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Cardiovascular Medicine, Health and Fitness, Medicine and Society, Research

Study questions safety of excessive exercise for heart attack survivors

Study questions safety of excessive exercise for heart attack survivors

Scope runningA recent article in PsychCentral highlighted findings published in the Mayo Clinic Proceedings offering more evidence that extreme exercise for heart attack survivors could put them at a higher risk for a cardiovascular event.

Paul Williams, PhD, staff scientist for the Life Sciences Division of Lawrence Berkeley National Laboratory, and Paul Thompson, MD, a cardiologist at Hartford Hospital, conducted a long-term study looking at the relationship between exercise and cardio-disease related death in about 2,400 physically-active heart attack survivors. The study reported on data taken from the National Walker’s and Runners’ heath studies at Lawrence Berkeley Laboratory.  From the piece:

“These analyses provide what is to our knowledge the first data in humans demonstrating a statistically significant increase in cardiovascular risk with the highest levels of exercise,” say Williams and Thompson.

“Results suggest that the benefits of running or walking do not accrue indefinitely and that above some level, perhaps 30 miles per week of running, there is a significant increase in risk.

Competitive running events also appear to increase the risk of an acute event.”

However, they point out that “our study population consisted of heart attack survivors and so the findings cannot be readily generalized to the entire population of heavy exercisers.”

On the other end of the spectrum, the journal also included research from Spain related to mortality in elite athletes. The investigation included over 42,000 top athletes, of which 707 were women, and examined the beneficial health effects of excessive exercise, particularly in decreasing cardiovascular disease and cancer risk. Senior investigator Alejandro Lucia, MD, PhD, said in the article, “What we found on the evidence available was that elite athletes (mostly men) live longer than the general population, which suggests that the beneficial health effects of exercise, particularly in decreasing cardiovascular disease and cancer risk, are not necessarily confined to moderate doses.”

With the majority of Americans still at risk for obesity, cardiovascular disease and diabetes, regular moderate exercise is still recommended by these researchers. As Hippocrates, the father of medicine, once said, “Everything in excess is opposed to nature.”

Previously: Study reveals initial findings on health of most extreme runners, The exercise pill: A better prescription than drugs for patients with heart problems?, Examining how prolonged high-intensity exercise affects heart health and Study reveals initial findings on health of most extreme runners
Photo by: Matthias Weinberger

Jen Baxter is a freelance writer and photographer. After spending eight years working for Kaiser Permanente Health plan she took a self-imposed sabbatical to travel around South East Asia and become a blogger. She enjoys writing about nutrition, meditation, and mental health, and finding personal stories that inspire people to take responsibility for their own well-being. Her website and blog can be found at www.jenbaxter.com.

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From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.

Behavioral Science, Health and Fitness, In the News, Pediatrics, Research

Regular exercise may help young girls struggling with depression

Regular exercise may help young girls struggling with depression

Girls running Scope Blog

Staying physically fit may help keep depression at bay for young girls, a study recently presented at the annual meeting of the American Psychological Association in Washington D.C. showed. On Thursday, the findings were reported in an article in U.S. News & World Report that pointed to a trend between fitness levels and depression in sixth grade girls.

“We don’t know exactly why there is a link [between fitness levels and depression], but it’s probably a number of things,” Camilio Ruggero, PhD, lead researcher and assistant professor at the University of North Texas, said in the article. “It might be better self-esteem, healthier weight or getting more positive reinforcements that go along with being active, and/or it could be more biological. We know certain proteins and hormones associated with less depression respond to increased exercise.”

The article goes on to say that the trend between fitness levels and depression in boys was not as statistically significant. Although the findings could not show a direct link between the two, they do suggest that for middle school children, staying active and being physically fit is an important piece of the puzzle for emotional well-being.

Jen Baxter is a freelance writer and photographer. After spending eight years working for Kaiser Permanente Health plan she took a self-imposed sabbatical to travel around South East Asia and become a blogger. She enjoys writing about nutrition, meditation, and mental health, and finding personal stories that inspire people to take responsibility for their own well-being. Her website and blog can be found at www.jenbaxter.com.

Previously: Using fMRI to understand and potentially prevent depression in girls, Yoga classes may boost high school students’ mental well- being and Lucile Packard Children’s Hospital partners with high schools on student mental health programs
Photo by Sangudo

Behavioral Science, Health and Fitness, Mental Health, Research

Exercise and relaxation techniques may help ease social anxiety, study finds

Exercise and relaxation techniques may help ease social anxiety, study finds

TrishWardMeditationPicPhysical exercise and relaxation techniques are common forms of stress-relief. Now, a new study has found that both may help people with social anxiety perceive their surroundings as less threatening environments.

Researchers from Queen’s University in the U.K. conducted two experiments measuring anxiety in participants. In both experiments, the participants were shown point-of-light displays describing a human but not indicating which way the stick figure was facing or whether it appeared to be approaching or receding. Facing-the-viewer bias, a possible biological protective mechanism, may lead people to assume the figure is approaching and posing a threat. And, according to the study, people who are more anxious may place their attention on more threatening stimuli, thereby increasing anxiety.

The researchers tested two means of altering participants’ perception of threat when looking at the stick-figure displays. From a release:

“We wanted to examine whether people would perceive their environment as less threatening after engaging in physical exercise or after doing a relaxation technique that is similar to the breathing exercises in yoga (called progressive muscle relaxation),” researcher [Adam Heenan, a PhD candidate,] said in a statement. “We found that people who either walked or jogged on a treadmill for 10 minutes perceived these ambiguous figures as facing towards them (the observer) less often than those who simply stood on the treadmill. The same was true when people performed progressive muscle relaxation.”

“This is a big development because it helps to explain why exercising and relaxation techniques have been successful in treating and mood and anxiety disorders in the past,” Heenan said.

The research was published in PLOS ONE.

Previously: Research brings meditation’s health benefits into focusAh…OM: Study shows prenatal yoga may relieve anxiety in pregnant womenStudy reveals initial findings on health of most extreme runners and The remarkable impact of yoga breathing for trauma
Photo courtesy of Trish Ward-Torres

Health and Fitness, Nutrition, Obesity, Parenting, Pediatrics, Stanford News

Childhood obesity expert to parents: Reduce your child’s screen time

Childhood obesity expert to parents: Reduce your child's screen time

screen-tvTake a few minutes to read a brief and informative piece about the negative health effects of too much screen time for children and how you can set boundaries for your kids – or perhaps yourself. In a Stanford Medicine News Q&A, pediatrician Thomas Robinson, MD, MPH, director of the Center for Healthy Weight at Lucile Packard Children’s Hospital Stanford, explains how watching TV or playing video games contributes to inactivity, overeating and obesity. Robinson also speaks to the modern-day concern of restricting access to screen devices that can also be educational tools, such as the iPad.

From the Q&A:

What’s the relationship between excessive screen time and childhood obesity?

It’s a true cause-and-effect relationship. The more time kids spend with screens, the less time they are spending being active. The best evidence supports two primary mechanisms—that kids eat more while watching screens and that exposure to food advertising leads to an increased eating of high-sugar, high-fat and calorie-dense foods. Lots of research shows that kids—and adults—eat more when distracted by a screen. So one of the most important things a family can do is eliminate eating while watching TV and other screens.

Previously:  Talking to kids about junk food ads, This is your 4-year-old on cartoons, Study: Too much TV, computer could hurt kids’ mental health, Does TV watching, or prolonged sitting, contribute to child obesity rates? and Paper explores effects of electronic media on kids’ health

Health and Fitness, Obesity, Research, Stanford News

Without exercise, Americans are growing more obese, according to Stanford researchers

Without exercise, Americans are growing more obese, according to Stanford researchers

gym_smallerMore than half of all American women don’t exercise at all, according to a survey that tracked the health of nearly 7,000 people in 2009 and 2010. Men don’t fare much better: 43 percent don’t work out at all.

Those percentages are dramatically higher than results from a similar study conducted in the early 1990s, which uncovered only 19 percent of sedentary women and 11 percent of inactive men.

More troubling, obesity rates jumped during the same period, according to an analysis by Stanford researchers published in the August issue of The American Journal of Medicine and now available online in a draft form.

What gives? Experts have been intoning “exercise 30 minutes a day most days” for more than a decade. People are just lazy, right?

It’s not that simple, says Pamela Powers Hannley, MPH, the journal’s editor, in a sharply worded commentary that accompanies the study. Many women work long hours, then spend their “spare” time parenting, not jogging, Hannley said. Exercise alternatives need to be convenient and low-cost, Hannley said, noting that some communities, like Tucson, Arizona, where she lives, are considering reducing hours at swimming pools or even closing pools entirely to save money.

“It’s going to take widespread change, not just individual change, not just an app for your iPhone,” Hannley says.

She, along with primary study author Uri Ladabaum, MD, associate professor of gastroenterology, heartily endorse the five recommendations issued by the Institute of Medicine in 2012. They are: integrate physical activity into daily life; make healthy food choices easy and routine; reinvigorate messages about exercise and food; focus on schools; and expand the role of employers, medical professionals and insurers.

Some people, including my editor here at Stanford, aren’t convinced that exercise can single-handedly curb obesity. Diet, the other obvious causal factor, didn’t play a leading role in this data set. The study considered the total calories consumed, but that didn’t vary significantly from 1988 to 2010, Ladabaum and his colleagues write. Genetics, environment and plain ‘ol chance all play a role in overall weight.

This study dug up another worrying trend, as well, one that particularly jumped out to second author, Ajitha Mannalithara, PhD, a Stanford social science research associate: Independent of weight, Americans are getting thicker around the middle.  The incidence of so-called abdominal obesity climbed from 46 percent to 62 percent in women and from 29 to 42 percent in men.

Abdominal girth is linked to increased risks of cancer and cardiovascular disease, even in normal weight individuals, Mannalithara said.

The stats are all based on the robust National Health and Nutrition Examination Survey, a long-term project of the Centers for Disease Control and Prevention that collects information from both surveys and physical examinations to assess Americans’ health.

Becky Bach is a former park ranger who now spends her time writing, exploring, or practicing yoga. She’s currently a science writing intern in the medical school’s Office of Communication & Public Affairs.

Previously: Lack of exercise shown to have largest impact on heart disease risk for women over 30, More evidence that boosting Americans’ physical activity alone won’t solve the obesity epidemic, To meet weight loss goals, start exercise and healthy eating programs at the same time and Study shows regular physical activity, even modest amounts, can add years to your life
Photo by Ms. Phoenix

Behavioral Science, Health and Fitness, Obesity, Research, Stanford News

The behavioral consequences of overindulgence

The behavioral consequences of overindulgence

sundae_070714In today’s world of Big Gulps and supersized portions, one giant question looms: How does overindulgence affect our pleasure of food?

To provide an answer, Baba Shiv, MBA, PhD, a professor at the Stanford Graduate School of Business, and colleagues performed a series of experiments investigating how your feeling of satiety impacts the likelihood that you’ll soon eat the same food again. Their findings offer insights for both individuals that have trouble eating and drinking in moderation and those who are picky eaters.

During the first study, students tried three different flavors of crackers, selected their favorite and then were instructed to eat a specific number. They rated their enjoyment after eating each one. According to a business school release:

The students who ate the larger portion (15 crackers) reported significantly lower enjoyment than those who ate the smaller portion (3 crackers).

These findings replicate previous ones on “sensory-specific satiety”: Each bit of the same food is less pleasant than the one before it. Thus, the bigger the portion, the less enjoyment you get out of the last few bites.

More importantly, participants’ enjoyment of the last cracker (manipulated by portion size) seemed to influence how soon the students wanted to eat the crackers again: Participants who ate a small portion typically opted to receive a giveaway box of [crackers] sooner than did participants who ate the larger portion.

In another study exploring behaviors of finicky eaters, study authors gave one group of participants sips of juice and two crackers to eat. A second group was also given the juice and crackers, but had the added distractor task of counting “e’s” in a series of passages before drinking more juice. Results showed that the crackers partially reset their satiety level, allowing students to find the second sip of juice as enjoyable as the first. Shiv notes in the release how these findings could be useful for parents trying to get their little ones to eat more veggies:

Parents of picky eaters could keep this lesson to heart, says Shiv. Rather than insisting that your child eat every last bite of broccoli, introduce another taste in the middle of the serving of broccoli, to reset levels of satiety. Next time there’s broccoli on the plate, your youngster may be more willing to eat it again.

Continue Reading »

Health and Fitness, Health Disparities, Public Health, Technology

Creating safer neighborhoods for healthier lifestyles

hoodWalking sounds like a simple path to maintaining a healthy weight if you can’t afford a gym membership. But what if your neighborhood isn’t a safe space to walk or jog, or for your kids to play? Abby King, PhD, and scientists from Stanford Prevention Research Center‘s Healthy Aging Research and Technology Solutions lab have been working with residents of North Fair Oaks, Calif., to understand which environmental factors contribute to or detract from a healthy-living environment.

Participants used a GPS-powered Stanford Healthy Neighborhood Discovery Tool to survey the streets where they lived and provide information about which areas most need improvement in order to facilitate physical activity. During 36-minute walks, the middle-school-aged and older-adult participants collectively provided 224 audio and video recordings of their environment.

The low-income community of North Fair Oaks comprises 73 percent Latino residents. An article in Salud America! Growing Healthy Change reports:

“There are a lot of issues and challenges in the area,” [Priscilla Padilla-Romero, MPH, a public health educator at the Fair Oaks Center and a study author] said. “New immigrants face substantial challenges on a daily basis such as high unemployment rates, and significant social stressors.” Additionally, [Lisa Goldman Rosas, PhD, MPH] mentioned that, “Many immigrants point out that their lifestyles were naturally more active in their countries of origin and when they move to the US they have to think about how to get more physical activity for the first time.”

Among the findings, the piece notes:

The features that were reported as being facilitators of physical activity by the greatest number of participants were:

  • Having amenities and destinations to walk to
  • The presence of good quality sidewalks
  • The presence of parks, playgrounds and crosswalks
  • The aesthetic feel of the neighborhood (for example, attractive plants and well maintained homes)

The features that were reported as being barriers to physical activity by the greatest number of participants were:

  • Poor quality sidewalks
  • Trash and illegal dumping
  • Personal safety

At a June meeting with county officials the study participants, termed “citizen scientists,” discussed which factors of their environment were the greatest barriers to physical activity, hoping to influence local policy and strengthen their community.

Previously: Moderate exercise program for older adults reduces mobility disability, study showsHelp from a virtual friend goes a long way in boosting older adults’ physical activity and What type of smartphone apps are effective for promoting healthy habits among older adults?
Photo by Jukie Bot

Cancer, Health and Fitness, Stanford News

The ride of his life: Local cyclist races across the country to benefit Stanford Cancer Institute

John Tarlton big

Menlo Park businessman John Tarlton is on the ride of his life, attempting to bike 3,000 miles across the country in 12 days. He’s competing in the Race Across America (RAAM), one of the world’s most extreme endurance events. RAAM originated in 1982 as four cyclists raced from the Santa Monica Pier to the Empire State Building.

“I have dreamed of competing in RAAM since childhood,” Tarlton told me by e-mail prior to the race. As of this post, he is more than halfway through, having biked more than 1,800 miles in about six and a half days.

Tarlton, 45, a lifetime cycling enthusiast, has been preparing for RAAM for several years. The RAAM course is nearly 50 percent longer than the Tour de France, though completed in about half the time. And unlike the Tour de France riders, who rest and refuel at their hotels each night, most RAAM riders can’t afford to sleep more than four hours a day, since every minute counts against the 12-day time limit. Eating presents an interesting challenge: Tarlton, a lean vegetarian, estimates he’ll need to consume 16,000 calories per day (and no, that’s not a typo!) during the race.

Like many RAAM riders and teams, Tarlton is using interest generated by this event to raise awareness and dollars for a cause – in this case, cancer, which has affected both his and his supports team’s families. Donations made in honor of Tarlton’s effort will support the Stanford Cancer Institute.

Since I mostly ride an indoor stationary bike with a TV screen affixed, I had a few questions for this ultra-driven athlete. Below are Tarlton’s answers provided by e-mail and lightly edited:

Describe your typical training day.

There really is no “typical” training day for me. Some days I only ride the bike for one hour, spend another hour weight training and then two hours doing recovery activities. Other days I will be on the bike for 14 hours straight.

What is the biggest challenge during the race?

It is hard to predict. Some years, there have been lightening storms that require riders to hide inside cars, while other years there are strong headwinds for extended periods of time. Our biggest challenge will be to adapt to whatever nature throws at us, in addition to any unexpected equipment failures, while sticking to our plan.

Besides finishing, what’s your goal for the race?

We hope to raise quite a bit of money for Stanford Cancer Institute. In all honesty, the goal of completing the race within the allotted 12 days is such an overarching goal, that any other athletic goals would pale in comparison.

Why did you choose to benefit the Stanford Cancer Institute (SCI)?

SCI is at the forefront of the cancer treatment effort, from cutting-edge primary research to new ways of focusing on the patient during recovery. My professional life revolves around buildings for life science research and commercialization. The partnership between Tarlton Properties and SCI seems a natural fit.

My family has been deeply affected by cancer and has strong ties to Stanford. My parents met in the Stanford Choir in 1954, and my father is a past president of Stanford Associates. My wife, Jenny Dearborn, graduated from the Stanford Teacher Education program; her father attended Stanford and her grandfather was a professor there.

Finally, Stanford doctors were central to the care of my mother and sister, as well as my crew chief’s wife, during their battles with cancer.

Continue Reading »

Complementary Medicine, Health and Fitness, In the News, Sports

How do you get through the NBA Finals? Practice, practice, practice (yoga)

How do you get through the NBA Finals? Practice, practice, practice (yoga)

LeBron JamesA student in a yoga class I attended in Berkeley, Calif. last Saturday asked the teacher about the origin of the Sanskrit chant we had just repeated. He explained that the words were the lyrics from the theme song to Battlestar Galactica. Inviting pop-culture references into the sometimes-serious space of the studio is a terrific way to normalize the complementary medicine practice. So is welcoming 6’8″, 250-pound athletes to an activity often stereotyped as being for the petite, female and flexible.

That is to say that LeBron James takes yoga. In case you somehow missed it, the Miami Heat star got sidelined by cramps near the end of Game 1 of the NBA Finals. A piece on Sports Illustrated‘s Point Forward describes how yoga played a role in James’ recovery and preparation for the next game of the series:

[Readying his body for Game 2] included, among a more extensive hydration regimen, James’ decision to attend a Sunday morning yoga class at the Heat’s team hotel in San Antonio.

“Yoga isn’t just about the body, it’s also about the mind and it’s a technique that has really helped me,” James told Brian Windhorst (then of the Cleveland Plain-Dealer) in 2009. “You do have to focus because there’s some positions that can really hurt you at times if you aren’t focused and breathing right.”

Upon his arrival in Miami, James also credited yoga for his supernatural level of endurance. Only Kevin Durant has logged more total minutes since James joined the Heat in 2011.

The piece notes that James’ teammate Dwayne Wade and the Heat’s playoffs opponents, the San Antonio Spurs, are among the other NBA affiliates who stand in Mountain Pose.

Previously: Third down and ommm: How an NFL team uses yoga and other tools to enhance players’ well-beingNIH to host Twitter chat on science of yoga and Expert argues that for athletes, “sleep could mean the difference between winning and losing”
Via Tiffany Russo Yoga
Photo by ASSOCIATED PRESS

Aging, Health and Fitness, Mental Health, Neuroscience

Depression, lifestyle choices shown to adversely affect memory across age groups

Depression, lifestyle choices shown to adversely affect memory across age groups

IMG_0140Have trouble remember where you put your keys? Forgetting the names of familiar faces? A lack of physical activity, depression, high blood pressure and a variety of other health factors could be to blame, according to findings recently published in PLOS ONE.

In the study, researchers at the University of California, Los Angeles and the Gallup organization surveyed more than 18,000 people about memory and lifestyle choices previously shown to increase the risk of Alzheimer’s disease and dementia. PsychCentral reports:

Depression, low levels of education, physical inactivity, and high blood pressure increased the likelihood of memory complaints in younger adults (ages 18–39), middle-aged adults (40–59), and older adults (60–99), the researchers found.

Depression was the strongest single risk factor for memory complaints in all age groups.

Having just one risk factor significantly increased the frequency of memory complaints, regardless of age, according to researchers. Memory complaints rose when the number of risk factors increased.

Overall, 20 percent of those polled had memory complaints, including 14 percent of younger adults, 22 percent of middle-aged adults, and 26 percent of older adults.

For younger adults, stress may play more of a role, and the ubiquity of technology — including the Internet and wireless devices, which can often result in constant multi-tasking — may impact their attention span, making it harder to focus and remember.

Researchers hope the findings, and follow-up studies, better identify how health choices made earlier on may impact cognitive function at a later age and lead to interventions to lower the risk of memory loss.

Previously: Newly identified protein helps explain how exercise boosts brain health, Exercise may protect aging brain from memory loss following infection, injury, Stanford biostatistician talks about saving your aging brain and Exercise may be effective in treating depression
Photo by bibliojojo

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