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5-minute workout lowers blood pressure as much as exercise, drugs

The ultra-time-efficient maneuver known as High-Resistance Inspiratory Muscle Strength Training (IMST) could play a key role in helping aging adults fend off cardiovascular disease.

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Working out just five minutes daily via a practice described as “strength training for your breathing muscles” lowers blood pressure and improves some measures of vascular health as well as, or even more than, aerobic exercise or medication, new CU Boulder research shows.

The study, published in the Journal of the American Heart Association, provides the strongest evidence yet that the ultra-time-efficient maneuver known as High-Resistance Inspiratory Muscle Strength Training (IMST) could play a key role in helping aging adults fend off cardiovascular disease.

In the United States alone, 65% of adults over age 50 have above-normal blood pressure – putting them at greater risk of heart attack or stroke. Yet fewer than 40% meet recommended aerobic exercise guidelines.

“There are a lot of lifestyle strategies that we know can help people maintain cardiovascular health as they age. But the reality is, they take a lot of time and effort and can be expensive and hard for some people to access,” said lead author Daniel Craighead, an assistant research professor in the Department of Integrative Physiology. “IMST can be done in five minutes in your own home while you watch TV.”

Developed in the 1980s as a way to help critically ill respiratory disease patients strengthen their diaphragm and other inspiratory (breathing) muscles, IMST involves inhaling vigorously through a hand-held device which provides resistance. Imagine sucking hard through a tube that sucks back.

Initially, when prescribing it for breathing disorders, doctors recommended a 30-minute-per-day regimen at low resistance. But in recent years, Craighead and colleagues have been testing whether a more time-efficient protocol–30 inhalations per day at high resistance, six days per week–could also reap cardiovascular, cognitive and sports performance improvements.

For the new study, they recruited 36 otherwise healthy adults ages 50 to 79 with above normal systolic blood pressure (120 millimeters of mercury or higher). Half did High-Resistance IMST for six weeks and half did a placebo protocol in which the resistance was much lower.

After six weeks, the IMST group saw their systolic blood pressure (the top number) dip nine points on average, a reduction which generally exceeds that achieved by walking 30 minutes a day five days a week. That decline is also equal to the effects of some blood pressure-lowering drug regimens.

Even six weeks after they quit doing IMST, the IMST group maintained most of that improvement.

“We found that not only is it more time-efficient than traditional exercise programs, the benefits may be longer lasting,” Craighead said.

The treatment group also saw a 45% improvement in vascular endothelial function, or the ability for arteries to expand upon stimulation, and a significant increase in levels of nitric oxide, a molecule key for dilating arteries and preventing plaque buildup. Nitric oxide levels naturally decline with age.

Markers of inflammation and oxidative stress, which can also boost heart attack risk, were significantly lower after people did IMST.

And, remarkably, those in the IMST group completed 95% of the sessions.

“We have identified a novel form of therapy that lowers blood pressure without giving people pharmacological compounds and with much higher adherence than aerobic exercise,” said senior author Doug Seals, a Distinguished Professor of Integrative Physiology. “That’s noteworthy.”

The practice may be particularly helpful for postmenopausal women.

In previous research, Seals’ lab showed that postmenopausal women who are not taking supplemental estrogen don’t reap as much benefit from aerobic exercise programs as men do when it comes to vascular endothelial function. IMST, the new study showed, improved it just as much in these women as in men.

“If aerobic exercise won’t improve this key measure of cardiovascular health for postmenopausal women, they need another lifestyle intervention that will,” said Craighead. “This could be it.”

Preliminary results suggest MST also improved some measures of brain function and physical fitness. And previous studies from other researchers have shown it can be useful for improving sports performance.

“If you’re running a marathon, your respiratory muscles get tired and begin to steal blood from your skeletal muscles,” said Craighead, who uses IMST in his own marathon training. “The idea is that if you build up endurance of those respiratory muscles, that won’t happen and your legs won’t get as fatigued.”

Seals said they’re uncertain exactly how a maneuver to strengthen breathing muscles ends up lowering blood pressure, but they suspect it prompts the cells lining blood vessels to produce more nitric oxide, enabling them to relax.

The National Institutes of Health recently awarded Seals $4 million to launch a larger follow-up study of about 100 people, comparing a 12-week IMST protocol head-to-head with an aerobic exercise program.

Meanwhile, the research group is developing a smartphone app to enable people to do the protocol at home using already commercially available devices.

Those considering IMST should consult with their doctor first. But thus far, IMST has proven remarkably safe, they said.

“It’s easy to do, it doesn’t take long, and we think it has a lot of potential to help a lot of people,” said Craighead.

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Fitness

How exercise interventions could help people with asthma

Research has shown that people living with asthma engage in less physical activity and are more sedentary than people without asthma.

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Interventions aimed at promoting physical activity in people with asthma could improve their symptoms and quality of life – according to new research from the University of East Anglia.

Researchers looked at whether interventions such as aerobic and strength or resistance training, had helped participants with asthma.

Although they found that these interventions worked, patients with asthma may have had difficulty undertaking them because of their difficulty travelling to fitness groups or because the interventions were not suitable for people with additional health conditions.

But the team say that digital interventions – such as video appointments, smartwatches and mobile apps – could remove some of these barriers and enable patients to carry out home-based programmes in future.

Prof Andrew Wilson, from UEA’s Norwich Medical School, said: “Being physically active is widely recommended for people with asthma. Doing more than 150 minutes a week of moderate to vigorous physical activity has extensive benefits including improved lung function and asthma control.

“But research has shown that people living with asthma engage in less physical activity and are more sedentary than people without asthma.

“We wanted to find out whether interventions – such as being asked to perform aerobic exercise a few times a week in group sessions, together with ‘goal setting’ – are effective in helping people with asthma be more active.”

The team studied interventions that were designed to promote physical activity in adults with asthma. They looked at 25 separate studies from around the world involving 1,849 participants with asthma, to see whether their symptoms and quality of life were changed thanks to the interventions.

Postgraduate researcher Leanne Tyson, also from UEA’s Norwich Medical School said: “We found that interventions that promote physical activity had significant benefits in terms of increasing physical activity, decreasing time spent sedentary, improving quality of life, and decreasing asthma symptoms.

“This is really important because helping patients make significant behaviour changes could really improve their outcomes in the long term.

“Our review also highlights the potential use of digital interventions, which were notably absent.

“This is important now more than ever as patients have not been able to attend face-to-face support during the Covid-19 pandemic, and services will likely become overwhelmed. Therefore, alternative interventions and methods of delivery need to be considered.”

This study was funded by the Asthma UK Centre For Applied Research.

‘A Systematic Review of the Characteristics of Interventions that Promote Physical Activity in Adults with Asthma’ is published in the Journal of Health Psychology.

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Fitness

Study: Exercising at the start of fast can help people reach ketosis 3.5 hours faster

Exercise made a big difference: when participants exercised, they reached ketosis on average three and a half hours earlier in the fast and produced 43% more BHB. The theory is that the initial exercise burns through a substantial amount of the body’s glucose, prompting a quicker transition to ketosis. Without exercise, the participants hit ketosis about 20 to 24 hours into the fast.

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A new Brigham Young University study published in the journal Medicine & Science in Sports & Exercise finds that exercising intensely at the start of a fast may help maximize health benefits of temporarily foregoing food.

“We really wanted to see if we could change the metabolism during the fast through exercise, especially how quickly the body enters ketosis and makes ketones,” said BYU Ph.D. student Landon Deru, who helped design the study for his thesis.

Ketosis occurs when the body runs out of glucose — its first, preferred fuel — and begins breaking down stored fat for energy, producing chemicals called ketones as a byproduct. In addition to being a healthy energy source for the brain and heart, ketones combat diseases like diabetes, cancer, Parkinson’s and Alzheimer’s.

For the study, the researchers asked 20 healthy adults to complete two 36-hour fasts while staying hydrated. Each fast began after a standardized meal, the first fast starting without exercise and the other with a challenging treadmill workout. Every two hours while awake, the subjects completed hunger and mood assessments and recorded their levels of B-hydroxybutyrate (BHB), a ketone-like chemical.

Exercise made a big difference: when participants exercised, they reached ketosis on average three and a half hours earlier in the fast and produced 43% more BHB. The theory is that the initial exercise burns through a substantial amount of the body’s glucose, prompting a quicker transition to ketosis. Without exercise, the participants hit ketosis about 20 to 24 hours into the fast.

“For me, the toughest time for fasting is that period between 20 and 24 hours, so if I can do something to stop fasting before 24 hours and get the same health outcomes, that’s beneficial,” said study coauthor Bruce Bailey, a BYU exercise science professor. “Or if I do fast for my usual 24 hours but start with exercise, I’ll get even more benefits.”

There are a few caveats to the proposed strategy, however.

“If you carb load or eat a huge meal before you fast, you may not reach ketosis for days, even if you do exercise, so you should eat moderately before fasting,” Bailey said. “We also don’t know the ideal frequency for fasting. There are definitely certain people who shouldn’t fast, such as those with Type 1 diabetes, and obviously it’s detrimental to fast 24/7. But for most people it’s perfectly safe and healthy to fast once or even twice a week for 24 or more hours.”

The study, which required participants to run on a treadmill for an average of 45 to 50 minutes, also didn’t establish an ideal amount or type of exercise for every person. Overall, though, the researchers believe the more energy a person can burn, the better.

“You can get a pretty good estimation of how many calories you’re burning in most exercises, and the more carbohydrates you burn off (without overdoing it or injuring yourself), the better you set the stage for starting ketosis early in your fast,” Deru said.

Also important to note is that, according to the participants’ reports, exercise didn’t seem to aggravate hunger or affect moods during the fast.

“Everyone’s going to be a little grumpier when they fast, but we found that you aren’t going to feel worse with the intervention of exercise — with exercise, you can get these extra benefits and be the exact same amount of grumpy as you would be if you didn’t exercise,” said Deru.

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Wellness

Top 5 heat tips for those with medical-based heat intolerance

Prolonged exposure to routine summer weather is a persistent issue for those with chronic diseases. But the recent record-breaking temperatures are causing ripple effects, sparking symptom flareups, inflammation, and debilitating fatigue.

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The current and seemingly relentless heat waves are dangerous to a growing, but often overlooked community, people with medically-caused heat intolerance, often associated with neurological and autoimmune diseases.

Prolonged exposure to routine summer weather is a persistent issue for those with chronic diseases. But the recent record-breaking temperatures are causing ripple effects, sparking symptom flareups, inflammation, and debilitating fatigue.

“The general public doesn’t really understand what fatigue means,” said Kim Klein, 63. “It causes overwhelming brain fog and I can’t think straight — it gets the best of me. Trying to stay ahead of my multiple sclerosis-related fatigue is the best thing I can do.”

“Extreme heat unfortunately impacts Kim Klein and many of our clients disproportionately,” says Kurtis Kracke, ThermApparel CEO. “But people without chronic disease need to be vigilant as well since many common medications for blood pressure, allergies, and depression, are compounding these issues for all of us. This is a recipe for disaster.”

ThermApparel’s Top Five Tips to Battle Unprecedented Heat Waves:

  1. Limit your exposure: reduce activity, stay indoors, find air conditioning, drink fluids, avoid caffeine, and liquor.
  2. Using a cooling vest can reduce symptom flareups, shorten fatigue, and increase recovery times.
  3. Inflammation and fatigue are your worst enemies: If you must be active, know that heat can aggravate inflammation, and increase corresponding fatigue.
  4. Understand your medications and which can increase your risk to heat-related illness: antidepressants, blood pressure meds, antihistamines, etc.
  5. Know that when it is over 85 degrees, your heart is working double or triple than normal to cool your body down.
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