Real benefits of cardio

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The body of work on that part of our routine we love to hate or just hate completely brings a number of arguments to the forefront to reignite our commitment to cardio in our workouts:

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Reducing coronary heart disease:

Yep, we’ve all heard it and just do it, it’s actually nothing new, so you’re probably wondering how exactly?

In an investigation led by Stephen W. Farrell, PhD, of The Cooper Institute, Dallas, TX, researchers found strong evidence that moderate-to-high level of fitness counteracted some of the negative effects of a high blood triglyceride/high-density lipoprotein (TG:HDL) ratio.

“While it is still extremely important to measure traditional risk factors such as resting blood pressure, blood cholesterol, triglyceride, and glucose levels, having a measure or estimate of the patient’s cardiorespiratory fitness level gives us additional information regarding cardiovascular disease risk,” says Farrell, “…regardless of whether the blood TG:HDL ratio was low or high, having at least a moderate level of fitness provided some protection from CHD death when compared to having a low level of fitness.”

A total of 40,269 men received a comprehensive physical examination between January 1, 1978 and December 31, 2010.  The exam included a maximal treadmill exercise test to measure cardiorespiratory fitness level, and also included measurement of the blood TG:HDL ratio.  This ratio is easily calculated by taking the fasting blood triglyceride level and dividing it by the blood HDL cholesterol level.  A lower ratio is an indicator that insulin is working well, while a higher ratio indicates resistance to insulin. Higher ratios also indicate an increased risk of future prediabetes, type 2 diabetes, and cardiovascular disease.

When used in combination with other risk factors, such as the patient’s blood pressure, bloodwork, family history, etc., measuring or estimating the patient’s level of cardiorespiratory fitness (CRF) can result in a much more accurate determination of their cardiovascular disease risk status.

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In another study researchers from several universities and institutes in Spain highlight the importance of monitoring CRF for early detection of present and future cardiovascular risk in youth. They describe how measuring CRF in 6- to 10-year-olds and later in 8- to 12-year-olds can reveal indicators of increased cardiovascular disease (CVD) risk later in life.

Lead investigator José Castro-Piñero, PhD, from the Department of Physical Education, School of Education, University of Cádiz, Puerto Real, Spain, noted, “Although CVD events occur most frequently during or after the fifth decade of life, there is evidence indicating that CVD precursors have their origin in childhood and adolescence.  Consequently, early detection and diagnosis of CVD risk factors in children and adolescents will contribute to the development of effective prevention programs, counseling, school-based strategies, and public health policies.”

Participants were part of the UP&DOWN study of 2225 youths between 6 and 18 years of age, and for this study, 213 primary schoolchildren were tested. CRF was expressed as an oxygen consumption value (units of mL/kg per minute) calculated from a shuttle-run test. Other data collected included skinfold thickness, blood pressure, serum triglyceride (TG) levels, total cholesterol (TC) level, high-density lipoprotein cholesterol (HDL-C) level, glucose level, insulin level, and CRF.  From these data, single CVD risk factors were determined as well as an overall CVD risk score.

Researchers determined that several single CVD factors increased during the two-year follow-up period for both boys and girls, while overall CVD risk score increased significantly only for boys.

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The link between Vitamin D blood levels and cardiorespiratory fitness, bone AND muscle health:

A study published in the European Journal of Preventive Cardiology, a publication of the European Society of Cardiology (ESC).

“Our study shows that higher levels of vitamin D are associated with better exercise capacity,” said Dr Amr Marawan, assistant professor of internal medicine, Virginia Commonwealth University, Virginia, US. “We also know from previous research that vitamin D has positive effects on the heart and bones.  Make sure your vitamin D levels are normal to high.  You can do this with diet, supplements, and a sensible amount of sun exposure.”

It is well established that vitamin D is important for healthy bones, but there is increasing evidence that it plays a role in other areas of the body including the heart and muscles.

Cardiorespiratory fitness, a reliable surrogate for physical fitness, is the ability of the heart and lungs to supply oxygen to the muscles during exercise. It is best measured as the maximal oxygen consumption during exercise, referred to as VO2 max. People with higher cardiorespiratory fitness are healthier and live longer.

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Dr Marawan said: “The relationship between higher vitamin D levels and better exercise capacity holds in men and women, across the young and middle age groups, across ethnicities, regardless of body mass index or smoking status, and whether or not participants have hypertension or diabetes.”

Each 10 nmol/L increase in vitamin D was associated with a statistically significant 0.78 mL/kg/min increase in VO2 max. “This suggests that there is a dose response relationship, with each rise in vitamin D associated with a rise in exercise capacity,” said Dr Marawan.

Dr Marawan noted that this was an observational study and it cannot be concluded that vitamin D improves exercise capacity.  But he added: “The association was strong, incremental, and consistent across groups.  This suggests that there is a robust connection and provides further impetus for having adequate vitamin D levels, which is particularly challenging in cold, cloudy places where people are less exposed to the sun.”

On the other hand, Vitamin D toxicity can lead to excess calcium in the blood, which can cause nausea, vomiting, and weakness. “It is not the case that the more vitamin D, the better,” said Dr Marawan. “Toxicity is caused by megadoses of supplements rather than diet or sun exposure, so caution is needed when taking tablets.”

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Effects on brain activity and executive functioning:

The aging process is associated with declines in brain function, including memory and how fast our brain processes information, yet previous research has found that higher levels of cardiorespiratory fitness in older adults leads to better executive function in the brain, which helps with reasoning and problem solving.  Higher cardiorespiratory fitness levels have also been found to increase brain volume in key brain regions.

A study from the Beckman Institute for Advanced Science and Technology at the University of Illinois revealed a connection between brain activation, cardiorespiratory fitness, and executive function in older adults, finding that dual-task processing in a core executive function brain region is associated with higher cardiorespiratory fitness and dual-task performance.

“Previous studies have shown that there’s a relationship between cardiorespiratory fitness and behavioral performance in older adults. Other studies have looked at cardiorespiratory fitness and brain function, but really linking all three of those hasn’t been quite been done as explicitly as we did in this paper,” said Chelsea Wong, a M.D./Ph.D. student at the University of Illinois.

The team, led by Art Kramer, Beckman Institute director and professor of psychology and neuroscience at Illinois, examined brain imaging and fitness level data from 128 adults between the ages of 59-80.  With functional magnetic resonance imaging (fMRI) scans gathered in the Beckman Institute’s Biomedical Imaging Center, the researchers found that certain regions of the brain were activated more when performing two simultaneous tasks compared to a single task.  They concluded an overall relationship between cardiorespiratory fitness levels and higher executive function may be partially explained through activation in a region of the brain called the anterior cingulate cortex and the supplementary motor area (ACC/SMA).

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“We analyzed areas of the brain that were activated while the participants were completing two tasks, and found that the ACC/SMA activation was associated with higher cardiorespiratory fitness. It’s an important area for higher level functions, such as conflict monitoring, multitasking, and dual-task processing itself,” said Wong.

German scientists have shown that physical fitness is associated with better brain structure and brain functioning in young adults. This opens the possibility that increasing fitness levels may lead to improved cognitive ability, such as memory and problem solving, as well as improved structural changes in the brain.  The scientists used a publicly available database of 1206 MRI brain scans from the Human Connectome Project, which had been contributed by volunteers who wanted to contribute to scientific research.

The tests were able to show two main points: better performance on a 2-minute walking test in young healthy adults is associated with better cognitive performance, and with structural integrity of the white matter in the brain: healthy white matter is known to improve the speed and quality of nerve connections in the brain.

Repple said, “This leads us to believe that a basic level of fitness seems to be a preventable risk factor for brain health.  This type of study raises an important question. We see that fitter people have better brain health, so we now need to ask whether actually making people fitter will improve their brain health.”

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Why they say it increases our lifespan?

Cleveland Clinic study found that increased cardiorespiratory fitness was directly associated with reduced long-term mortality, with no limit on the positive effects of aerobic fitness. Extreme aerobic fitness was associated with the greatest benefit, particularly in older patients (70 and older) and in those with hypertension.

Researchers retrospectively studied 122,007 patients who underwent exercise treadmill testing at Cleveland Clinic between Jan. 1, 1991, and Dec. 31, 2014, to measure all-cause mortality relating to the benefits of exercise and fitness.

“Aerobic fitness is something that most patients can control. And we found in our study there is no limit to how much exercise is too much,” said Wael Jaber, M.D., Cleveland Clinic cardiologist and senior author of the study. “Everyone should be encouraged to achieve and maintain high fitness levels.”

The risk associated with poor cardiorespiratory fitness was comparable to or even exceeded that of traditional clinical risk factors, such as cardiovascular disease, diabetes and smoking.  The study’s findings emphasise the long-term benefits of exercise and fitness, even to extreme levels, regardless of age or coexistent cardiovascular disease.

“We were particularly interested in the relationship between extremely high fitness and mortality” said Kyle Mandsager, M.D., an electrophysiology fellow at Cleveland Clinic and the lead author of the study. “This relationship has never been looked at using objectively measured fitness, and on such a large scale.”

All patients had previously undergone stress tests at Cleveland Clinic, and were broken up into five performance groups — elite, high, above average, below average and low. Elite performers were defined as having aerobic fitness in the top two and half percent by age and gender, and demonstrated fitness levels comparable to endurance athletes. Long-term survival was adjusted for a patient’s age, sex, height, weight, BMI, medications and comorbidities.

When the subgroups were analyzed by age, the survival benefit of elite versus high performance was most notable in older patients. In those over the age of 70, elite performers had a nearly 30% reduced risk of mortality compared to high performers. In younger age groups there was no statistical difference in outcomes between elite and high performers.

When the subgroups were analyzed by comorbidities, all-cause mortality inversely related to cardiorespiratory fitness and was lowest in the ePeople who are physically fit and active have fewer and milder colds, indicates research published online in the British Journal of Sports Medicine.

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The US researchers base their findings on 1,000 adults up to the age of 85 whose respiratory health was tracked for 12 weeks during the autumn and winter of 2008.

Six out of 10 participants were women, and four out of 10 were aged between 18 and 39; 40% were middle aged, and one in four were aged 60 and older.

All the participants reported back on how frequently they took aerobic exercise and rated their fitness levels using a validated 10 point scoring system. They were also asked about lifestyle, diet and recent stressful events, as these can all affect immune system response.

The number of days with cold symptoms varied considerably between winter and autumn, with an average of 13 days in the winter and 8 days in the autumn.

Being older, male, and married, seemed to reduce the frequency of colds, but after taking account of other influential factors, the most significant factors were perceived fitness and the amount of exercise taken.

The number of days with symptoms among those who said they were physically active on five or more days of the week and felt fit was almost half (43% to 46% less) that of those who exercised on only one or fewer days of the week.

The severity of symptoms fell by 41% among those who felt the fittest and by 31% among those who were the most active.

In the US, an average adult can expect to have a cold two to four times a year, while children can catch between half a dozen and 10 colds a year, on average, all of which costs the US economy around $40 billion dollars.

Bouts of exercise spark a temporary rise in immune system cells circulating around the body, say the authors. Although these levels fall back within a few hours, each bout is likely to enhance surveillance of harmful viruses and bacteria, so reducing the number and severity of infections, such as the common cold.lite performers. For those patients with hypertension, the elite performers again showed a nearly 30% reduction in all-cause mortality compared to high performers.  For all other comorbidity subgroups there was no statistical difference in survival rates between the elite and high performers.

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How it could help prevent the basic cold:

People who are physically fit and active have fewer and milder colds, indicates research in the British Journal of Sports Medicine on 1,000 adults up to the age of 85 whose respiratory health was tracked for 12 weeks during the autumn and winter of 2008.

6out of 10 participants were women, and 4 out of 10 were aged between 18 and 39;

40% were middle aged, and one in four were aged 60 and older.

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All the participants reported back on how frequently they took aerobic exercise and rated their fitness levels using a validated 10 point scoring system. They were also asked about lifestyle, diet and recent stressful events, as these can all affect immune system response. The number of days with cold symptoms varied considerably between winter and autumn, with an average of 13 days in the winter and 8 days in the autumn.

Being older, male, and married, seemed to reduce the frequency of colds, but after taking account of other influential factors, the most significant factors were perceived fitness and the amount of exercise taken.

The number of days with symptoms among those who said they were physically active on five or more days of the week and felt fit was almost half (43% to 46% less) that of those who exercised on only one or fewer days of the week.

The severity of symptoms fell by 41% among those who felt the fittest and by 31% among those who were the most active.

Bouts of exercise spark a temporary rise in immune system cells circulating around the body, say the authors. Although these levels fall back within a few hours, each bout is likely to enhance surveillance of harmful viruses and bacteria, so reducing the number and severity of infections, such as the common cold.

 


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