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Health and Fitness, Public Health, Research

Study shows taking short walks may offset negative health impact of prolonged sitting

Study shows taking short walks may offset negative health impact of prolonged sitting

3046594832_cc702e6266_zWhile most of us know that sitting for prolonged periods of time can be detrimental to our health, sometimes, despite our best intentions, we’re locked into our seats by other circumstances. Perhaps you’re on a long flight with lots of turbulence and, even though our activity tracker is buzzing us to stand up, the fasten seatbelt sign forces you to ignore the alerts. Or maybe you’re at a daylong workshop or training and the opportunities to stretch your legs are few and far between. But recent research suggests that you may be able to counteract such periods of prolonged sitting with a short walk.

In the small study published in Experimental Physiology, researchers at the University of Missouri and University of Texas at Arlington compared the vascular function of a group of healthy men at the beginning of the project, after sitting for six hours and again once they completed a short walk. Results confirmed that when you sit for the majority of an eight-hour work day, blood flow to your legs is significantly reduced. The findings also showed “that just 10 minutes of walking after sitting for an extended time reversed the detrimental consequences,” lead author Jaume Padilla, PhD, said in a release.

In addition to keeping your vascular system in good working order, walking can boost your creative inspiration. A past Stanford study showed a person’s creative output increased by an average of 60 percent when he or she was walking.

Previously: Does TV watching, or prolonged sitting, contribute to child obesity rates?, More evidence that prolonged inactivity may shorten life span, increase risk of chronic disease, Study shows frequent breaks from sitting may improve heart health, weight loss and How sedentary behavior affects your health
Photo by Laura Billings

Chronic Disease, Health and Fitness, In the News, Nutrition, Obesity, Stanford News

A conversation about the diabetes epidemic

A conversation about the diabetes epidemic

On this morning’s KQED’s morning radio show, Forum, several doctors including Stanford’s Bryant Lin, MD, discussed how diabetes is affecting the health of millions of people globally.

A recent study in the Journal of the American Medical Association estimated that about half of all adults have diabetes (diagnosed or undiagnosed) or pre-diabetes. Lin and his fellow panelists talked about how changes in our diet and lifestyle have fueled the number of diabetic cases, as well as how genetics can tip the odds against certain patients. Lin mentioned that Asians have a higher rate of diabetes than whites, for example.

Like Lin, I have a family history of diabetes. (Like Lin, I’ve also struggled to maintain my weight). That history has made me keenly interested in staying abreast of recent findings about diabetes – and I surprised to hear that among young people, high rates of liquor consumption is influencing diabetes rates. It’s not just soda intake that we have to watch out for.

Another surprising finding that Lin described was that for pre-diabetics, taking Metformin, a drug that helps control diabetes and blood sugar, can help stave off full-blown diabetes. Eventually, it may become routine to prescribe this medication in certain populations, but Lin said that guidelines haven’t caught up with this aspect of diabetes care.

Other factors at play, Lin noted, include the role of the microbiome in promoting or protecting people from diabetes. And people who undergo bariatric surgery for weight management often find their diabetes is cured, but doctors don’t understand exactly why that’s the case.

Despite the staggering number of people affected, it’s clear that we still don’t understand all the complex factors that influence this disease.

Previously: Faulty fat cells may help explain how Type 2 diabetes beginsThe role of nutrition in diabetes prevention and managementThe importance of regular exercise in delaying and treating diabetes and Examining the role of exercise in managing and preventing diabetes

Cardiovascular Medicine, Chronic Disease, Health and Fitness, NIH, Research, Stroke

NIH-funded study shows effectiveness of intensive blood pressure management

NIH-funded study shows effectiveness of intensive blood pressure management

blood pressure reading2This morning the National Institutes of Health announced that it halted a clinical trial on high blood pressure in order to share the results publicly right away. According to the initial study findings, managing high blood pressure so it falls below a specific blood pressure target significantly reduces rates of cardiovascular disease and lowers risk of mortality.

The Systolic Blood Pressure Intervention Trial, commonly called SPRINT, is the largest known study of its kind to examine how holding systolic blood pressure below the currently recommended level affects cardiovascular and kidney diseases.

For this trial, nearly 100 medical centers in the United States and Puerto Rico, including Stanford, recruited more than 9,300 participants age 50 and older for a study that involved carefully adjusting the amount or type of blood pressure medication to achieve a target systolic pressure of 120 millimeters of mercury (mm Hg).

As outlined in an NIH press release, the researchers found that reducing systolic pressure to 120 mm Hg or less, reduced rates of stroke, heart attacks, heart failure and other cardiovascular events by almost a third and reduced the risk of death by almost a quarter, compared to the target systolic pressure of 140 mm Hg.

“SPRINT addressed a fundamental question faced by internal medicine physicians, nephrologists, cardiologists and other specialists – that is, how low should our blood pressure target be?” said Glenn Chertow, MD, MPH, principal investigator for the Stanford site.

Although researchers have known for some time that lowering patients’ blood pressure can improve survival rates and reduce their chances of having a stroke, heart disease or a kidney-related event, studies that link these benefits to a specific blood pressure were lacking. This is why the SPRINT study is so important.

“Before today there was no evidence from randomized clinical trials to demonstrate that lowering systolic blood pressure toward or below 120 mmHg was safe and effective,” Chertow told me yesterday afternoon.

“Adoption of the approach learned from SPRINT could change medical practice and materially improve the public health,” Chertow continued. “We’re proud to have participated” in the study.

Previously: The importance of knowing your blood pressure level in preventing hypertensionUltra-thin flexible device offers non-invasive method of monitoring heart health, blood pressureAsk Stanford Med: Stanford interventional cardiologist taking questions on heart health and High-quality chocolate linked to lower risk of heart failure
Photo by World Bank Photo Collection

Health and Fitness, Obesity, Pediatrics, Public Health

Taking breaks for physical activity may benefit children’s long-term health

Taking breaks for physical activity may benefit children’s long-term health

109320999_8b61257d14_zHere’s an eye-opening statistic: Children in the United States spend on average 6 hours per day sitting or reclining. As we head into the fall and winter months, it’s likely that the shorter, darker days and chilly weather will only add to our kids being more sedentary.

National exercise standards advocate for children getting at least 30 minutes of exercise daily to curb the risk of obesity, diabetes and other conditions. But for those days when achieving this goal isn’t possible, new research shows that short activity breaks can help offset a lack of exercise.

In the study (subscription required), researchers invited 28 healthy, normal-weight children to visit the National Institutes of Health on two separate occasions. During the first visit, participants were randomly assigned to two groups. One group watched TV, read or engaged in other sedentary activities for three hours; the other group alternated sitting with three minutes of moderate-intensity walking on a treadmill every 30 minutes for the three-hour period. On the return visit, the children switched groups. Each one took an oral glucose tolerance test at both visits. According to an NIH release:

On the days they walked, the children had blood glucose levels that were, on average, 7 percent lower than on the day they spent all 3 hours sitting. Their insulin levels were 32 percent lower.   Similarly, blood levels of free fatty acids — high levels of which are linked to type 2 diabetes — were also lower, as were levels of C-peptide, an indicator of how hard the pancreas is working to control blood sugar.

After the sessions, the children were allowed to choose their lunch from food items on a buffet table. Based on the nutrient content of each item, the researchers were able to calculate the calorie and nutrient content of what each child ate. The short, moderate-intensity walking sessions did not appear to stimulate the children to eat more than they ordinarily would, as the children consumed roughly the same amounts and kinds of foods after each of the sessions.

The study authors concluded that, if larger studies confirm their findings, interrupting periods of prolonged sitting with regular intervals of moderate-intensity walking might be an effective strategy for reducing children’s risk of diabetes and heart disease.

While regular walking breaks may not excite the average child, three-minute dance parties or stomping on bubbles are other options for getting kids out of their seat and moving.

Previously: Pediatrics group issues new recommendations for building strong bones in kids, Understanding the impact of sedentary behavior on children’s health and British government urging toddlers to ‘get physical’
Photo by Miika Silfverberg

Ask Stanford Med, Health and Fitness, Nutrition, Obesity, Precision health, Stanford News

A Stanford physician takes a precision health approach to living a healthier lifestyle

A Stanford physician takes a precision health approach to living a healthier lifestyle

timthumbNearly 70 percent of Americans ages 20 or older are overweight or obese, including Larry Chu, MD, a Stanford anesthesiologist and executive director of Medicine X.

Chu, who has struggled with his weight for over a decade, knew he was overweight but didn’t think it was a serious threat to his health. This changed during a routine doctor’s visit. As he explains in a podcast, Chu was shocked to learn that lab results showed he was at high risk for stroke and heart attack. He decided to take action and launch precision:me, a personal blog project chronicling the first 90 days of his journey to live a healthier lifestyle.

Why most of us try to slim down by shunning carbs, stepping up our exercise routines and secretly weighing ourselves each morning, Chu is tracking his health data using a range of gadgets and other tools and sharing the every detail of his progress publicly on his blog. He is also posting photos and podcasts.

Below Chu discusses why he choose to take this unique approach to achieve his weight-loss goals, how he hopes it will inform the broader conversation about obesity and its potential to demonstrate the value of digital tools in enhancing personal health.

What was the catalyst for precision:me?

One of the misconceptions about obesity is that it is a lifestyle disease and if people would only eat less and move more they would be fit. In my case, this is a health journey I have been struggling with since my residency training at Stanford. Using precision health tools to address obesity is a new approach that we are focusing on in precision:me. Stanford has recently announced exciting plans for precision health. I thought it was a good time to share how we at Medicine X see precision health as a novel approach that individuals and their providers can use today to tailor precise and individualized care. It is a very practical and personal dive into developing and implementing a precise plan to modify my diet and metabolic profile to forestall the development of more significant chronic diseases, such as diabetes and heart disease, using data and analytics provided through digital health tools and expert medical, nutritional and fitness collaborators.

Why did you decide to make all of your health data available online for public consumption?

It was an easy and difficult decision at the same time. There is incredible stigma associated with obesity, which we discuss on the precision:me website. Being overweight or obese is a subject that many of us find difficult to talk about. Sharing information can make it easier to start a dialogue. Advances in precision health at Stanford and around the world will depend upon patients sharing their personal health data in a secure and protected fashion with researchers. By sharing my data with the public, I hope to help everyone see what it is like to live with obesity as a condition, break down misconceptions and misperceptions about the disease, and help shine a light on the value of sharing data to help others.

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Emergency Medicine, Health and Fitness, Mental Health

Stanford’s “time banking” program helps emergency room physicians avoid burnout

Stanford's "time banking" program helps emergency room physicians avoid burnout

saving_timeFor emergency room doctors, few things are more important than time. They’re trained to work quickly and efficiently to gain the moments, minutes and hours that can be the difference between life or death for a patient. Yet, few ER doctors have the luxury of time in their personal lives.

According to a 2012 study, physicians’ work weeks are roughly ten to 20 hours longer than that of other professionals. This means that it would take the average professional about a year and a half to accomplish what a hard-working physician does in a single year. With a schedule like this, it’s no wonder that burnout is an issue for many physicians.

So, Stanford’s Department of Emergency Medicine adopted a “time banking” program that allows doctors to log the time they spend doing often under-valued activities, such as mentoring and covering colleagues’ shifts, to earn credits for the work and home-related services that would normally gobble up their free time.

Recently, the Washington Post highlighted this time-saving initiative in a story featuring emergency physician Gregory Gilbert, MD. “This gives me more bandwidth at work,” Gilbert said. “And because I can hang out with my kids and not be exhausted all the time, I’m able to be the kind of parent I’d always hoped to be.” From the Washington Post story:

Stanford’s time bank, part of a two-year, $250,000 pilot funded largely by the Sloan Foundation, showed big increases in job satisfaction, work-life balance and collegiality, in addition to a greater number of research grants applied for and a higher approval rate than Stanford faculty not in the pilot.

And for the first time, this year there are no openings for new fellows in the Department of Emergency Medicine. “All our spots have been retained,” Gilbert said. “There’s been no turnover.”

Previously: Surgeon offers his perspective on balancing life and workProgram for residents reflects “massive change” in surgeon mentalityLess burnout, better safety culture in hospitals with hands-on executives new study shows and Using mindfulness interventions to help reduce physician burnout
Photo by: mbgrigby

Cancer, Health and Fitness, Pediatrics, Public Health, Research, Women's Health

Examining the long-term health benefits for women of exercise in adolescence

Examining the long-term health benefits for women of exercise in adolescence

soccer_8.4.15Sometime around the age of five, I distinctly remember my mother telling me, “You have to play a sport. You can pick any sport you want, but you have to play a sport.” I recall this encounter vividly because I really, really didn’t want to play sports. At the time, I was the “everything-has-to-be-pink, Barbie-doll-playing, glitter-loving” type. But I picked a sport, soccer, and surprisingly stuck with it through college.

Fast forward to today, when I came across new research touting the health benefits of exercise during adolescence and was compelled to send a “Thanks, mom” text for her fitness mandate. The findings, which were recently published in the journal Cancer Epidemiology, Biomarkers & Prevention, show that women who regularly exercised as teenagers had a decreased risk of dying from cancer, cardiovascular disease and other causes during middle-age and later in life.

The study was conducted by Vanderbilt University Medical Center and the Shanghai Cancer Institute and involved the analysis of data from the Shanghai Women’s Health Study, a large ongoing prospective cohort study of 74,941 Chinese women ages 40 to 70.

Researchers defined regular exercise as occurring a minimum of once a week for three consecutive months. Lead author Sarah Nechuta, PhD, said in a release, “In women, adolescent exercise participation, regardless of adult exercise, was associated with reduced risk of cancer and all-cause mortality.”

More details about the study results:

Investigators found that participation in exercise both during adolescence and recently as an adult was significantly associated with a 20 percent reduced risk of death from all causes, 17 percent for cardiovascular disease and 13 percent for cancer.

While there have been several studies of the role of weight gain and obesity on overall mortality later in life, the authors believe this is the first cohort study of the impact of exercise during adolescence on later cause-specific and all-cause mortality among women.

The authors note that an important next step is to evaluate the role of adolescent exercise in the incidence of major chronic diseases, such as cardiovascular disease and major cancers, which will also help provide more insight into the mechanisms of disease.

Previously: Study finds teens who play two sports show notably lower obesity rates, Exercise may lower women’s risk of dementia later in life, How physical activity influences health and Stanford pediatrician discusses developing effective programs to curtail childhood obesity
Photo by Ole Olson

Health and Fitness, Nutrition, Obesity, Research

Can food mentions in newspapers predict national obesity rates?

Can food mentions in newspapers predict national obesity rates?

New_York_TimesFood words trending in today’s newspapers could help predict a country’s obesity rates in three years, according to findings recently published in the journal BMC Public Health. 

In the study, researchers examined whether media mentions of food predate obesity prevalence by analyzing mentions of foods in New York Times and London Times articles over the past 50 years. Using this data, they statistically correlated it with each country’s annual Body Mass Index, or BMI. Brennan Davis, PhD, lead author of the study and an associate professor of marketing at California Polytechnic State University, said in a release that results showed:

The more sweet snacks are mentioned and the fewer fruits and vegetables that are mentioned in your newspaper, the fatter your country’s population is going to be in 3 years, according to trends we found from the past fifty years … But the less often they’re mentioned and the more vegetables are mentioned, the skinnier the public will be.

Researchers say the research could help public health officials better understand the effectiveness of current obesity interventions.

Previously: Adventurous eaters more likely to be healthy, new study shows, Want kids to eat their veggies? Researchers suggest labeling foods with snazzy names, Can edible “stop signs” revive portion control and curb overeating? and Can dish color influence how much you eat?
Photo by Jaysin Trevino

Health and Fitness, Videos

A day in the life of your body, in video

A day in the life of your body, in video

Most of us give little thought to the daily inner workings of our bodies. We’re more focused on the tasks of getting ourselves, and the kids, out the door in the morning; tackling the to-do items filling up our inboxes; carving out a few minutes for exercise; and battling traffic on the commute home. But it’s worth a moment to hit pause and watch the latest ASAP Science video about the range of biological activities taking place in our bodies morning, noon and night. The short video is packed with surprising statistics, including the factoids that the majority of us are mentally sharpest 2.5-4 hours after waking and that research shows you can gain 20 percent more muscle strength by working out in the afternoon.

Previously: MeDesign Human Health Book: human anatomy diagrams with sleek new look, Stanford partnering with Google [x] and Duke to better understand the human body and Touring the microscopic worlds of the human body

Behavioral Science, Health and Fitness, Mental Health, Public Health, Research, Stanford News

Exposure to nature helps quash depression – so enjoy the great outdoors!

Exposure to nature helps quash depression - so enjoy the great outdoors!


hiking_news-1

Walking is good for your health. But walking somewhere natural is even better, according to a new Stanford-led study.

Study participants who walked in a natural area for 90 minutes showed less activity in a brain region associated with depression than those who walked through a city or other urban area, a Stanford News story states. From the piece:

“These results suggest that accessible natural areas may be vital for mental health in our rapidly urbanizing world,” said co-author Gretchen Daily, the Bing Professor in Environmental Science and a senior fellow at the Stanford Woods Institute for the Environment. “Our findings can help inform the growing movement worldwide to make cities more livable, and to make nature more accessible to all who live in them.”

Even further, the research supports — but does not prove — a link between urbanization and growing rates of mental illness, said co-author James Gross, PhD, a professor of psychology.

The researchers had one group of participants walk in a grassland with oak trees and shrubs. The other group walked along a traffic-clogged four-lane road. They then measured heart and respiration rates, performed brain scans and had the participants answer a series of questions. The results showed that:

Neural activity in the subgenual prefrontal cortex, a brain region active during rumination – repetitive thought focused on negative emotions – decreased among participants who walked in nature versus those who walked in an urban environment.

Evidence that supports the knowledge you’ve had since grade school: The outdoors really can make you feel better.

Previously: To get your creative juices flowing, start movingA look at the effects of city living on mental health and Out-of-office autoreply: Reaping the benefits of nature
Photo by Linda A. Cicero/Stanford News Service

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