NewsMakers
People with atrial fibrillation live longer with exercise
Four months of regular interval training reduced both the recorded flutter length and the symptoms of the disease. In addition, the exercise provided better quality of life and heart function. And last but not least: the training resulted in a marked increase in fitness.
“Regular endurance training and good fitness seem to protect against serious cardiovascular events and early mortality for people diagnosed with atrial fibrillation,” says exercise physiologist Lars Elnan Garnvik.
Garnvik recently completed his doctorate at the Norwegian University of Science and Technology. His latest article was recently published in the prestigious European Heart Journal.
Garnvik and his colleagues in the Cardiac Exercise Research Group (CERG) have investigated how physical activity and good fitness levels are linked to future health risks for men and women who have been diagnosed with atrial fibrillation.
“The results show that people with atrial fibrillation who meet the authorities’ recommendations for physical activity generally live longer than patients who exercise less. They also have almost half the risk of dying from cardiovascular disease,” says Garnvik.
The minimum recommendation is to be physically active for 150 minutes of moderate intensity or 75 minutes of high intensity exercise each week. Moderate intensity means getting out of breath and sweaty, but still able to carry on a conversation. At high intensity you are so out of breath that you can’t speak in longer sentences.
“We found that both moderate and high intensity training are associated with significantly reduced risk,” says Garnvik.
People with atrial fibrillation have a higher health risk than same-aged individuals who do not have the disease. The new NTNU study also shows that inactive men and women with atrial fibrillation generally die earlier than inactive men and women without the condition.
“On the other hand, the risk for physically active participants with atrial fibrillation wasn’t higher than for physically inactive healthy people in the same age group,” Garnvik says.
The study includes a total of 1117 people who participated in the Trøndelag Health Study (HUNT Study) between 2006 and 2008. All had a confirmed atrial fibrillation diagnosis, and their average age was over 70. Garnvik used national health records to find out who died or was impacted by cardiovascular disease in the years leading up to and including 2015.
“It’s worth noting that this is an observational study, so the results cannot be used to establish definite causal relationships. However, we’ve tried to isolate the relationship between exercise and health risk as much as possible by adjusting the analyses for all other known differences between people who exercise a lot and a little,” he says.
In the study, the researchers calculated the condition of atrial fibrillation patients with CERG’s widely used Fitness Calculator. It was found that the participants with the lowest calculated fitness levels had the highest mortality risk during the follow-up period.
“For every 3.5 point increase in fitness score, the risk of dying dropped by 12 per cent over the next eight to nine years. In the case of cardiovascular-related deaths, this risk reduction was 15 per cent,” Garnvik says.
The fact that fitness is important is not new information.
“Both our research and other research suggests that staying in shape can be even more crucial to health than the level of physical activity. Our genes determine some of our fitness, but the vast majority of people can improve on their gene pool by exercising properly. This is also the case for individuals with atrial fibrillation,” he says.
Training in a way that actually influences your fitness level is especially important.
“Our research team has repeatedly shown that high-intensity interval training is more effective than moderate exercise for improving fitness. This is true for both healthy individuals and people with different types of lifestyle diseases,” says Garnvik.
No specific training recommendations for people with atrial fibrillation have been published yet. Last year, however, another CERG researcher completed his doctorate on the same topic. Cardiologist Vegard Malmo’s studies show that interval training using the 4 × 4 method is very effective for this group as well.
“The findings suggest that aerobic interval training has the same beneficial effect on risk factors in people with atrial fibrillation as in patients with other cardiovascular illnesses,” says Malmo.
Four months of regular interval training reduced both the recorded flutter length and the symptoms of the disease. In addition, the exercise provided better quality of life and heart function. And last but not least: the training resulted in a marked increase in fitness.
“Lifestyle changes, including exercise, should be key for treating atrial fibrillation,” Malmo says.
Biathlete Ole Einar Bjørndalen had to end his sports career due to atrial fibrillation. Cross-country ski racer Marit Bjørgen has experienced flutter episodes, and the same goes for several other high-level Norwegian and international endurance athletes.
“We know that very high levels of exercise over many years can increase the risk of developing atrial fibrillation. However, this is not something most of us need to worry about. Too little physical activity is a much greater cause of atrial fibrillation in the population than people exercising too much,” says Garnvik.
The people who exercise the most probably don’t tend to be the first to get scared and stop exercising if they have a flutter episode. A study of older people who participated in the Birkebeinerrennet – an annual long-distance cross-country ski marathon held in Norway – shows that two-thirds of these super-exercisers continue to train actively even after being diagnosed.
And they can do that with good conscience. Recently, Vegard Malmo and other Norwegian experts published an overview article on exercise and atrial fibrillation and concluded by saying: “We believe that most athletes with non-permanent atrial fibrillation can exercise without any restrictions when their heartbeat is normal. If they experience symptoms during exercise, the natural response will be to stop the activity.”
References:
Garnvik, L. E., Malmo, V., Janszky, I., Ellekjær, H., Wisløff, U., Loennechen, J. P., & Nes, B. M. (2020). Physical activity, cardiorespiratory fitness, and cardiovascular outcomes in individuals with atrial fibrillation: the HUNT study. European Heart Journal.
Malmo, V., Nes, B. M., Amundsen, B. H., Tjonna, A. E., Stoylen, A., Rossvoll, O., Wisløff, U., & Loennechen, J. P. (2016). Aerobic interval training reduces the burden of atrial fibrillation in the short term: a randomized trial.. Circulation, 133 (5), 466-473.
Myrstad, M., Malmo, V., Ulimoen, S. R., Tveit, A., & Loennechen, J. P. (2019). Exercise in individuals with atrial fibrillation. Clinical Research in Cardiology, 108 (4), 347-354.
NewsMakers
The look and feel of your neighborhood may affect your sleep
Those living in neighborhoods rated as having a stronger sense of safety tended to sleep longer, and that this rating appeared to be shaped by the streetscape.
Your neighborhood’s “streetscape”—the physical environment of your street—is something that you have probably never consciously thought about, despite seeing it every day. But what if the streetscape was affecting you on a subconscious level and disrupting your sleep?
This intriguing question is posed by the findings of a study led by Professor Daisuke Matsushita of the Graduate School of Human Life and Ecology at Osaka Metropolitan University. The research team used AI to analyze more than 200,000 Google Street View images to identify visual neighborhood characteristics. They then linked these characteristics to the self-reported sleep of 1,089 working adults living on the lower floors of apartments in Tokyo, who were most likely to be affected by the streetscape.
They found that those living in neighborhoods rated as having a stronger sense of safety tended to sleep longer, and that this rating appeared to be shaped by the streetscape. Generally, people slept longer in areas with lots of greenery, such as leafy trees, on the street. Similarly, high “enclosure”—meaning many tall vertical buildings and few wide-open spaces—was also associated with longer sleep and fewer insomnia symptoms.
However, the study also made a surprising finding. The researchers found that highly walkable streetscapes, such as those with more sidewalks and traffic signs, were associated with a lowered sense of safety and shortened sleep duration.
This suggests that walkability does not always represent a reassuring environment. Instead, a possible explanation is that streets with extensive pedestrian infrastructure are often busier, more crowded, and used by more strangers, which may be perceived as less safe or less relaxing than quieter residential streets.
“This study demonstrates the potential for evaluating streetscape characteristics across large geographic areas in a cost-effective manner,” Dr. Matsushita said. “Based on the technique used in this study, cities could potentially measure perceived safety, beauty, liveliness, and enclosure as well as pollution and noise.”
“We hope that opening up this new perspective creates further possibilities for designing healthier neighborhoods,” he concludes.
The findings were published in Building and Environment.
NewsMakers
Workout or nap? Either can help your sleepless brain, study finds
People who either completed 20 minutes of moderate-to-vigorous exercise or took a 90-minute nap performed about 22 per cent better on memory tests after 30 hours without sleep than those who did neither.
A short workout or a nap can help protect memory after a sleepless night, a McGill University-led study has found.
Researchers found people who either completed 20 minutes of moderate-to-vigorous exercise or took a 90-minute nap performed about 22 per cent better on memory tests after 30 hours without sleep than those who did neither. The findings, published in Proceedings of the National Academy of Sciences (PNAS), point to practical ways to counter the effects of sleep deprivation.
“Sleep loss affects nearly every aspect of how we think and function, but many people can’t simply stop what they’re doing and get more sleep,” said senior author Marc Roig, Professor in McGill’s School of Physical and Occupational Therapy. “Our findings show that even a brief bout of exercise may help preserve one of our most important cognitive abilities.”
The study involved 54 healthy young adults who stayed awake for 30 consecutive hours under lab supervision. Participants were then assigned to one of three groups: a 20-minute cycling session, a 90-minute nap or a control condition. Three days later, researchers tested their memory for images they had viewed immediately after the intervention. Those who exercised or napped remembered significantly more images than participants who did neither.
Same result, different pathways
While the memory benefits were nearly identical, brain recordings revealed that exercise and napping helped in different ways.
Napping appeared to help the brain recharge, making it easier to take in and remember new information. Exercise, by contrast, helped the brain use its remaining resources more efficiently, without making participants feel more tired.
The findings could eventually inform fatigue-management strategies in workplaces where sleep loss is common and mistakes can have serious consequences, such as health care, transportation and emergency response.
“A nap isn’t always possible in the middle of a shift,” said first author Madhura Lotlikar, a doctoral candidate in McGill’s Department of Neurology and Neurosurgery. “Exercise is accessible, inexpensive and easy to implement. That makes it a promising tool to help people stay cognitively sharp when sleep is limited.”
The researchers emphasize that exercise cannot replace sleep, but it may help people function better when getting enough rest isn’t possible.
About the study
“Protecting episodic memory after sleep loss: Similar benefits of exercise and naps via distinct neural contributions” by Madhura Lotlikar and Marc Roig et al., was published in Proceedings of the National Academy of Sciences of the United States of America.
NewsMakers
Study links coffee consumption to metabolic health and sex hormones
Despite having a similar body mass index (BMI), individuals with higher coffee consumption had lower total and visceral fat and greater skeletal muscle mass than those who consumed less coffee.
Coffee is one of the world’s most widely consumed beverages, and previous research has linked its consumption to a lower risk of conditions such as type 2 diabetes and cardiovascular disease. However, the biological mechanisms behind these benefits remain unclear. A new Finnish study links habitual coffee consumption to healthier body composition and metabolic markers, while revealing distinct associations with sex hormones in men and women.
The study, conducted at the University of Oulu, analysed data from 2,264 participants aged 46 in the Northern Finland Birth Cohort 1966. Researchers examined how habitual coffee consumption was associated with circulating metabolites, cardiometabolic risk markers and sex hormones.
Despite having a similar body mass index (BMI), individuals with higher coffee consumption had lower total and visceral fat and greater skeletal muscle mass than those who consumed less coffee.
In both men and women, higher coffee consumption was correlated with lower circulating levels of branched-chain amino acids, biomarkers that have previously been linked to insulin resistance and an increased risk of type 2 diabetes when chronically elevated.
The strongest sex-specific associations were observed in men. Higher coffee consumption was linked to a more favourable glucose–insulin profile, higher concentrations of total and bioavailable testosterone, and increased levels of sex hormone-binding globulin (SHBG). At the same time, free testosterone and the free androgen index were modestly lower. In women, hormonal associations were more limited and were primarily characterised by higher SHBG and lower measures of free androgens.
“Coffee is consumed by millions of people every day, yet we still know surprisingly little about how it relates to our metabolism and hormones. What stood out in our findings was a distinct hormonal signature that didn’t disappear even after we took into account BMI and lifestyle factors, with several of these associations differing between men and women,” says Luca Verroest, lead author of the study and Doctoral Researcher at the University of Oulu.
The results suggest that hormonal pathways may partly explain the relationship between coffee consumption and metabolic health. However, as this was an observational study, the findings demonstrate associations rather than cause-and-effect relationships.
The study is particularly relevant in Finland, one of the world’s highest coffee-consuming countries, where annual consumption averages around 11.8 kilograms per person.
The researchers say the findings provide a foundation for future studies aimed at determining whether coffee itself drives these biological changes and identifying the compounds responsible. These questions are currently being investigated in animal models, with the long-term goal of progressing to human intervention studies. Further research will be needed before the findings could inform dietary recommendations.
The study, Associations of habitual coffee intake with testosterone and cardiometabolic markers: the Northern Finland Birth Cohort 1966 study, has been published in the European Journal of Nutrition.
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