Fighting depression with exercise

Many children and adolescents suffer from clinical depression. That is why experts have recently come up with guidelines that recommended routine screening for depression in the younger segment of the population. The guidelines also recommended psychotherapy or psychotropic drugs or both in the management of clinical depression in adolescents. But aren’t there other ways - especially non-pharmacological approaches to manage depression?

Researchers at the Medical College of Georgia looked at the effect of exercise on depressive kids. The participants were 207 weight children aged 7 to 11 years old. The participants were tested for depressive symptoms using the Reynolds Child Depression scale as well as the Self-Perception Profile for Children, a test which measures childrens’ perception of themselves before (at baseline) and after the study. The children were randomly assigned to three different physical exercise regime which lasted for 13 weeks

• Group one: a “low-dose” exercise group which was physically active20 minutes each day
• Group two: a “high-dose” exercise group which was physically active for 40 minutes each day
• Group three: a control group which consisted of sedentary children.

Exercises consisted of activities which were fun but maximized for intensity and designed so that the participants’ heart rates exceeded more than 150 beats per minute.

The study results showed that depressive symptoms improved significantly with increasing exercise time even though no noticeable weight increase was observed. It seems that exercise has a positive impact on the children’s self-esteem. However, this positive effect was only observable in white but black participants.

Physical activity has been shown to greatly help in managing depression in adults. In patients who suffered from stroke or cardiac events, exercise helps in improving health outcomes. In patients with primarily clinical depression, exercise leads to release of the hormone endorphin which induces positive feeling. The study results here suggest that physical exercise can positively affect children’s self-worth should therefore be considered as intervention against depressive symptoms.

This is very relevant considering the results of another study last year which showed that American children take more psychotropic medications that their counterpart in Western Europe. Comparing the US with two European countries, the annual prevalence of use of psychotropic medications is:

• US  - 6.7%
• The Netherlands - 2.9%
• Germany - 2.0%

The most common of these psychotropic drugs were antidepressants and stimulants and there was a tendency for multiple drug therapy among US kids. There is some indication that Europeans tend to use alternative ways of managing depression - including exercise.

               

A therapy to get osteoarthritis patients moving

Physical exercise is essential in maintaining joint health and in managing symptoms of osteoarthritis. But it doesn’t feel like it, as many arthritis patients would attest, making performance of simple daily activities challenging, much less compliance with prescribed exercise routines.

But a new type of therapy, the so-called activity strategy training might just be the help that patients with osteoarthritis of the hip and knee.

This is based on a study conducted by researchers at the University of Michigan Health System.

Taught by occupational therapists, this structured rehabilitation program is designed to educate patients about joint protection, proper body mechanics, activity pacing, and environmental barriers. For example, patients with joint pain caused by osteoarthritis learn techniques for walking around the house or outdoors, or even getting in and out of a car.

The study compared two strategies: the commonly prescribed regular exercise and health education sessions vs the activity strategy training (AST) plus regular exercise. The outcomes showed that AST was more effective in increasing and maintaining physical activity in osteoarthritis patients. The difference between the two strategies is probably that AST is more customized to the patients’ needs while structured exercise is not. Furthermore, AST addresses barriers to physical activity that may be specific to certain communities or environment, such as those found in senior homes, for example.

Osteoarthritis is “a degenerative disease that causes the breakdown of the cartilage in joints. Activity strategy training, however, is not commonly prescribed to patients with hip or knee osteoarthritis… Most physical activity programs for these patients only offer structured exercise, which has been shown to have short-term positive effects on arthritis pain and physical disability. But these effects usually fade soon after participation in the program ends.”

The researchers went on to urge osteoarthritis patients to take a proactive role in their therapy. According to lead author Susan L. Murphy

“People with osteoarthritis need to be their own agents of change. They can do so much to manage symptoms and stave off functional decline caused by osteoarthritis just by being physically active. The bottom line is to find ways to help people create and maintain these healthy habits.”

 

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Physical activity helps reduce memory decline

This study by psychologists at the University of Illinois at Pittsburg is not directly related to Alzheimers and dementia but it does tell us about how to keep our spatial memory functioning even at an advanced age.

The hippocampus is a curved structure deep inside the medial temporal lobe of the brain, is essential to memory formation. And for this part of the brain, size does matter. The bigger your hippocampus is, the better is your ability to store new experiences and the better is your spatial memory skills. A damage hippocampus however, prevents an individual to form new memories, as in the well-known case of Henry Gustav Molaison (also known as HM or Henry Right Now) who suffered from retrograde amnesia.

Certain activities make the size of the hippocampus bigger in some people and smaller in others.

For example, a study of London taxi drivers found that the posterior portion of the hippocampus was larger in experienced taxi drivers than in other subjects. And a study of German medical students found that the same region of the hippocampus increased in size as they studied for their final exams.

The size of the hippocampus, however, decreases with age, and with it certain brain functioning. The deterioration of spatial and relational memory in the elderly is one of the major causes of loss of independence and disorientation.

The shrinkage of the hippocampus, however, varies from one individual to another and the researchers found that one way of keeping the hippocampus- and thus memory skills fit is through physical exercise.

This has been observed before in laboratory studies using rodents. The University of Illinois researchers looked at 165 adults aged 59 to 81 years old. 65% of the participants were females. The researchers measured the cardiorespiratory fitness of the participants and conducted a volumetric analysis of the subjects’ left and right hippocampi using magnetic resonance imaging (MRI). The participants’ spatial reasoning was also tested.

The study results revealed that there is a significant link between an individual’s physical fitness and his or her performance in spatial memory tests as well as the size of his or her hippocampus. The size of the hippocampus in physically fit adults accounts for about 40% of their advantage in spatial memory.

According to lead researcher Kirk Erickson

“This is really a clinically significant finding because it supports the notion that your lifestyle choices and behaviors may influence brain shrinkage in old age. Basically, if you stay fit, you retain key regions of your brain involved in learning and memory.”

We all the benefits of exercise to our cardiovascular health. This study gives me another reason to leave my desk and go for a run in the early spring rain.

 

Photo credit: stock.xchng

               

It’s not the weather, it’s your lifestyle

Winter time is a difficult time for many people. It’s cold, dark, and gloomy. No wonder winter is associated with high incidence of depression.

Currently available data indicate that depressed individuals have a 50% higher risk for cardiovascular disease than those without psychological problems. Guidelines issued by American Heart Association (AHA) and endorsed by the American Psychiatric Association recommend that cardiac patients be routinely screened for depression. In addition, treatment of depression is commonly addressed during cardiac rehabilitation. In related previous posts, depression among heart patients were shown to be best tackled with a combination of psychotherapy and physical exercise.

But - we cannot blame the weather for everything. Researchers at the University of College London report that the wrong lifestyle leads to psychological distress, which in turn result in increased risk for cardiovascular disorders. In addition, the findings of the current study “suggest that treating psychological stress on its own might not be the best approach to reducing the risk of cardiovascular disease.”

The study used data from the Scottish Health Survey (SHS) which followed up 6576 adults aged 30 years and above fo7 seven years (on the average). The researchers measured psychological distress as well as behavioral and pathophysiological risk factors. The measurements were based on the General Health Questionnaire (GHQ-12), an assessment tool which basically looked at general levels of happiness, depression and anxiety, and sleep disturbances.

The results showed that

“…behavioral factors, including smoking, physical activity, and alcohol consumption, accounted for 65% of the relationship between psychological distress and cardiovascular disease risk. An additional 19% of the association was explained by pathophysiological risk factors, such as hypertension and C-reactive protein (CRP).”

The role of smoking and physical activity seems especially significant. People who were stressed of psychologically distressed tended to be smokers who little or no exercise at all. “These two factors alone explain well over 50% of the association between distress and cardiovascular risk.” Surprisingly, alcohol explained only a small part of the psychological distress - cardiovascular risk link.

The study results indicate the association between psychological distress and cardiovascular risk can be largely explained by behaviour and lifestyle factors, in this case, cigarette smoking and physical activity.

If your goal is to treat mental illness for the purposes of reducing cardiovascular risk, you need to take a fairly broad approach and not just look at the psychological components,” lead investigator Dr Mark Hamer (University College London, UK) told heartwire. “You need to also look at the behavioral risk factors as well, with a particular emphasis on physical activity and smoking cessation.”

Now that we are about to enter the New Year, maybe it’s time to reflect on our lifestyle. Is there anything we can change for the better? For better mental and physical health?

               

Exercise and Cancer: the latest updates

Resource post for December

Exercise has always been one of the major keys to health and longer lifespan. Conversely, lack of exercise has been linked to many diseases including cardiovascular disorders, type 2 diabetes, obesity, and osteoporosis. But what about cancer and exercise? Is there a link? Here are the latest updates on this topic.

Exercise and rest reduce cancer risk in women

This very recent report suggests that physical exercise among women only affords protection against cancer if complemented by a good night’s sleep. It seems that lack of sleep can cancel out the beneficial effects of exercise. Previous studies have linked poor sleep hygiene to breast cancer. In the current study, “findings suggest that sleep duration modifies the relationship between physical activity and all-site cancer risk among young and middle-aged women… Among women 65 or younger when surveyed and in the upper half of [physical activity energy expenditure] PAEE, sleeping less than seven hours a day increased overall cancer risk, negating much of the protective effects of physical activity on cancer risk for this group.”

Exercise cuts cancer death in men

Men who regularly engage in physical activity are less likely to die from cancer than those who don’t, These are the findings of a study conducted by Swedish researchers. The study looked at over 40,000 men aged 45 to 79 over a 7-year period. Those who walked or rode the bicycle for at least 30 minutes each day had a 5% lower risk of developing cancer and an increased survival rate of 33% compared to sedentary individuals. Those who did a longer exercise routine of 60 to 90 minutes had a 16% lower incidence of cancer. However, it is not only activities such as walking or cycling that can reduce cancer risk. According to the researchers, “we looked at more moderate exercise such as housework, undertaken over a longer period of time and found that this also reduced men’s chances of dying from the disease.”

Exercise and breast cancer

Most study results point to one thing: that physically active women have a lower risk of developing breast cancer compared to their sedentary counterparts. The risk reduction can vary between 20 to 80% and may also be closely linked to weight and body fat.  The protective effects of exercise are especially evident among adult women (premenopausal and postmenopausal age) but exercise during adolescent years also makes a difference. Maximum protection is achieved through a lifetime of physical activity though not many people will probably qualify for this. However, increasing physical activity will show the greatest benefits when done just after the menopause. The protective mechanism may be explained as follows:

Physical activity may prevent tumor development by lowering hormone levels, particularly in premenopausal women, lowering levels of insulin and insulin-like growth factor I (IGF-I) improving immune response, and assisting with weight maintenance to avoid a high body mass and excess body fat.

Exercise and colorectal cancer

Many research studies have found that exercise can reduce the risk of developing colon cancer. Those who increase their physical activity in terms of frequency, intensity, and duration, or frequency can actually have a 30 to 40% risk reduction. Although some studies indicate that the protective effects of exercise increase with increasing intensity, it is not clear what the optimal levels of physical activities are. The current estimate is that about 30 to 60 minutes of moderate to vigorous physical exercise each day can render protection against colon cancer. Several mechanisms have been proposed to explain the anti-cancer effects of exercise.

Physical activity may protect against colon cancer and tumor development through its role in energy balance, hormone metabolism, insulin regulation, and by decreasing the time the colon is exposed to potential carcinogens. Physical activity has also been found to alter a number of inflammatory and immune factors, some of which may influence colon cancer risk.

Guidelines on physical activity for cancer survivors

Recently, the very first guidelines on physical activities for Americans have been issued by the US Department of Health and Human Services. Included in Chapter 7 are physical activity guidelines for people with chronic medical conditions. Here are the recommendations for cancer survivors:

With modern treatments, many people with cancer can either be cured or survive for many years, living long enough to be at risk of other chronic conditions, such as high blood pressure or type 2 diabetes. Some cancer survivors are at risk of recurrence of the original cancer. Some have experienced side effects of the cancer treatment.

Like other adults, cancer survivors should engage in regular physical activity for its preventive benefits. Physical activity in cancer survivors can reduce risk of new chronic diseases. Further, studies suggest physically active adults with breast or colon cancer are less like to die prematurely or have a recurrence of the cancer. Physical activity may also play a role in reducing adverse effects of cancer treatment.

Cancer survivors, like other adults with chronic conditions, should consult their health-care providers to match their physical activity plan to their abilities and health status.

Photo credit: stock.xchng

               

CVD News Watch November 7

CVD conference watch

AHA!
The best experts of the heart will be gathering in New Orleans, Louisiana this weekend. The 2008 Scientific Sessions of the American Heart Association run from November 8 to 12. Next week, I will try to bring you a review of the latest heart news from the conference.

CVD exercise watch

President-elect’s workout has predecessors gasping
He is not your typical American - at least as far as the Europeans are concerned. He’s black and he’s skinny. And he works out. Barack Obama is the first African-American to be elected US president. And the Obama fitness workout will probably become a legend.
“The main reason I do it is just to clear my head and relieve me of stress… My blood pressure is pretty low and I tend to be a healthy eater,” the UK Guardian quotes president-elect Obama.

CVD gender watch

Brown Named CEO of the American Heart Association
No, it’s not that kind of gender issue. Nancy Brown will be the next Chief Executive Officer of the American Heart Association, starting January 1, 2009. She will be the first woman to hold the position.

CVD drug watch

Sanofi-Aventis scraps ongoing rimonabant research
It was thought to be the next blockbuster - a drug that can be used to treat obesity as well as cardiovascular disorders. Unfortunately, rimonabant (Acomplia) fell short of these expectations and dealt a big blow to the big pharma Sanofi-Aventis, which announced that it is halting all clinical development programs associated with rimonabant. The downfall of the potential wonder drug is due to safety issues. In one trial, 5 suicides were reported in the rimonabant treatment group compared to 1 suicide in the placebo group. Two weeks ago, the European Medicines Agency (EMEA) announced that “it had asked the company to suspend marketing of the drug, on the grounds that its benefits no longer seemed to outweigh its risks.”

CVD obesity watch

Can Nintendo Wii Tackle Child Obesity?
Nintendo Wii, a program which simulates sports on the computer, is very popular among children and young people. The question is - is it effective against child obesity? This is the question that researchers at the University of Derby (UK) is tackling.
“This study aims to see if young children can lose weight or improve their health by using the Nintendo Wii. There is a lot of discussion that video games are bad for your health and we hope this research will determine if playing on this equipment could actually have physical benefits for children,” according to researcher Dr Michael Duncan.

CVD patient watch

Health of Ted Rogers stabilizes
Ted Rogers, head and founder of the Canadian company Rogers Communications was hospitalized Friday last week for an existing heart condition. The company announced that his condition has stabilized.

               

On exercise: are doctors practicing what they preach?

They are just like the rest of us. They have jobs, they have families, kids, and pets to take care of. And most often their jobs are much more demanding than those of ordinary folks like you and me. They might need to travel, work night shifts, or on weekends. They are our doctors and sometimes we wonder, with their full and hectic schedules, whether they have the time to practice what they preach, e.g. do they do exercise? And if yes, how do they find the time?

heartwire interviewed several cardiologists and other doctors whether they exercise and most of the answer is “yes”.

They were also asked details about their exercise routines and why they exercise.

Why exercise?

Here is what several doctors say:

• A doctor can communicate and connect better with his patients about exercise based on his or her personal experience.
• An exercising doctor can transmit his or her passion and enthusiasm for exercise to the patients.
• Exercise helps a doctor to concentrate on the job.
• Exercise keeps a doctor healthy.
• Exercise helps a doctor clear his/her mind work off some stress.
• Exercise can help perform a job effectively. For an electrophysiologist, for example, exercise helps “maintain endurance for long EP cases and the flexibility needed for wearing lead for hours.”

Which exercise?

The routines the doctors followed were kind of varied as described below.

• Dr Valentin Fuster of Mount Sinai School of Medicine is an avid cyclist and tackles the stages of Tour de France and other challenging cycling competitions.
• Dr Peter Gallagher, an electrophysiologist at the Nebraska Heart Institute, runs and does stretches.
• Dr Roger Blumenthal of the Johns Hopkins Medical Institute keeps fit through golf and keeping up with his kid’s sports activities, from lacrosse, to basketball.
• Dr Jon Resar also of the Johns Hopkins Medical Institute runs about five miles daily, six times a week outdoors. He has his dog to keep him company on his early morning runs.
• Dr Christopher Cannon of Brigham and Women’s Hospital, Boston, MA works out indoors every morning for 30 minutes with different machines, from stationary cycle to weights.
• Dr Melissa Walton-Shirley of TJ Sampson Community Hospital, Glasgow, KY goes for the treadmill, the elliptical machine, and the cycle.

As one of the experts say

“I do think it’s a little hypocritical of a cardiologist who is not taking care of himself to ask patients to stay active.”

Well, what about me?

I am not a cardiologist but time and time again, I’ve emphasized the importance of exercise in my posts. Do I practice what I advocate? Well, I definitely try. I jog outside 3 to 4 times a week, 30 to 60 minutes. My family and I go for long walks or hikes in the mountains and forests. I firmly believe in the health benefits of exercise and I live it.

Watch out for a resource post on exercise here.

 

Photo credit: lovleah at stock.xpert

               

Exercise makes the heart grow younger

As we grow older, our body and its organs deteriorate. Including our heart. Now, is there in any way that we can slow down, even reverse our heart’s aging process?

Researchers at the Washington University at St. Louis may just have found the secret to eternal youth and it’s none of the power pills that you take or the power beverages that you drink. Surprise, surprise - it’s endurance exercise.

The research involved 12 participants - 6 males and 6 females aged 60 and 75. The participants were of normal weight but not physically active.

The researchers compared two treatments among non-active older adults: the effects of exercise training on the heart vs the effects of dobutamine, a drug that increases the heart rate similar to what happens during an exercise.

Endurance exercise training was defined as

walking, running or cycling exercises three to five days a week for about an hour per session.

Dobutamine induced increased energy demands, but the hearts of the study participants did not increase their blood sugar (glucose) uptake for more energy. This is how an aging heart would react.

Endurance exercise however resulted in higher glucose uptake by the participants’ hearts. This increased in blood sugar uptake - about double the energy demand of a heart at rest - is what young hearts do.

Lead author Pablo Soto explains:

…if heart muscle doesn’t take in glucose in response to increased energy needs, it goes into an energy-deprived state, which may raise the risk of heart attack. But if it can increase glucose uptake, the heart is better protected against ischemia (low oxygen) and heart attack.

The participants underwent 11 months of exercise training guided by a professional trainer. During the first 3 months, exercise was up 65% of the participants’ capacity. It was then increased to 75%, with no major problems. In fact, the participants reported feeling fit and young.

Many other studies have found strong links between exercise and aging. Nature News reported about a UK study that showed how physical activity keeps us young while an inactive lifestyle shortens our life. They used one biological measure of aging which is the length of telomeres at the end of our chromosomes. Telomeres protect our DNA from wearing down and tend to get shorter as we age.

The research went on to show that people who regularly engaged in exercise and are nonsmokers have longer telomeres compared to those who are inactive, overweight and smokers. The biological age difference based on telomere length differences can be as high as 10 years.

Now, who wouldn’t want to live a decade longer?

Photo credit

               

Springing Back From The Flu, Some Tidbits On Living Life With Arthritis

I’ve been bugged down by flu recently and so I had to rest for awhile and just sleep the night off than usual. But I am back and now it’s the first of August. Wow, time flies really!

Now it’s Friday. But before I close my week and take it easy the rest of the weekend, let me share with you all a few things that show how life with arthritis can be lived with some better quality, if we make some adjustments.

1. Kitchen adjustments and tools that can help those with arthritis

Diagnosed with rheumatoid arthritis in 1987, Tuovi Cochrane, 67, of Rockford, has joined thousands of women in inventing new ways to create in the kitchen.

Using a specially designed ergonomic kitchen knife with a broad blade and sawlike handle that is easier to grip, Cochrane is able to slice, dice and chop.

For opening jar lids, she uses the adjustable Black & Decker Lids Off, which can handle even small prescription-pill containers.

2. Lower arthritis risks with simple changes

• Keep your weight down: excess weight puts additional stress on the joints and is especially hard on the knees and hips.
• Don’t avoid exercise: Although high-impact activities can irritate arthritis, keeping muscles strong and joints moving is therapeutic; try swimming, yoga or even golf.
• Take stretch breaks at work: Don’t sit or stand in the same position for long periods of time. Stand up and move or stretch every 30 minutes.
• Get your vitamins: everyone can benefit from a healthy, balanced diet, but getting adequate calcium and vitamin C is of particular importance to bone and joint health,
• Wear comfortable shoes: Don’t sacrifice your health for fashion; high heels put added stress on feet and knees.

3. Wii Fit as indoor exercise for arthritis patients

Elaine Bartz would never lie to her doctor.

Since the 62-year-old grandmother bought a Nintendo Wii Fit system to help fight her arthritis, that hasn’t been a consideration.

“Every time I go to the doctor, she would ask me if I’d been exercising, because I do have high cholesterol, too,” Bartz said. “I would say, ‘Uh, no, I’m not.’ Now, when I go to her, I can say I am exercising daily.”

4. Yoga for arthritis

Thanks to fascinating advances in medication too, which has definitely saved an arthritic from the devastating side effects of steroids. But, have we hit the nail on its head? Have we been able to cure or prevent joint diseases? The answer is a clear ‘No’.

5. Cooking workshop that may help arthritis patients

This month, the Indiana Chapter of the Arthritis Foundation will team up with Whole Foods Market to offer a short series of FREE, fun and educational courses for the community called Healthy Cooking 101. These courses were created for Indiana residents who struggle with rheumatoid arthritis but still want to maintain some sort of independence in the kitchen.

Well, we all do need all the help we can get. Be it turning ergonomic, doing yoga or buying the Wii fit, i think I won’t hurt to try and see what’s going to work for you. Take your prescribed meds too! Most importantly, you gotta eat right.

That’s all for now and I wish you all a great weekend.

               

Exercise Benefits Arthritis

Countless time here, I have mentioned the importance of exercise in managing arthritis. While exercise (as shown by various studies) can relieve the pain, stiffness and swelling in joints caused by arthritis, we do not want an exercise that will strain the arthritis patient.

If you dig into my archives, the top 2 exercise for arthritis that will come out are:

1. Tai Chi

Tai Chi is most known to relieve stress and improve one’s agility. Recently however, it has been noticed as a beneficial exercise form for people with arthritis. From the Mayo Clinic’s list of uses of tai chi, one cannot deny the fact that it can indeed help against arthritis:

• Reduce stress
• Increase flexibility
• Improve muscle strength and definition
• Increase energy, stamina and agility
• Increase feelings of well-being

In the case of oseoarthritis, stress is a risk factor. Therefore tai chi in one way to relieve stress and improve one’s quality of life.

2. Water Aerobics or other water exercises

Exercising in water doesn’t strain the joints and so it offers a different way of exercising with too much stress to people suffering from arthritis. Besides, studies have attested to its benefits. It is better though to have a trainor for this or join a class. With the approval of course of your doctor.

From wikipedia:

In addition to the standard benefits of any exercise, the use of water in water aerobics supports the body and reduces the risk of muscle or joint injury. The mitigation of gravity by flotation places less stress on the joints when stretching, and can allow a greater range of motion. The mitigation of gravity makes water aerobics safe for any individual able to keep their head out of water, including the elderly.[2] Exercise in water can also prevent overheating through continuous cooling of the body. Most classes last for 45-55 minutes.

I couldn’t agree more. People with arthritis should exercise but with minimal to none injury to the muscle or joints.

Swimming and walking, am not to sure to add to this list. While it may be beneficial, it should with done with caution as we do not want to be strained, stress nor injured. Simple stretching exercises could be helpful as well. Nothing too fancy, I guess. It would be best to discuss with your doctor, it might be good to consider as well if you work with a professional therapist or trainor experienced in arthritis patients. At least from my reading about managing life with arthritis, that piece of info I has always bumped into.

Would you mind sharing to us here, what kinds of exercises have you found beneficial in living life with arthritis? We’d like to know.

               

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