Exercise, Health & You: How Much Is Enough?

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Re: Exercise, Health & You: How Much Is Enough?

Postby JeffN » Wed Nov 16, 2022 11:20 am

Original Investigation Nutrition, Obesity, and Exercise
September 3, 2021

Steps per Day and All-Cause Mortality in Middle-aged Adults in the Coronary Artery Risk Development in Young Adults Study

https://jamanetwork.com/journals/jamane ... le/2783711

JAMA Netw Open. 2021;4(9):e2124516. doi:10.1001/jamanetworkopen.2021.24516

Key Points
Question Are step volume or intensity associated with premature mortality among middle-aged Black and White women and men?

Findings In this cohort study of 2110 adults with a mean follow-up of 10.8 years, participants taking at least 7000 steps/d, compared with those taking fewer than 7000 steps/d, had a 50% to 70% lower risk of mortality. There was no association of step intensity with mortality regardless of adjustment for step volume.

Meaning This cohort study found that higher daily step volume was associated with a lower risk of premature all-cause mortality among Black and White middle-aged women and men.

Abstract
Importance Steps per day is a meaningful metric for physical activity promotion in clinical and population settings. To guide promotion strategies of step goals, it is important to understand the association of steps with clinical end points, including mortality.

Objective To estimate the association of steps per day with premature (age 41-65 years) all-cause mortality among Black and White men and women.

Design, Setting, and Participants This prospective cohort study was part of the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants were aged 38 to 50 years and wore an accelerometer from 2005 to 2006. Participants were followed for a mean (SD) of 10.8 (0.9) years. Data were analyzed in 2020 and 2021.

Exposure Daily steps volume, classified as low (<7000 steps/d), moderate (7000-9999 steps/d), and high (≥10 000 steps/d) and stepping intensity, classified as peak 30-minute stepping rate and time spent at 100 steps/min or more.

Main Outcomes and Measures All-cause mortality.

Results A total of 2110 participants from the CARDIA study were included, with a mean (SD) age of 45.2 (3.6) years, 1205 (57.1%) women, 888 (42.1%) Black participants, and a median (interquartile range [IQR]) of 9146 (7307-11 162) steps/d. During 22 845 person years of follow-up, 72 participants (3.4%) died. Using multivariable adjusted Cox proportional hazards models, compared with participants in the low step group, there was significantly lower risk of mortality in the moderate (hazard ratio [HR], 0.28 [95% CI, 0.15-0.54]; risk difference [RD], 53 [95% CI, 27-78] events per 1000 people) and high (HR, 0.45 [95% CI, 0.25-0.81]; RD, 41 [95% CI, 15-68] events per 1000 people) step groups. Compared with the low step group, moderate/high step rate was associated with reduced risk of mortality in Black participants (HR, 0.30 [95% CI, 0.14-0.63]) and in White participants (HR, 0.37 [95% CI, 0.17-0.81]). Similarly, compared with the low step group, moderate/high step rate was associated with reduce risk of mortality in women (HR, 0.28 [95% CI, 0.12-0.63]) and men (HR, 0.42 [95% CI, 0.20-0.88]). There was no significant association between peak 30-minute intensity (lowest vs highest tertile: HR, 0.98 [95% CI, 0.54-1.77]) or time at 100 steps/min or more (lowest vs highest tertile: HR, 1.38 [95% CI, 0.73-2.61]) with risk of mortality.

Conclusions and Relevance This cohort study found that among Black and White men and women in middle adulthood, participants who took approximately 7000 steps/d or more experienced lower mortality rates compared with participants taking fewer than 7000 steps/d. There was no association of step intensity with mortality.
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Re: Exercise, Health & You: How Much Is Enough?

Postby JeffN » Mon May 22, 2023 11:30 am

ARTICLE

Washington Post
When too much exercise is bad for your heart
By Gretchen Reynolds
May 17, 2023

https://www.washingtonpost.com/wellness ... -exercise/

New research of nearly 1,000 long-time endurance athletes found that heavy training may contribute to an increased chance of developing atrial fibrillation.

Exercise is, without question, good for our hearts. But can we potentially get too much of a good thing?

A growing body of science, including a new report of the health of almost 1,000 longtime runners, cyclists, swimmers and triathletes, finds that years of heavy endurance training and competition may contribute to an increased chance of developing atrial fibrillation, especially in men.

Atrial fibrillation, or AFib as it’s commonly called, is an irregular heart beat that can lead to blood clots and a higher risk of stroke.



ORIGINAL RESEARCH

The AFLETES Study: Atrial Fibrillationin Veteran Athletes and the Risk of Stroke
Clinical Journal of Sport Medicine 33(3):p 209-216, May 2023. | DOI: 10.1097/JSM.0000000000001115
FREE

https://journals.lww.com/cjsportsmed/Fu ... ran.2.aspx

Abstract
Objectives:
Endurance athletes are at an increased risk of atrial fibrillation (AF) when compared with the general population. However, the risk of stroke in athletes with AF is unknown.

Design and Setting:
We aimed to assess this risk using an international online survey.

Patients:
Individuals that had competed in ≥1 competitive events and were ≥40 years old were included.

Interventions:
Self-reported demographic, medical history, and training history data were collected, and a CHA2DS2-VASc was calculated.

Main Outcome Measures:
Binary logistic regression was used to assess variables associated with AF and stroke.

Results:
There were 1002 responses from participants in 41 countries across Africa, Asia, Australasia, Europe, and North and South America, and 942 were included in the final analysis. The average age was 52.4 ± 8.5 years, and 84% were male. The most common sports were cycling (n = 677, 72%), running (n = 558, 59%), and triathlon (n = 245, 26%). There were 190 (20%) individuals who reported AF and 26 individuals (3%) who reported stroke; of which, 14 (54%) had AF. Lifetime exercise dose [odds ratio (OR), 1.02, 95% confidence interval (95% CI),1.00-1.03, P = 0.02] and swimming (OR, 1.56, 95% CI, 1.02-2.39, P = 0.04) were associated with AF in multivariable analysis, independent of other risk factors. Atrial fibrillation was associated with stroke (OR, 4.18, 95% CI, 1.80-9.72, P < 0.01), even in individuals with a low (0/1) CHA2DS2-VASc score (OR, 4.20, 95% CI, 1.83-9.66, P < 0.01).

Conclusions:
This survey provides early evidence that veteran endurance athletes who develop AF may be at an increased risk of developing stroke, even in those deemed to be at low risk by CHA2DS2-VASc score.
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Re: Exercise, Health & You: How Much Is Enough?

Postby JeffN » Fri Jul 14, 2023 9:14 am

Lifelong endurance exercise and its relation with coronary atherosclerosis
European Heart Journal, Volume 44, Issue 26, 7 July 2023, Pages 2388–2399,

https://doi.org/10.1093/eurheartj/ehad152
Published: 06 March 2023

Full Text
https://academic.oup.com/eurheartj/arti ... ogin=false

Abstract

Aims
The impact of long-term endurance sport participation (on top of a healthy lifestyle) on coronary atherosclerosis and acute cardiac events remains controversial.

Methods and results
The Master@Heart study is a well-balanced prospective observational cohort study. Overall, 191 lifelong master endurance athletes, 191 late-onset athletes (endurance sports initiation after 30 years of age), and 176 healthy non-athletes, all male with a low cardiovascular risk profile, were included. Peak oxygen uptake quantified fitness. The primary endpoint was the prevalence of coronary plaques (calcified, mixed, and non-calcified) on computed tomography coronary angiography. Analyses were corrected for multiple cardiovascular risk factors. The median age was 55 (50–60) years in all groups. Lifelong and late-onset athletes had higher peak oxygen uptake than non-athletes [159 (143–177) vs. 155 (138–169) vs. 122 (108–138) % predicted]. Lifelong endurance sports was associated with having ≥1 coronary plaque [odds ratio (OR) 1.86, 95% confidence interval (CI) 1.17–2.94], ≥ 1 proximal plaque (OR 1.96, 95% CI 1.24–3.11), ≥ 1 calcified plaques (OR 1.58, 95% CI 1.01–2.49), ≥ 1 calcified proximal plaque (OR 2.07, 95% CI 1.28–3.35), ≥ 1 non-calcified plaque (OR 1.95, 95% CI 1.12–3.40), ≥ 1 non-calcified proximal plaque (OR 2.80, 95% CI 1.39–5.65), and ≥1 mixed plaque (OR 1.78, 95% CI 1.06–2.99) as compared to a healthy non-athletic lifestyle.


Conclusion
Lifelong endurance sport participation is not associated with a more favourable coronary plaque composition compared to a healthy lifestyle. Lifelong endurance athletes had more coronary plaques, including more non-calcified plaques in proximal segments, than fit and healthy individuals with a similarly low cardiovascular risk profile. Longitudinal research is needed to reconcile these findings with the risk of cardiovascular events at the higher end of the endurance exercise spectrum
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