antidepressants, with 96 participating in running. The members of the group which chose antidepressants were slightly more depressed than the members of the group which chose to take running.

Professor Penninx said, “This study gave anxious and depressed people a real-life choice, medication or exercise. Interestingly, the majority opted for exercise, which led to the numbers in the running group being larger than in the medication group.”

Treatment with antidepressants required patients to adhere to their prescribed medication intake but this generally does not directly impact on daily behaviours. In contrast, exercise directly addresses the sedentary lifestyle often found in patients with depressive and anxiety disorders by encouraging persons to go outside, set personal goals, improve their fitness and participate in a group activity.  

The antidepressant group took the SSRI Escitalopram for 16 weeks. The running group aimed for two to three closely supervised 45-minute group sessions per week (over 16 weeks). The adherence to the protocol was lower in the running group (52%) than in the antidepressant group (82%), despite the initial preference for running over antidepressants.

At the end of the trial, around 44% % in both groups showed an improvement in depression and anxiety, however the running group also showed improvements in weight, waist circumference, blood pressure, and heart function, whereas the antidepressant group showed a tendency towards a slight deterioration in these metabolic markers.

“Both interventions helped with the depression to around the same extent. Antidepressants generally had worse impact on body weight, heart rate variability and blood pressure, whereas running therapy led to improved effect on general fitness and heart rate for instance. We are currently looking in more detail for effects on biological aging and processes of inflammation’,” Prox Benninix said.

Physical activity is a good option, but antidepressants still have a role

Prof Benninx noted that it is not a case of one or the other when it comes to treating depression. “It is important to say that there is room for both therapies in care for depression. The study shows that lots of people like the idea of exercising, but it can be difficult to carry this through, even though the benefits are significant. We found that most people are compliant in taking antidepressants, whereas around half of the running group adhered to the two-times-a-week exercise therapy. Telling patients to go run is not enough. Changing physical activity behaviour will require adequate supervision and encouragement as we did by implementing exercise therapy in a mental health care institution.”

She added: “Antidepressants are generally safe and effective. They work for most people. We know that not treating depression at all leads to worse outcomes; so antidepressants are generally a good choice. Nevertheless, we need to extend our treatment arsenal as not all patients respond to antidepressants or are willing to take them. Our results suggest that implementing exercise therapy is something we should take much more seriously, as it could be a good – and maybe even better – choice for some of our patients.  

“In addition, let’s also face potential side effects our treatments can have. Doctors should be aware of the dysregulation in nervous system activity that certain antidepressants can cause, especially in patients who already have heart problems. This also provides an argument to seriously consider tapering and discontinuing antidepressants when depressed or anxious episodes have remitted. In the end, patients are only truly helped when we are improving their mental health without unnecessarily worsening their physical health.”

Source: EurekAlert!

Categories : General Interest Mental HealthTags :

SA Man’s Epic Coastal Run For Mental Health Charity

On By ModernMedia

One South African man, who, like many South Africans, suffered from COVID-related anxiety, is looking to set a running world record as he runs along the South African coastline in order raise funds for a mental health charity.

The lockdown was hard on millions of South African, including restauranteur Henry Cock. It forced the closure of his restaurants, leaving his employees without income. But even before the stresses of lockdown, he had been suffering from severe anxiety, and in 2019 had started seeing a therapist.

As with so many people faced with the unexpected hardships of lockdown, he came up with a way to help his employees. He aimed to raise R80 000 for them through a innovative campaign, which involved Cock ‘running the Comrades Marathon’ — consisting of some 6000 laps up and down his own passageway to make up the 90km.

Though no less a gruelling undertaking than doing it outdoors, this turned out to be more successful than anticipated.

“In the end, we managed to raise R120 000,” he related. “It took eleven hours. Eleven hours of running back and forth across a 15-metre passage with just a few short breaks to eat and rest my legs,” he said.

With only his walls to look at during his hours of running, the 34-year-old had time to think about helping out others in light of the mental health challenges he himself had experienced.

Cock has started the ‘Mentally Aweh’ campaign to raise funds for South African Depression and Anxiety Group (SADAG), an organisation that provides free counselling to thousands of South Africans on a daily basis. His inspiration was the Terry Fox Initative, started by Canadian Terry Fox, who attempted to run across that vast country to raise funds for cancer research, though he passed away before he could complete it.

“I will be running the length of the South African coastline, from Kosi Bay in KwaZulu-Natal to Vioolsdrift near the Namibia border, to raise awareness for mental health and raise R6 million for the South African Depression and Anxiety Group,” Cock told Health-e News.

And the unmet need is vast. As he explained on his fundraising page, only a shocking 0.89% of the uninsured South African population has access to free mental health care.

Call volumes doubled since lockdown

SADAG senior counsellor Fatima Seedat said that call volumes had doubled since the start of lockdown.

“We used to receive 600 calls a day. When we entered the pandemic, with lockdown, we were getting over 1200 calls a day. That’s excluding the emails we receive, the SMSes received, and the WhatsApp messages that we receive on a daily basis. We have had around 500,000 calls since lockdown until now.”

Because it is toll free, SADAG’s phone bill runs up to R120 000 each month, so Cock’s mission to raise R6 million will help greatly.

“It is an absolutely amazing initiative,” said Seedat. “Henry is an inspiration for standing up for mental health, because that alone breaks a lot of barriers and boundaries.”

Mental health in South Africa

A third of South Africans will experience a mental health issue during their lifetime, according to SADAG. Depression and anxiety are also considered as mental illnesses, and are much more common than believed.

Cock endured his own mental strain during the lockdown; financial uncertainty, the ending of a long-term relationship, and the illness of a family member all set off his battle with anxiety.

“I was in a very bad space last year, like a very bad space. I was struggling. You get to a point when you’re an anxiety sufferer that you just think this is normal. You just think that this state of being is normal, but it’s not normal,” he said.

This is a pattern that Alexa Scher, a clinical psychologist in private practice, often sees.

“I think there is a lot under the surface that blocks people from actually saying, you know what, I’m not okay. We are usually scared to acknowledge and admit that and notice that in ourselves, so it can creep in invisibly, and then all of a sudden, you’re crying all the time, and then you think, ‘Oh, yeah, maybe this isn’t actually normal.’”

She advised that one should seek help when their state of mind begins to impact their ability to function. 

Free help is available

While Cock was able to seek help, the majority of South Africans cannot access mental health treatment, which is why he is trying to help SADAG.

The organisation operates the only suicide crisis line in the country, and also has a 24-hour toll-free telephonic, SMS, and WhatsApp lines.

“We reach people not only in your urban areas, but deep rural areas. People are really in need of help in rural areas because there are not many resources available. So we try to help as many people as we can, by reaching out to everyone,” Seedat explained.

SADAG has about 200 volunteers working in shifts, and all go through a screening process.

While Cock will hit the road solo, and does feel a certain pressure to succeed within the 133 days, he said he is using his emotions to motivate himself.

“I channel all of that energy into days when I’m feeling down or feeling bad. I remind myself that I’m not doing it just for me — I’m doing it to raise awareness for these people that really struggle and don’t have access to the same resources that I do,” he said.

“No matter how dark it is, it’s important to remember that you’re not alone. Reach out. You’ll be surprised how much help you actually receive if you just ask.”

Henry Cock’s journey can be followed on Instagram at @cock.henry.

SADAG can be reached on 0800 567 567.

Source: Health-e News