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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.

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“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.

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How to help children build a growth mindset

Consider these three tips to help children build a growth mindset.

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A new year is a perfect time to consider the habits you want to keep and the ones you’d like to develop. One resolution to consider is helping your children develop a growth mindset this year.

“We know one of the greatest boosts to parents’ confidence over the past year came from knowing their children’s whole selves are being nurtured, and we want to see that trend continue,” said Carter Peters from KinderCare Learning Center’s education team. “A growth mindset helps children try new things despite fear of failure. It’s the kind of thinking that allows inventors and creative thinkers to get excited about trying something new and ensures they have the cognitive flexibility and problem-solving skills to work through hurdles.”

Adults can often easily spot when children are engaged in creative thinking and prideful of their work, but that confidence may be lost as failures turn into insecurities. By nurturing a growth mindset and showing children they can learn and develop new skills in any area, it better sets them up for long-term success.

Consider these three tips to help children build a growth mindset:

Photo by Markus Spiske from Unsplash.com

1. Praise effort

It’s easy to fall into the habit of praising successes. However, praising effort encourages children to try new things without the fear of failing. It also teaches children personal growth and achievement are possible, even if their overall effort wasn’t a success.

“Young children often get excited to try something new,” Peters said. “By praising effort and showing children they’ll still be loved and valued despite the outcome, you can reframe how they approach challenges and teach them that difficult doesn’t mean impossible.”

2. Encourage the process

People often withhold praise until there’s a result, which leads children to hurriedly scribble a picture to hold up for a “good job” instead of taking time to focus on their efforts. When children know adults will encourage them during the process, instead of only upon the achievement, they’re more likely to try new things or master a new skill. For example, try providing encouragement such as, “I can see you’re focused on drawing that tree. It looks so lifelike because you’re putting so much thought into what you’re doing.” Once their project is finished, continue the encouragement by hanging up their artwork or school projects in a prominent place.

3. Model a growth mindset

You can model a growth mindset for children by narrating your actions when you are facing a challenge: “I am having a difficult time putting this shelf together, but it’s OK. I’ll take a break then read the instructions again.” Remove negative words from your vocabulary, such as “I can’t” or “I’m stupid.” Even when you are joking, children may not be able to tell the difference. You can also ask your children to join you in problem-solving. Take time to hear their ideas and try them even if you think they won’t work. This not only supports the development of their growth mindset, but the quality time and encouragement reinforces their sense of self-worth and builds confidence.

For more tips to help children develop a growth mindset, visit kindercare.com.

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Signs of a Healthy Marriage

Although there are many different ways to define a healthy marriage, these three qualities are essential for any lasting and fulfilling relationship.

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A healthy marriage is built on trust, respect, and communication. Couples with these qualities in their relationship tend to be more satisfied with their marriage and overall life. They also report feeling closer to their partner and having stronger well-being. With 2.3 out of every 1000 people in the US experiencing divorce in 2022, it is important to frequently check in on the health of your marriage.

Although there are many different ways to define a healthy marriage, these three qualities are essential for any lasting and fulfilling relationship.

Signs of a Healthy Marriage

A healthy marriage is built on trust, communication, and mutual respect. If you and your partner can effectively communicate and share a mutual level of respect, then your relationship is off to a good start. Trust is also important in a healthy marriage, as it allows you and your partner to feel secure in your relationship and rely on each other.

Many other signs can indicate whether or not a marriage is healthy. For example, couples who can spend quality time together and enjoy shared activities usually do well. Couples who can openly discuss their relationship with each other and work through difficulties together are also more likely to have a happy and healthy marriage. Finally, marriages, where both partners feel like they can be themselves without judgment from their spouse tend to be the strongest and most lasting.

Freedom to be yourself

In a healthy marriage, partners feel free to be themselves. They don’t have to put on a facade or pretend to be someone they’re not. They can be open and honest with each other and feel comfortable sharing their thoughts, feelings, and desires.

Both partners should pursue their interests and hobbies without compromising or sacrificing for the sake of the relationship. There’s no need to agree on everything – in fact, it’s healthy to have some separate interests – but overall, both partners should feel like they’re able to be true to themselves within the relationship.

Lots of good communication

In a healthy marriage, partners can communicate effectively. It means expressing needs and wants and listening and responding to what the other person is saying. There are mutual respect’s opinions, even if there are disagreements. Couples in a healthy marriage feel comfortable communicating with each other about both the good and the bad.

Good sex life

A good sex life can be a major sign of a healthy marriage. A lack of sexual activity can be an early warning sign that something is wrong in the relationship. Often, couples who have a good sex life are more connected emotionally and physically. They are also more likely to trust each other and communicate openly.

Trust in each other

In any relationship, trust is essential. Without trust, there is no foundation for the relationship to grow. In a marriage, trust is even more important. Trusting your spouse means you feel confident in their ability to support you emotionally and financially. It also means that you feel safe sharing your innermost thoughts and feelings with them.

When you trust your spouse, you know they have your best interests. You feel comfortable being yourselves around each other and sharing your hopes, dreams, and fears. Openness and honesty in your relationship allow you to be vulnerable with each other. This vulnerable honesty creates a deeper level of intimacy in your marriage.

When you trust each other, you can be more forgiving when mistakes are made. You know that everyone makes mistakes and that nobody is perfect. You also understand that your spouse is human and capable of making mistakes like anyone else. If they make a mistake, you are more likely to forgive them because you know they are sorry and will try not to make the same mistake again.

Trust is one of the most important foundations of a healthy marriage. If you want your marriage to thrive, build trust in each other.

A successful, strong marriage takes work, but with communication, trust, respect, vulnerability, and affection as its core components, you can together create a partnership that will be long-lasting.

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Obesity linked to macular degeneration

Immune cells are also activated when the body is exposed to stressors such as excess fat in obesity, making being overweight the number one non-genetic risk factor for developing AMD, after smoking.

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A Canadian study published in the prestigious journal Science elucidates a new molecular mechanism that may cause age-related macular degeneration (AMD).

The research at Hôpital Maisonneuve-Rosement, in Montreal, shows how life stressors such as obesity reprogram immune system cells and make them destructive to the eye as it ages.

“We wanted to know why some people with a genetic predisposition develop AMD while others are spared,” said Université de Montréal ophtalmology professor Przemyslaw (Mike) Sapieha, who led the study by his postdoctoral fellow Dr. Masayuki Hata.

“Although considerable effort has been invested in understanding the genes responsible for AMD, variations and mutations in susceptibility genes only increase the risk of developing the disease, but do not cause it,” Sapieha explained.

“This observation suggests that we must gain a better understanding of how other factors such as environment and lifestyle contribute to disease development.”

AMD is a major cause of irreversible blindness worldwide and affected approximately 196 million people in 2020. It comes in two forms:

  • dry AMD, characterized by the accumulation of fatty deposits at the back of the eye and the death of nerve cells in the eye,
  • and wet AMD, which is characterized by diseased blood vessels that develop in the most sensitive part of the sight-generating tissue, called the macula.

Contact with pathogens

It is already known that the immune system in the eye of a person with AMD becomes dysregulated and aggressive. Normally, immune cells keep the eye healthy, but contact with pathogens such as bacteria and viruses can make them go awry.

At the same time, immune cells are also activated when the body is exposed to stressors such as excess fat in obesity, making being overweight the number one non-genetic risk factor for developing AMD, after smoking.

In their study, Sapieha and Hata used obesity as a model to accelerate and exaggerate the stressors experienced by the body throughout life.

They found that transient obesity or a history of obesity leads to persistent changes in the DNA architecture within immune cells, making them more susceptible to producing inflammatory molecules.

“Our findings provide important information about the biology of the immune cells that cause AMD and will allow for the development of more tailored treatments in the future,” said Hata, now an ophthalmology professor at Kyoto University, in Japan.

The researchers hope their discovery will lead other scientists to broaden their interest beyond obesity-related diseases to other diseases characterized by increased neuroinflammation, including Alzheimer’s disease and multiple sclerosis.

About this study

“Past history of obesity triggers persistent epigenetic changes in innate immunity and exacerbates neuroinflammation,” by Mike Sapieha and Masayuki Hata, was published in Science.

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