Tuesday, January 19, 2016

Too much exercise can be bad for your heart, two new studies have warned.
Research by German scientists found overdoing high intensity exercise may actually increase the risk of death from a heart attack or stroke in those with existing heart disease.
And a Swedish study, also published online in the journal Heart, suggests that young men undertaking endurance exercise for more than five hours a week may increase their risk of developing an irregular heart rhythm in later life.
The studies support research released yesterday which showed that young men who run marathons are more likely to need pacemakers in old age.
Both sets of new findings indicate that more does not always mean better when it comes to the health benefits of exercise, and raise questions about the intensity and duration of physical activity at different times of life.
In the German study, the researchers tracked the frequency and intensity of physical activity and the survival of more than 1,000 people with stable coronary artery heart disease for 10 years.
All the participants, most of whom were in their sixties, had attended a cardiac rehabilitation programme to help them exercise regularly and ward off a further heart attack or stroke.
Current guidance recommends that heart disease patients should do up to an hour of moderate intensity aerobic activity at least five times a week.
Around 40 per cent were physically active two to four times weekly, 30 per cent did more and 30 per cent did less. Overall, one in 10 said they rarely or never did any exercise.
After taking account of other influential factors, the most physically inactive were around twice as likely to have a heart attack or stroke as those who were regularly physically active. And they were around four times as likely to die of cardiovascular disease and all other causes.
However, surprisingly, researchers found those who did the most strenuous daily exercise were also more than twice as likely to die of a heart attack or stroke.
In the Swedish study, the researchers questioned more than 44,000 45 to 79-year-old men about their leisure time physical activity patterns at the ages of 15, 30, 50, and during the past year, when their average age was 60.
Their heart health was tracked for an average of 12 years from 1997 onwards to gauge how many developed an irregular heartbeat - a known risk factor for stroke.
The studies support research released yesterday which showed men who run marathons are more likely to need pacemakers in old age

They found that men who had exercised intensively for more than five hours a week were 19 per cent more likely to have developed the condition by the age of 60 than those exercising for less than one hour a week.
The level of risk rose to 49 per cent among those who did more than five hours of exercise a week at the age of 30, but who subsequently did less than an hour by the time they were 60.
However, those who cycled or walked briskly for an hour a day or more at the age of 60 were around 13 per cent less likely to develop an irregular heartbeat than those who did virtually no exercise at all.
Despite these findings, the researchers insist that exercising remains important for the health

Researchers suggest that this might be because the intensity of exercise is likely to be greater at the age of 30 than it is at the age of 60, so may have less extreme effects on the body.
Dr Lluis Mont, of the Hospital Clinic de Barcelona in Spain, said: ‘Maximum cardiovascular benefits are obtained if performed at moderate doses, while these benefits are lost with [very high] intensity and prolonged efforts.’
However, Dr Mont emphasised that not exercising at all is bad for our long term health, adding: ‘A thin line separates accurate information and unnecessary alarmism, leading to inactivity and consequent heart disease.
‘The benefits of exercise are definitely not to be questioned, on the contrary, they should be reinforced.
‘The studies, and future studies, will serve to maximise benefits obtained by regular exercise while preventing undesirable effects - just like all other drugs and therapies.’
Just yesterday another study revealed that running marathons can be bad for the heart.
Researchers at the University of Manchester found that people who take part in extreme sporting challenges when they are young are more likely to need pacemakers in old age.
Tests on mice, funded by the British Heart Foundation, showed microscopic changes take place in the body due to exercise training.
This can disrupt the electrical pulse of the heart, causing the super-fit to suffer abnormal heart rhythms.

Researchers, who analyzed data from a heart-health study of stroke-free older Americans, conclude that frequent and varied physical activity appears to protect against premature death. However, they found a higher risk of heart-related death among seniors who undertook frequent bouts of high intensity exercise.


The researchers suggest that older people who perform frequent and diverse exercise without high intensity can reduce the risk of premature death.
Ying Kuen Cheung, a professor in biostatistics at Columbia University's Mailman School of Public Health in New York, NY, and colleagues report their findings in the Journal of General Internal Medicine.
The team hopes the study will help healthcare providers give better, more specific advice to their older patients on how to stay active and healthy.
According to the American Heart Association, regular exercise has many health benefits for older people.
For example, it can help prevent bone loss and thus reduce the chances of fracture, and it lessens the risk of many aging-related diseases.
Regular exercise also increases muscle strength and can improve balance and coordination, which in turn reduces the risk of falls. It can help older people get up from a chair, do household chores, go out shopping, carry their bags, and generally maintain quality of life and independence.
For their study, Prof. Cheung and colleagues analyzed data on 3,298 stroke-free people from different ethnic groups who took part in the population-based Northern Manhattan Study (NOMAS).

Study looked at dimensions of physical activity

The team wanted to identify which dimensions of leisure-time physical activity might be linked to heart-related premature deaths in older people.
Fast facts about exercise for older people
  • Over 30 percent of Americans aged 65 and older report no leisure-time physical activity
  • Active people with chronic diseases are less likely to die prematurely than inactive people with these conditions
  • Older adults can work with healthcare providers to plan activities around limitations.
Learn more about exercise
The authors note that previous studies have mostly used overall measures - such as total energy counts - and not looked at specific dimensions of physical activity, such as frequency, variety, and intensity of exercise.
The NOMAS data includes information that helps to evaluate medical, socioeconomic and other risk factors relevant to heart health in a group of people with no history of stroke.
The average age of the participants when they signed up to the study during 1993-2001 was 69 years.
After enrollment, they took part in yearly telephone interviews. The median follow-up was 17 years.
Every year, the participants answered questions about general health, plus frequency, intensity, and types of leisure time physical activity.
Examples of activity included walking, jogging, cycling, gardening, yard work, aerobics, water sports, tennis, golf, and squash.

Frequent, varied, but not intense

From the data, the researchers were able to assess frequency, variety, and intensity of physical activity, and compare them with heart-related and non-specific deaths. For exercise intensity, they used a measure called energy-to-duration ratio (EDR).
The analysis found that higher frequency of activity was linked to reduced rates of heart-related deaths, but it showed no link to non-heart-related deaths.
It also showed higher variety of activity (high number of activity types) appeared to be beneficial in protecting against death from any cause.
However, the team found a high EDR - frequent bouts of high intensity exercise - was linked to higher risk of heart-related deaths.
"Performing frequent and diverse exercise without high intensity in an elderly population such as ours is achievable and can reduce the risk of death," says Prof. Cheung.
He says taking part in a large number of different activities can be more strongly linked to cardio-respiratory fitness. This could explain why they found variety of exercise appeared to have a protective effect across the board.
"Our findings thus suggest that high frequency of high intensity exercise may undo the benefits of frequent exercise in terms of cardiovascular mortality. Given the ease of participating in low intensity but daily leisure time physical activity, our findings suggest that this can be incorporated in current recommendations provided to older people."
Prof. Ying Kuen Cheung
Learn how laughter may boost physical activity and mental health in seniors.

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