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People who are in good shape take fewer mental-health related medication

Being in good physical shape helps all age groups and both genders. However, some people get greater benefits from exercise and being in good physical shape than others.

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“We find that people who are in better shape fill fewer prescriptions for anxiety and depression medications,” says Linda Ernstsen, the senior author of the article and an associate professor from the Department of Public Health and Nursing at the Norwegian University of Science and Technology (NTNU).

The research group based its work on the  Trøndelag Health Study (HUNT). Since 1984, 250,000 Trøndelag residents have voluntarily contributed their health data to this comprehensive research project. The data are available to researchers, who can use the data to estimate people’s fitness levels, among other things.

The figures were taken from the third data collection round, called HUNT3, which was conducted from 2006 to 2008.

The research group compared the data from HUNT3 with data from the Norwegian Prescribed Drug Registry, which provides an overview of medications that have been dispensed in Norway.

Reduces the need for medication

“Being in better physical shape appears to reduce the need for anxiolytic drugs and antidepressants,” Ernstsen said.

In a previous study, Ernstsen and her co-authors found that people who were in good physical shape during the second HUNT study had a lower prevalence of depressive symptoms when they were participants in HUNT3 ten years later. However, at the time, the researchers found no correlation between good physical shape and anxiety.

But the new study design, which allows the researchers to look at what kinds of medication HUNT3 participants obtained from pharmacies as late as 2018, allowed the researchers to find the correlation.

However, the study does have a theoretical catch. The researchers can only see what kinds of medication were dispensed to people by pharmacies. They cannot see whether people actually took the medication — there’s no way to monitor people at their medicine cabinets.

“Nevertheless, there is reason to believe that people who are prescribed medication have more symptoms than those who do not see a doctor,” according to first author Audun Havnen, an associate professor at the Department of Psychology at NTNU.

Greatest effect for men and young people

Being in good physical shape helps all age groups and both genders. However, some people get greater benefits from exercise and being in good physical shape than others.

“We find that men experience a greater effect from exercise than women. The correlations are also less clear for the elderly,” Ernstsen says.

But that doesn’t mean that it isn’t important for women and the elderly to exercise.

What came first?

We can, of course, ask what triggers what. Is it actually the case that good physical health helps prevent anxiety and depression? Or is it the case that people who suffer from anxiety and depression exercise less and are therefore in poorer shape?

In order to not include anyone who was already experiencing anxiety or depression at the start of the study, the researchers excluded anyone who had filled prescriptions for these conditions before participating in HUNT3, as well as for three months afterwards.

“We also adjusted for symptoms of anxiety and depression in statistical analyses. To the extent that the figures can be believed, we also feel fairly confident that we started with a relatively anxiety and depression-free cohort in HUNT3,” Ernstsen said.

In other words, the subjects were unlikely to have suffered from anxiety or depression beforehand.

Unfortunately there are no shortcuts for people who can’t be bothered to exercise. We simply have to get started — unless we decide to give up. But is there really no other alternative?

“The results indicate that you can achieve a protective effect by improving your physical shape from poor to moderate, so any activity is beneficial,”  Havnen says.

You should be physically active in a way that leaves you breathless and sweaty if you want to improve or maintain your physical condition. The Norwegian health authorities recommend that adults be physically active for at least 150 to 300 minutes at moderate intensity each week.

However, one option for people who are short on time is to aim for 75 minutes of high-intensity training each week or a combination of moderate and high-intensity training.

“Research reinforces the finding that each minute of physical activity counts,” Ernstsen said.

Authored by Audun Havnen, Ekaterina Zotcheva, Ottar Bjerkeset, Xuemei Sui, and Linda Ernstsen, “Cardiorespiratory fitness and incident use of anxiolytics and antidepressants in adults. A linkage study between HUNT and the Norwegian Prescription Database” appeared in the Journal of Affective Disorders.

Wellness

4 Core factors to avoid a heart health syndrome

To avoid CKM syndrome, health experts suggest paying close attention to four of the American Heart Association’s Life’s Essential 8 – blood pressure, lipids, body weight and blood sugar level – which are core health factors that impact your metabolic health.

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In the U.S., 1 in 3 adults is at risk for a newly recognized syndrome that comes from a combination of heart disease, kidney disease, type 2 diabetes and excess body weight. This cluster of conditions, called cardiovascular-kidney-metabolic (CKM) syndrome, is an example of how problems in one part of your body can affect other parts.

To avoid CKM syndrome, health experts suggest paying close attention to four of the American Heart Association’s Life’s Essential 8 – blood pressure, lipids, body weight and blood sugar level – which are core health factors that impact your metabolic health.

Good metabolic health means your body uses energy well and keeps these factors in a normal range. However, when numbers are off in one area, it can affect others, raising your risk for heart disease, stroke, kidney disease and diabetes.

Consider these tips from the American Heart Association to help keep your core health factors under control.

Blood Pressure

High blood pressure, also known as hypertension, happens when the force of your blood pushing against the walls of your blood vessels is too high. High blood pressure is a leading cause of heart disease, stroke and kidney disease.

Because high blood pressure doesn’t have symptoms, the only way to know you have it is to get your blood pressure checked. Healthy blood pressure is below 120/80. If your blood pressure is 130/80 or higher, talk to your doctor about checking your other core health factors.

Lifestyle changes can help reduce high blood pressure. One example is a Dietary Approaches to Stop Hypertension (DASH) eating pattern that’s low in fat and rich in fruits, vegetables, whole grains and low-fat dairy products. Losing 10 pounds and reducing alcohol consumption can also reduce blood pressure.

Cholesterol

Cholesterol is a waxy substance your liver makes then circulates in the blood where your body uses it to build cells and make vitamins and hormones. You may also get cholesterol from eating animal products. If there’s too much cholesterol circulating, your risk of type 2 diabetes, heart disease and stroke may increase.

For optimal CKM health, your LDL cholesterol should be below 100 and triglycerides below 150. Triglycerides are the most common type of fat in the body. If your triglyceride level is 135 or higher, talk to your doctor about decreasing your risk.

Losing body weight and increasing physical activity decrease triglyceride levels. In addition, DASH and Mediterranean (plant-based, high-fiber, low-fat) eating patterns support healthy LDL and triglyceride levels.

Body Weight

Healthy weight may be determined by body mass index (BMI), a number that represents your weight in relation to your height. Extra body fat can mean a higher risk for many health problems, including heart disease, stroke, high blood pressure, high cholesterol and diabetes.

CKM syndrome starts when BMI is 25 or higher and waist circumference is 88 centimeters or higher for women and 102 centimeters or higher for men. Aim for a BMI between 18.5-25.

To lose weight and keep it off, start by setting realistic goals. Understand how much and why you eat, manage portion sizes, make smart snack substitutions and be physically active.

Blood Sugar

High blood sugar can slowly damage the kidneys. In fact, diabetes is the leading cause of kidney disease, and it increases the risk of heart attack and stroke.

Blood sugar is measured in two ways: a fasting blood glucose test (short term blood sugar) and an A1C test (long term blood sugar control). A normal fasting blood glucose level is 70-99 and a normal A1C level is below 5.7%. Fasting blood glucose above 125 and A1C of 6.5% or higher means you have diabetes.

Habits that help you avoid high blood pressure, weight gain and high cholesterol also keep your blood sugar in check. These are especially important if you have a family history of diabetes.

Learn more about CKM syndrome and how to manage your risk at heart.org/CKMhealth.

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Wellness

Being physically active, even just a couple of days a week, may be key to better health

Being physically active for one to two days a week, often called a “weekend warrior,” may provide comparable health and life-prolonging benefits as smaller doses of daily physical activity if the physical effort is moderate to vigorous and totals 150 minutes a week in line with recommended guidelines for weekly physical activity.

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Being physically active for one to two days a week, often called a “weekend warrior,” may provide comparable health and life-prolonging benefits as smaller doses of daily physical activity if the physical effort is moderate to vigorous and totals 150 minutes a week in line with recommended guidelines for weekly physical activity.

This is according to new research published in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

“You don’t need to exercise every day to stay healthy. As long as you get 150 minutes of moderate to vigorous physical activity per week — whether packed into one to two days or spread out — you can significantly reduce your risk of dying from cardiovascular disease, cancer or other causes,” said study corresponding author Zhi-Hao Li, Ph.D., an epidemiologist in the School of Public Health at Southern Medical University in Guangzhou, China.

“This message is encouraging news for busy people who struggle to fit in daily workouts but can manage a concentrated burst of activity on weekends or over a couple of days,” Li said. “The research provides reassuring evidence that even sporadic physical activity can have lasting health benefits, making it easier for people to prioritize their well-being amid busy schedules.”

To achieve health benefits, both the World Health Organization and the American Heart Association recommend that throughout a week adults engage in 150 to 300 minutes of moderate-intensity aerobic physical activity, or 75 to 150 minutes of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate and vigorous-intensity activity.

Researchers examined health and physical activity data for more than 93,000 people in a large biomedical database in the U.K. to explore how different physical activity patterns may affect the risk of dying from all causes, specifically cardiovascular disease and cancer. They reviewed physical activity data collected from wrist accelerometers, devices that measure movement and are likely more accurate than asking participants about their activity.

The study categorized the data into three groups: “active weekend warrior” — people who completed most of their exercise in one or two days; “active regular” — those who spread their activity throughout the week; and “inactive” — participants who did not complete the recommended minimum of 150 minutes of weekly physical activity.

Compared to the inactive group, the weekend warrior and active regular groups had a significantly lower risk of death from all causes, cardiovascular disease and cancer if they completed 150 minutes of physical activity a week.

The analysis also found:

  • For weekend warriors, the risk of death from all causes was 32% lower; the risk of death from cardiovascular disease was 31% lower; and the risk of death from cancer was 21% lower.
  • Among participants in the active regular group, the risk of death from all causes was 26% lower; the risk of death from cardiovascular disease was 24% lower; and the risk of death from cancer was 13% lower.
  • No significant differences in the risk of death surfaced between the weekend warrior vs. the active regular group.

While the new research aligns with previous studies, it is the first to analyze the relationship between physical activity patterns measured by accelerometers and the risk of death from cardiovascular disease and cancer.

Some of the findings surprised the research team, who initially expected that spreading activity throughout the week would be more beneficial. They did not anticipate that weekend warriors’ condensed physical activity would reduce the risk of death from disease.

“This reinforces the idea that meeting the 150-minutes of physical activity per week guideline is key to longevity, regardless of the activity pattern,” Li said. “Any activity — whether structured exercise such as jogging or daily tasks such as gardening — can be included if the intensity is moderate to vigorous.”

American Heart Association expert volunteer Keith Diaz, Ph.D., said the findings emphasize that the total volume of physical activity is the crucial factor for health benefits, rather than how it is distributed across a week. Diaz, the Florence Irving Associate Professor of Behavioral Medicine at Columbia University Medical Center in New York, was not involved in this research.

“Many people struggle to fit in daily exercise during the workweek; however, this research shows that even if you can only be active on the weekends, you can still gain meaningful health benefits,” said Diaz, a member of the Association’s Physical Activity Science Committee.

“One important caveat to remember is that trying to fit 150 minutes of exercise into just one or two days can be a lot on your body,” he added. “Some research suggests that weekend warriors have a slightly higher risk of musculoskeletal injuries compared to those who exercise more regularly. However, the benefits of exercising just on the weekend far outweigh the potential risks. If you are going to be a weekend warrior, make sure you do proper warm-ups and build up and progress to higher volumes of activity over time. This will help to reduce your risk of injuries.”

The study had several limitations, including that physical activity was only measured at baseline; participants lived in the U.K. and most were white, so the results may not apply to other populations. The researchers said future studies should be conducted to confirm these results in more diverse groups of people throughout the world and with more consideration for contradictory factors such as genetic predisposition or environmental exposures that may influence physical activity and the outcomes.

Study details, background and design:

  • The research data focused on seven days of accelerometer-measured physical activity from 2013 to 2015 for 93,409 participants, aged 37 to 73, enrolled in the UK Biobank.
  • More than 56% of the participants were women, 97% were white and their average age was 62 years old.
  • Based on accelerometer data, more than 42% of participants were classified as weekend warrior, about 24% as active regular and nearly 34% as inactive.
  • The accelerometers captured a range of activities, including walking, jogging, stationary cycling, elliptical exercises, household chores, gardening and leisure activities such as dancing.
  • During eight years of follow-up, nearly 4,000 adults died from all causes, including about 17% from cardiovascular disease and about 45% from cancer.
  • Compared to the inactive participants, those who exercised during two days each week were more likely to be men, younger, have a college degree, non-smokers, non-drinkers, less likely to have Type 2 diabetes and/or to have lower body mass index (an indicator of body fat to determine healthy weight).
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Wellness

Keeping fit and building muscle could increase survival rates in cancer patients

Anyone can benefit from higher muscle strength and cardiorespiratory fitness to have reduced mortality. But there are especially positive findings for those patients living with lung cancer and digestive cancer.

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Physical fitness and increasing muscle strength could reduce the mortality rate for cancer patients by between 31% to 46%, new research from Edith Cowan University (ECU) has found.

Around 20 million new cancer cases were reported in 2022, with 9.7 million cancer deaths reported world-wide during the same period, with experts expecting the trend to increase in the coming decades.

ECU PhD student Mr Francesco Bettariga noted that in healthy adults, physical fitness and muscle strength has been associated with a 21% reduction in all-cause mortality, as well as a 15% reduction for cardiovascular disease mortality, and a 27% reduction for chronic obstructive pulmonary disease mortality.

Mr Bettariga’s research has found that both muscle strength and cardiorespiratory fitness had a significant impact to lower the risk of all-cause and cancer-specific mortality in patients with any form of cancer and stage.

“Our research found that anyone can benefit from higher muscle strength and cardiorespiratory fitness to have reduced mortality. But when we did our sub-group analysis, we found especially positive findings for those patients living with lung cancer and digestive cancer,” Mr Bettariga said.

“Increased muscle strength and cardiorespiratory fitness had also significant potential to extend the lives of people living with advanced stage of cancer.”

Mr Bettariga said that while physical fitness was beneficial to everyone, increased muscle strength and cardiorespiratory fitness after a cancer diagnosis would still deliver results.

“In practical terms, if a person is diagnosed with cancer and only starts exercising to increase their muscle strength or cardiorespiratory fitness levels after that diagnosis, they will potentially extend their survival and reduce their mortality risk.”

He noted that cardiorespiratory fitness could be particularly increased by aerobic exercises like brisk walking, running, swimming or cycling, while muscle strength could be enhanced by the adoption of resistance exercise programs, including the use of dumbbells, barbell and weight-machine.

“The guidelines are that people should be exercising at least three to five days per week. They can do between 75 minutes and 150 minutes of vigorous-intensity exercise a week, or around 300 minutes of moderate-intensity exercise.

“Resistance exercise training can be done at least twice a week, and would need to incorporate at least two or three sets of each resistance exercise, consisting of around 8 to 15 repetitions each at moderate intensity at least.”

Mr Bettariga said the results from his research underscored the importance of clinical practitioners assessing the physical fitness of cancer patients as part of the process of predicting survival.

“Moreover, from a practical perspective, implementing tailored exercise prescriptions to enhance muscle strength and cardiorespiratory fitness throughout the cancer continuum may contribute to reducing cancer-related mortality.”

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