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Exercise reduces risk of airway disease

Exercise appears to reduce the long-term risk of bronchiectasis, a potentially serious disease of the airways, according to a study published in the journal Radiology.

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Exercise appears to reduce the long-term risk of bronchiectasis, a potentially serious disease of the airways, according to a study published in the journal Radiology.

Bronchiectasis is characterized by repeated cycles of inflammation and exacerbations that damage the airways, leaving them enlarged, scarred and less effective at clearing mucus. This creates an environment ripe for infections. Risk increases with age and the presence of underlying conditions like cystic fibrosis. There is no cure.

Computed tomography (CT) is used to confirm or rule out the disease in patients with symptoms like shortness of breath and coughing up mucus. Bronchiectasis has also been found on CT in asymptomatic and mildly symptomatic individuals.

Little is known about factors that can reduce the risk of bronchiectasis. While some studies have tied higher levels of cardiorespiratory fitness to a reduced risk of declining lung function and airway diseases, such as chronic obstructive pulmonary disease, its benefits in reducing the risk of bronchiectasis are unknown.

To examine the association between cardiorespiratory fitness and bronchiectasis, researchers analyzed data from the long-running Coronary Artery Disease in Young Adults (CARDIA) study. CARDIA was launched in 1984 across the U.S. to examine the risk factors for coronary artery disease in young adults.

The researchers looked at 2,177 healthy adults who were ages 18 to 30 years at the beginning of the study period. The study participants were followed up over a 30-year period with fitness tests and CT.

“We used year zero and year 20 cardiorespiratory fitness measured as exercise duration on a treadmill and ascertained bronchiectasis on chest CT at year 25,” said study lead author Alejandro A. Diaz, M.D., M.P.H., assistant professor of medicine at Harvard Medical School and associate scientist at Division of Pulmonary and Critical Care Medicine at Brigham and Women’s Hospital in Boston. “We assessed whether differences in treadmill duration between year zero and 20 were associated with bronchiectasis on CT at year 25.”

Of the 2,177 participants, 209, or 9.6%, had bronchiectasis at year 25. Preservation of cardiorespiratory fitness reduced the odds of bronchiectasis on CT at year 25.

“In an adjusted model, one minute longer treadmill duration between year zero and year 20 was associated with 12% lower odds of bronchiectasis on CT at year 25,” Dr. Diaz said. “Having preserved fitness at middle age is associated with lower chances of bronchiectasis.”

The researchers pointed to several possible explanations for the relationship between cardiorespiratory fitness and bronchiectasis. For one, a high level of cardiorespiratory fitness is linked with lower levels of systemic inflammation, which might help preserve the health of the airway. Good cardiorespiratory fitness also reduces the risk of certain diseases associated with bronchiectasis, such as asthma and pneumonia. Finally, high fitness levels may improve the ability of the airway to clear mucus.

The researchers observed a higher prevalence of bronchiectasis than found in previous studies. The difference may be explained by the use of CT for detecting bronchiectasis in the new study rather than the physician-based diagnosis used in previous studies.

“This study suggests that bronchiectasis on CT scans might be more frequent than previously thought,” Dr. Diaz said. “However, the clinical implications of finding bronchiectasis on CT scans in people with no or mild symptoms remain to be determined.”

The researchers are studying bronchiectasis in other populations like smokers to look for features of the airways and lung tissue associated with bronchiectasis flare-ups.

“These results amplify the benefits of fitness to human health when a sedentary lifestyle is a concerning world epidemic,” Dr. Diaz said. “It also highlights that fitness might be a tool to preserve lung health. The airways are challenged by what we breathe in every minute, and fitness may help to preserve lung health from injuries.”

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5 Steps for women to reduce their risk of COPD

Women tend to develop COPD earlier in life than men and are more likely to have severe symptoms and be hospitalized with the disease. The good news? According to the National Heart, Lung, and Blood Institute, there are steps you can take to reduce your risk for COPD.

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If you’re a woman who tries to stay healthy, you may exercise several times per week, watch what you eat and get 7-9 hours of sleep each night. But are you listening to your lungs?

Chronic obstructive pulmonary disease (COPD), a leading cause of disability and death in the United States, takes an especially heavy toll on women. You may think problems like shortness of breath, frequent coughs or wheezing are just signs of getting older, but it’s important to pay attention to these symptoms and discuss them with your doctor.

COPD is a serious lung disease that causes breathing problems and worsens over time. It has often been considered a man’s disease. Yet more women than men have been diagnosed with COPD in the past decade, and over the past 20 years more women have died from it, according to the US Centers for Disease Control and Prevention.

Women tend to develop COPD earlier in life than men and are more likely to have severe symptoms and be hospitalized with the disease. The good news? According to the National Heart, Lung, and Blood Institute, there are steps you can take to reduce your risk for COPD.

Don’t Smoke

You probably already know cigarette smoking is harmful  but did you know that women may be more vulnerable to the effects of smoking? Women who smoke tend to get COPD at younger ages and with less cigarettes smoked than men. COPD is the leading cause of death among U.S. women smokers.

If you do smoke, it’s never too late to quit.

If you thought vaping was a healthy alternative to smoking, think again. Researchers are still learning about the long-term health effects of e-cigarettes, but they may contain as many, if not more, harmful chemicals than tobacco cigarettes.

Avoid Pollutants

Among people with COPD who have never smoked, most are women. Women may be more vulnerable to indoor and outdoor air pollution. Women’s smaller lungs and airways mean the same amount of inhaled pollutants may cause more damage.

Working in places like nail salons, hair salons or dry cleaners can expose you to harmful chemicals. If you’re exposed to chemical fumes at your job, talk to your employer about ways to limit exposure. Better ventilation and wearing a mask can help.

Stay Current on Vaccines

People at risk for COPD are more likely to have serious problems resulting from some vaccine-preventable diseases. Ask a health care provider about getting vaccinated against the flu, pneumococcal disease and COVID-19.

Talk to Your Doctor About COPD

Women with COPD tend to be diagnosed later than men when the disease is more severe and treatments are less effective. If you think you could be at risk, or you are having symptoms, bring it up with your health care provider. Treatment can ease symptoms and improve your ability to exercise.

Learn More to Breathe Better

Find more information on COPD from NHLBI’s Learn More Breathe Better program at copd.nhlbi.nih.gov.

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Wellness

Sports like soccer, basketball better for young athletes’ bone health than running alone

The study’s findings support recommendations that athletes delay specialization in running and play multi-directional sports when younger to build a more robust skeleton – and potentially prevent bone stress injuries.

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Young athletes who participate in multidirectional sports, instead of specializing in a unidirectional sport like running, can build stronger bones that may be at less risk for bone injuries as adults, according to a new study from Indiana University researchers.

Published in the American College of Sports Medicine’s Medicine and Science in Sports and Exercise, the study examined Division I and II female cross country runners, who often experience bone stress injuries like stress fractures. The researchers found that athletes who ran and participated in sports that require movement in many directions – such as basketball or soccer – when younger had better bone structure and strength than those who solely ran, swam or cycled.

As a result, the study’s findings support recommendations that athletes delay specialization in running and play multi-directional sports when younger to build a more robust skeleton – and potentially prevent bone stress injuries.

Media kit: Access video interview with Stuart Warden

“Our data shows that playing multidirectional sports when younger versus specializing in one sport, such as running, decreased a person’s bone injury risk by developing a bigger, stronger skeleton,” said Stuart Warden, associate dean for research and Chancellor’s Professor in the IU School of Health and Human Sciences at IUPUI. “There is a common misperception that kids need to specialize in a single sport to succeed at higher levels. However, recent data indicate that athletes who specialize at a young age are at a greater risk of an overuse injury and are less likely to progress to higher levels of competition.”

Historically, Warden said, researchers have examined the bone’s mass – how much bone a person has – to determine how healthy their skeleton will be through life. But in previous studies, Warden and his colleagues found that as a person ages, both mass and size are equally important.

In the current study, the researchers used high-resolution imaging to assess the shin bone near the ankle and bones in the feet where bone stress injuries frequently occur in runners. They found that the athletes who participated in both running and multidirectional sports when younger had 10 to 20 percent greater bone strength than athletes who solely ran.

“Our research shows that the runners who played multidirectional sports when younger had stronger bones as collegiate athletes, which puts them at less risk for bone stress injuries including stress fractures,” Warden said. “We want to ensure people have better, stronger bones as they grow, become adolescents and go through life. Specializing in one sport at too young of an age means they are more likely to get injured and not make it at the collegiate and professional levels.”

Warden said that anyone who oversees a junior athlete or team – whether that be parents, coaches or trainers – should think twice about pushing them to specialize in one area too early. To allow for proper growth and development to occur, he recommends young athletes not specialize until at least their freshman year of high school. For athletes who already play multidirectional sports, he said it is important that they take time off for rest and recovery during the year, which can improve both bone strength and performance.

Additional authors on the study were Austin Sventeckis, Ph.D. student, and Robyn Fuchs, associate professor, of the IU School of Health and Human Sciences at IUPUI, and Rachel Surowiec of the School of Engineering and Technology at IUPUI.

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Wellness

Vegans who lift weights may have stronger bones than other people on a plant-based diet

The researchers found vegan participants who did resistance training exercises such as using machines, free weights, or bodyweight resistance exercises at least once a week had stronger bones than those who did not. They also found vegans and omnivores who engaged in resistance training had similar bone structure.

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People on a plant-based diet who do strength training as opposed to other forms of exercise such as biking or swimming may have stronger bones than other people on a vegan diet, according to new research published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

About 6 percent of people in the US are vegans. Recent research shows a plant-based diet can be associated with lower bone mineral density and increased fracture risk.

“Veganism is a global trend with strongly increasing numbers of people worldwide adhering to a purely plant-based diet,” said Christian Muschitz, M.D., of St. Vincent Hospital Vienna and the Medical University of Vienna in Vienna, Austria. “Our study showed resistance training offsets diminished bone structure in vegan people when compared to omnivores.”

The authors compared data from 43 men and women on a plant-based diet for at least five years and 45 men and women on an omnivore diet for at least five years. Omnivores eat meat as well as plant-based foods.

The researchers found vegan participants who did resistance training exercises such as using machines, free weights, or bodyweight resistance exercises at least once a week had stronger bones than those who did not. They also found vegans and omnivores who engaged in resistance training had similar bone structure. 

“People who adhere to a vegan lifestyle should perform resistance training on a regular basis to preserve bone strength,” Muschitz said.

Other authors of this study include: Robert Wakolbinger-Habel of the Vienna Healthcare Group and the Medical University of Vienna in Vienna, Austria; Matthias Reinweber of the Vienna Healthcare Group; Jürgen König, Daniel König and Rochus Pokan of the University of Vienna in Vienna, Austria; and Peter Pietschmann of the Medical University of Vienna.

The study received no external funding.

The manuscript, “Self-Reported Resistance Training is Associated with Better HR-pQCT Derived Bone Microarchitecture in Vegan People,” was published online, ahead of print.

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