Women may get more from exercise than men do

Women who exercise regularly have a significantly lower risk of an early death or fatal cardiovascular event than men who exercise regularly, even when women put in less effort, according to a National Institutes of Health-supported study.

The findings, published in the Journal of the American College of Cardiology, are based on a study involving more than 400,000 U.S. adults ages 27 to 61. The study showed that over a two-decades period, women were 24 percent less likely than those who don’t exercise to experience death from any cause, while men were 15 percent less likely. Women also had a 36 percent reduced risk for a fatal heart attack, stroke, or other cardiovascular event, while men had a 14 percent reduced risk.  

“We hope this study will help everyone, especially women, understand they are poised to gain tremendous benefits from exercise,” said Dr. Susan Cheng, a cardiologist for the Erika J. Glazer Women’s Cardiovascular Health and Population Science in the Smidt Heart Institute at Cedars-Sinai in Los Angeles. “It is an incredibly powerful way to live healthier and longer. Women on average tend to exercise less than men, and hopefully these findings inspire more women to add extra movement to their lives.”    

The researchers found a link between women experiencing greater reduced risks for death compared to men among all types of exercise. This included moderate aerobic activity, such as brisk walking; vigorous exercise, such as taking a spinning class or jumping rope; and strength training, which could include body-weight exercises.

Scientists found that for moderate aerobic physical activity, the reduced risk for death plateaued for both men and women at 300 minutes, or five hours, per week. At this level of activity, women and men reduced their risk of premature death by 24 percent and 18 percent, respectively. Similar trends were seen with 110 minutes of weekly vigorous aerobic exercise, which correlated with a 24 percent reduced risk of death for women and a 19 percent reduced risk for men.

Also, women also achieved the same benefits as men but in shorter amounts of time. For moderate aerobic exercise, they met the 18 percent reduced risk mark in half the time needed for men–140 minutes, or under 2.5 hours per week, compared to 300 minutes for men. With vigorous aerobic exercise, women met the 19 percent reduced risk mark with just 57 minutes a week, compared to 110 minutes for men.

This applied to weekly strength training, too. Women and men who participated in strength-based exercises had a 19 percent and 11 percent reduced risk for death, respectively, compared to those who didn’t do these exercises. Women who strength-trained saw an even greater reduced risk of cardiovascular-related deaths at 30 percent, compared to 11 percent for men. 

For all the health benefits of exercise for both groups, however, only 33 percent of women and 43 percent of men in the study met the standard for weekly aerobic exercise, while 20 percent of women and 28 percent of men completed a weekly strength training session.

“Even a limited amount of regular exercise can provide a major benefit, and it turns out this is especially true for women,” said Cheng. “Taking some regular time out for exercise, even if it’s just 20 to 30 minutes of vigorous exercise a few times each week, can offer a lot more gain than they may realize.”

“There is no singular approach for exercise,” said Eric Shiroma, Sc.D., a program director in the Clinical Applications and Prevention branch at the National Heart, Lung, and Blood Institute (NHLBI). “A person’s physical activity needs and goals may change based on their age, health status, and schedule. But the value of any type of exercise is irrefutable.”

The study authors said multiple factors, including variations in anatomy and physiology, may account for the differences in outcomes between the sexes. For example, men often have increased lung capacity, larger hearts, more lean-body mass, and a greater proportion of fast-twitch muscle fibers compared to women. As a result, women may use added respiratory, metabolic, and strength demands to conduct the same movement and in turn reap greater health rewards.

The Physical Activity Guidelines for Americans recommend adults get at least 2.5 to 5 hours of moderate-intensity exercise or about 1 to 2.5 hours of vigorous exercise each week, or a combination of both, and participate in two or more days a week of strength-based activities.

The National Heart, Lung, and Blood Institute is part of the National Institutes of Health. The latter is the the nation’s medical research agency and a component of the U.S. Department of Health and Human Services.

Regular memory screenings are an important early detection tool of potential memory problems and should be part of everyone’s health and wellness routine.

That’s a reminder from the Alzheimer’s Foundation of America (AFA), which offers free, confidential memory screenings every weekday through secure videoconference technology, with no minimum age or insurance prerequisites. Appointments can be scheduled at 866-232-8484 or alzfdn.org.

“Memory screenings are important for everyone, even if they aren’t currently experiencing memory problems. Just as with other facets of health, early detection of potential memory issues is critically important,” said Charles Fuschillo Jr., AFA’s president.

He said the screenings are simple, quick, and non-invasive, and consist of a series of questions to gauge memory and other cognitive functions. Any device with an Internet connection can be used for the videoconference.  

Memory screenings are similar to other routine health screenings, such as those for blood pressure, cholesterol, and skin checks. Results aren’t a diagnosis of any particular condition, but can suggest if someone should see a physician for a full evaluation.

Many types of conditions can cause memory issues, including treatable or curable conditions such as vitamin deficiencies, thyroid disorders, urinary tract infections, sleep apnea, stress, anxiety, and depression.

Even in the case of a dementia-related illness such as Alzheimer’s, early detection can help start treatments to slow the symptoms, take advantage of community services such as support groups and therapeutic programming  aimed at helping maximize quality of life, and help give people a greater say in making decisions about their  legal, financial, and healthcare situations.

By Jack Huber

A recent study found that the risk of dementia was higher and associated with adults in their 50s and 60s with a sleep duration of less than six hours. This emphasizes the importance for older adults to not only be screened for sleep disorders, but also to maintain and improve their sleep quality.

Between 40 percent and 70 percent of older adults have chronic sleep issues, but up to half go undiagnosed. Sleep disordered breathing, a potentially serious sleep disorder in which breathing repeatedly stops and starts, affects 22 million Americans; and 80 percent of the cases of moderate and severe obstructive sleep apnea, the repeated collapse or partial collapse of the upper airway, go undiagnosed.

Airway stents may be the answer for healthcare providers seeking to not only help optimize sleep for older patients, but also shift away from treating sleep issues with sedatives due to their addictive nature and side-effects, such as impaired memory and focus. 

Aging increases body fat and reduces total body water and plasma proteins, resulting in increased drug elimination half-life and the potential risk of adverse effects. For this reason, older adults should be treated first with non-pharmacological options before using pharmacological options.

Non-pharmacological approaches include relaxation techniques, improving sleep hygiene and cognitive behavioral therapy. These options can be effective even for older adults with cognitive impairment. For proper sleep hygiene, individuals should avoid daytime naps, maintain a regular sleep schedule, limit substances such as caffeinated beverages, nicotine and alcohol, and exercise at least six hours before bedtime.

Common among older people, sleep disorder breathing (SDB) can lead to cognitive impairment, mood changes, compromised quality of life (often attributed to reduced social functioning and vitality), higher risk of stroke and comorbidities, with up to 50 percent of patients with mild symptomatic chronic heart failure having SDB.

One study found that older adults with untreated severe SDB had increased all-cause mortality. Additional outcomes of particular interest in older people may include glaucoma, falls with fractures, impaired quality of life, decreased pain tolerance, frailty, and mortality.

Untreated obstructive sleep apnea (OSA) can lead to high blood pressure, congestive heart failure, atrial fibrillation, stroke, and other cardiovascular problems. This disorder is also associated with Type 2 diabetes and depression, and is a factor in a large number of traffic accidents due to persistent drowsiness.

Treatments

Treatments for breathing issues include weight loss, smoking cessation and increased cardiovascular exercise, enhanced sleep opportunity and environment, optimized medical management of comorbidities, and reduction in caffeine, alcohol and sedatives.

Continuous positive airway pressure (CPAP) therapy is a common treatment for OSA. CPAP pushes air into the airways to keep them open with a pump that controls airflow, a tube carrying air from the machine to the user, and a mask that goes over the mouth, nose or both. Typical problems with CPAP, however, include discomfort, leaky mask, trouble falling asleep, stuffy nose, and a dry mouth. Other treatments include oral appliances, surgery and sleep aid devices.

The most effective sleep-aid devices support natural nasal breathing, which is essential for optimal health because they filter, warm and humidify inhaled air. This protects the lungs, leads to better oxygen supply to the body, stimulates the calming nervous system, and reduces snoring and SDB. All of these factors contribute to a stronger immune system and improve quality of life.

Among the most promising sleep-aid devices, innovative stent-based therapies not only support healthy, natural nasal breathing, but also enhance physical performance, mitigate symptoms of chronic sinusitis and other quality-of-life conditions such as allergies, rhinitis, chronic rhinitis, sinusitis, allergic rhinitis, and many autoimmune diseases.

Stents can be worn comfortably for up to 18 hours at a time for optimal breathing, transform unhealthy sleep patterns, improve nasal breathing to increase oxygen supply, and result in more relaxing sleep.

Healthcare providers should look for airway stents that have been clinically tested for treatment of patients struggling with OSA and snoring and designed to support healthy, natural nasal breathing at night and during the day.

Jack Huber is president of Alaxo Airway Stents.

By Brandy Minks

Exercise for many people is a challenge because of limited mobility. Excess weight can be restraining and joint issues, decreased muscle mass and low endurance can be limiting factors to exercise. Reliance on a cane, walker or wheelchair may also restrict the number or types of activities you can perform.

The goal of exercise is ideally to improve “functional fitness,” or training for the daily activities of life. However, even if you struggle with mobility, there are ways to incorporate functional fitness training into your life.

Focus on these three areas to improve functional fitness:

  • Aerobic capacity refers to how much endurance you have when it comes to activities such as walking, climbing stairs, washing yourself, getting dressed, etc. These activities can increase your heart rate and breathing. When we lack aerobic capacity, daily activities seem harder and make us tire easily. By building up aerobic capacity through regular exercise, activities become easier and we have better quality of life.
  • Muscular strength refers to the strength of your muscles and whether your endurance is adequate enough to complete daily activities without problems. For example, think about whether it is difficult for you to brush your hair or push yourself up from a chair. If these activities are hard for you (or you require assistance), increasing your muscular strength and endurance will help you do these activities with ease.
  • Range of motion/flexibility refers to the ability to move our bodies in ways that allow us to do activities with minimal pain. Ask yourself: Can I reach behind my head to brush my hair? Can I stretch to tie my shoes or put on socks? Having good flexibility allows us to do daily activities effortlessly.

To increase aerobic capacity, start with simple seated exercises. You can do these on your own or in a class. Any movement that causes your heart rate and breathing to increase will work. Take breaks as you need them. Start off slowly and increase the time you exercise by a minute or two every day.

To increase muscular endurance and flexibility, practice the following exercises while seated in a chair 5–10 times. These exercises mimic activities we do every day:

  • Reach for it. Bend slightly forward at your hips and hold your arms straight out in front of you.
  • Pick it up. Pull a backpack or bag from the floor onto your lap. Then pull it up higher and hold it to your chest. You can add items to the bag to make this harder.
  • Push it. Push yourself up from your chair using your arms and legs and sit back down. Make your legs do most of the work.
  • Pull it. Reach your arms straight out in front of you. Pull your elbows back and pinch your shoulder blades together. You can do this with weights to make it harder.
  • Carry it. Carry your bag or backpack from one spot to another.

Brandy Minks, who has masters degrees in nutrition and exercise physiology, works for MultiCare Health System’s Center for Weight Loss and Wellness.