A newly released study appearing in Clinical Cardiology examines the average fitness level of the morbidly obese (body mass indexes between 40.0 and 49.9). The findings show that the tested population was sedentary for more than 99 percent of the day and, on average, walked less than 2,500 steps per day - far below healthy living guidelines of 10,000 steps per day. The results provide important links between obesity, poor fitness and cardiovascular disease.
The study used a precise body sensor to continually measure physical activity, caloric expenditure and movement minute-by-minute over a 72-hour period within their home environments. Following collection of the data, structured cardiorespiratory fitness testing waccording toformed on each subject.
Most morbidly obese participants in the study were markedly sedentary. On average, 23 hours and 51.6 min per day were spent sleeping or engaged in sedentary activity and the remaining 8.4 minutes were spent in moderate activity. On average, subjects took 3,763 ± 2,223 steps.
The highest level of activity attained by any single individual during one 24-hour period was 28 minutes of moderate activity. No length of time was spent at a high level of activity for any of the individuals while under observation. Two individuals in this study spent the entire monitoring period in sedentary activity.
Obesity contributes to five of the top 10 diseases with the highest mortality rates: cardiovascular disease, stroke, diabetes, high blood pressure and cancer. Increasingly, new technologic advances encourage individuals to move less and expend fewer calories.
However, it has been shown that, despite being obese, individuals with moderate-to-high levels of cardiorespiratory fitness have cardiovascular death rates that are 71 percent lower than their unfit counterparts. Moreover, low cardiorespiratory fitness is an independent predictor of mortality in normal weight, overweight and obese individuals alike. Morbidly obese individuals, however, have severely reduced cardiorespiratory fitness that is similar to those with established systolic heart failure.
Despite the lack of moderate or vigorous physical activity in the studied population, lighter amounts of physical activity may yield significant health benefits. Even light walking in speeds of 1 to 2 miles per hour shows significant health benefits. Over time, increasing amounts of light physical activity may improve aerobic capacity and ultimately reduce mortality.
“Our findings have important implications for the relationship between obesity and physical activity,” say authors Thomas Vanhecke, Barry Franklin,Wendy Miller, Adam deJong, Catherine Coleman and Peter McCullough of William Beaumont Hospital. “Our findings will add incentive to increase physical fitness in this population and increase the awareness of healthcare professionals of the need for recommending physical activity in their patients”.
Posted by: Evelyn Source
Continue Reading March 26th, 2009
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Posted by: Evelyn Source
Continue Reading March 26th, 2009
Survivors of early-stage lung cancer who take part in regular physical activity have a better quality of life, as per a research studyin the recent issue of the journal Cancer Epidemiology Biomarkers and Prevention, available online now. Patients who are more physically active report better mood, more vigor, and greater physical functioning, the study shows.
“The take-home message is that early-stage lung cancer survivors appears to benefit, both mentally and physically, from simple moderate exercise,” says the paper’s main author Elliot Coups, Ph.D., associate member of Fox Chase Cancer Center’s faculty and a participant in the Fox Chase Keystone Program in Cancer Risk and Prevention. “Of course, we’re generally not talking marathons here, but smaller, everyday forms of activity like going for a brisk walk several times a week”.
Lung cancer is the leading cause of cancer-related mortality in the United States, as per the American Cancer Society, and the disease tends to strike elderly adults who have a history of smoking. Coups and colleagues studied patients diagnosed with early-stage, non-small cell lung carcinomas. These individuals have a five-year survival rate of nearly 50 percent, in comparison to three percent for those diagnosed with metastatic lung cancer.
“With early detection and therapy, more people may live longer following surgery for early-stage lung cancer,” Coups says. “For these individuals, the act of surviving cancer will follow them the rest of their days, and we are interested in understanding what we can do to promote their overall health and well-being”.
Coups and colleagues at Fox Chase and Memorial Sloan-Kettering Cancer Center followed 175 people who had completed surgical therapy for early-stage non-small cell lung cancer within the prior six years. On average, patients were about 68 years old at the time of the study and did not currently have cancer. Patients were asked to estimate their level of physical activity six months before the diagnosis of non-small cell lung cancer, during the six months following surgery and their current activity levels. The survey included standardized questionnaires to assess quality of life in terms of a patient’s physical, mental and social well-being.
Approximately one in four participants met physical activity guidelines, which call for about 60 minutes each week of strenuous activity, such as jogging, or 150 minutes of moderate exercise, such as walking briskly. Overall, the level of activity for survey participants was comparable to that of the population at large for their age group, Coups says.
Coups and colleagues also observed that those participants who met the guidelines reported fewer depressive symptoms, greater vitality, and less shortness of breath when in comparison to their more sedentary counterparts.
“Unfortunately, we see that most lung cancer survivors do not meet guidelines set for physical activity, particularly in the six months following surgery,” Coups says. “While it is certainly understandable that people might not be able to exercise as vigorously as they had done before lung surgery, our study suggests that healthcare providers ought to discuss the potential benefits of moderate physical activity among early-stage lung cancer survivors as a means of increasing their quality of life”.
Posted by: Evelyn Source
Continue Reading February 4th, 2009
Patients with abnormal diastolic function (when the heart is relaxed and expanded) in the left ventricle of the heart have a substantially lower maximum capacity for exercise, as per a research studyin the January 21 issue of JAMA
A number of factors, including age, female sex, body mass index and co-existing medical conditions are known to be linked to a decrease in exercise capacity. Identifying potentially reversible mechanisms underlying the decline in maximum exercise capacity could have important implications. Some research has suggested that assessing left ventricular (one of four chambers in the heart) function could be used to predict exercise capacity, as per background information in the article.
Jasmine Grewal, M.D., of Mayo Clinic, Rochester, Minn., and his colleagues conducted a study to examine the relationship between left ventricular diastolic function and exercise capacity. The study included 2,867 patients undergoing exercise echocardiography (a noninvasive diagnostic procedure that uses ultrasound to study the structure and motions of the heart) with routine measurements of left ventricular systolic (contraction of the heart) and diastolic function. Analyses were conducted to determine the strongest correlates of exercise capacity and the age and sex interactions of these variables with exercise capacity.
The scientists observed that diastolic dysfunction (impaired relaxation) was strongly and inversely linked to exercise capacity. Compared with normal function, those with resting diastolic dysfunction had substantially lower exercise capacity. Variation of left ventricular systolic function within the normal range was not linked to exercise capacity.
Other independent correlates of exercise capacity were age, female sex, and body mass index greater than 30. Compared with those with normal diastolic function, patients with diastolic dysfunction had a progressive increase in the magnitude of reduction in exercise capacity with advancing age.
“In identifying diastolic function parameters as strong correlates of exercise capacity, we have identified potentially modifiable and preventable factors in the development of exercise intolerance. It is well known that exercise training improves diastolic function in healthy individuals ,” the authors write.
Posted by: Evelyn Source
Continue Reading January 21st, 2009
New evidence in mice bolsters the notion that a version of a gene earlier shown to protect lean people against weight gain and insulin resistance can have the opposite effect in those who eat a high-fat diet and are heavier, reveals a report in the January 7th issue of the journal Cell Metabolism, a Cell Press publication.
The findings suggest that the 12 percent of people who carry the so-called Ala12 version of the gene that serves as a master controller of fat differentiation will be more sensitive than most to the amount of fat in their diets. (That fat-moderating gene is called peroxisome proliferator-activated receptor gamma isoform 2, or Pparg2.).
The Ala12 gene variant in question is less active and less efficient in driving fat cells’ formation than the more common Pro12 version, the scientists explained. As a result, individuals carrying Ala12 are generally less obese and more sensitive to insulin, but that can change if they shift to a less sensible, fat-laden meal plan.
Genetic testing for the variant might therefore be used as a diagnostic tool, said Johan Auwerx of Universit Louis Pasteur in France and the Ecole Polytechnique Fdrale de Lausanne in Switzerland. “Through dietary counseling, carriers could be informed that they really need to watch out for high fat in their diets,” he said.
The findings also raise a potential caution about the long-term effects of drugs called thiazolidinediones (TZDs) now in use for the therapy of diabetes, he added. Those drugs stimulate activity of the Pparg2 receptor. The findings suggest it appears to be betterat least in some settingsto have a less active receptor.
Auwerx’s team first described the Ala12 version of Pparg2 about 10 years ago when they found in a Finnish and a Japanese American population living in Hawaii that the mutation lowered the risk of diabetes. Others tried to reproduce the findings in Americans to no avail. Indeed, the Americans in the followup study, who were generally heavier than the groups Auwerx had examined earlier, showed the exact opposite pattern.
That led to the idea that effects of the gene might somehow be sensitive to initial body weight, but an animal study was needed to sort out the underlying details.
The scientists now show that mice with two copies of the Ala12 variant, when fed a balanced diet of normal mouse chow, are leaner and have improved insulin sensitivity and better plasma lipid profiles than mice with two copies of Pro12. They also live longer.
When mice with the same genetic background were instead sustained on a diet high in fat, those benefits disappeared. In fact, those Ala12 animals grew somewhat more obese than mice with the more common Pro12 variant of the gene, though not significantly so.
The result shows an important interaction between the Pparg2 gene and the environment, they report. The underlying basis for the effect seems to depend on changes in the way the Pparg2 receptor interacts with its cofactors and in its sensitivity to a fat-produced hormone known as adiponectin, which influences blood sugar control and fatty acid breakdown.
” Collectively, our results establish the diet-dependent influence of Pparg2 Pro12Ala variant on metabolic control via modulated cofactor interaction and changes in gene expression patterns in mice,” the scientists concluded. “These data hence consolidate Pparg2 as an important factor at the interface between genes and the environment and may provide avenues to better, possibly Pro12Ala genotype-dependent therapy strategies for insulin resistance in type 2 diabetes and the metabolic syndrome”.
Posted by: Evelyn Source
Continue Reading January 7th, 2009
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