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Heart disease: Cardio fitness reduces death risk, promotes longevity

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Heart disease: Cardio fitness reduces death risk, promotes longevity
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A new meta-analysis shows aerobic exercise substantially reduces the risk of death from all causes, especially heart disease. Charday Penn/Getty Images
  • A new study confirms aerobic exercise can substantially reduce the risk of early death from any cause, especially heart disease.
  • The meta-analysis, which includes more than 20 million observations, shows that increased physical activity lowers mortality risk.
  • Cardiovascular health impacts the health of the entire body, and exercise is the best way to promote it.

A large new study shows that people who regularly engage in aerobic exercise have a significantly greater chance of living longer and a lower risk of heart disease.

The meta-analysis, led by Grant Tomkinson, PhD, a research professor at the University of South Australia, analyzed the results of 26 systematic reviews of 199 unique cohort studies.

These trials investigated links between exercise, all-cause mortality, and cardiovascular health. All told, they involved 20.9 million researcher observations.

The researchers measured energy expenditure from cardio fitness with METs or “metabolic equivalent of tasks.”

The amount of energy spent sitting quietly is 1-MET. The findings show that for every additional 1-MET exerted via aerobic exercise, the risk of all-cause death lowered from 11% to 17% and the risk of heart failure reduced by up to 18%.

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The results of this study are published in the British Journal of Sports Medicine.

Cardiorespiratory fitness is an important measure of overall health.

“Cardio fitness, often referred to as cardiorespiratory fitness (CRF) or aerobic fitness, reflects the ability of the heart, lungs, and blood vessels to supply oxygen during sustained physical activity,” said lead study author Justin J. Lang, PhD, a research analyst at CHEO Research Institute in Ottawa, Canada.

Aerobic exercise, Lang told Medical News Today, is the key to maintaining cardiorespiratory fitness.

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There are many ways to strengthen your cardiorespiratory fitness through aerobic activities. Examples of common, heart-pumping aerobic exercises include:

Jayne Morgan, MD, cardiologist and the executive director of Health and Community Education at the Piedmont Healthcare Corporation in Atlanta, GA, not involved in the study, explained to MNT:

“The heart is providing oxygen to every organ and tissue within the body. This allows for optimal performance of the body. As heart function declines, other organ systems are at risk of both a decreased blood flow as well as a decreased oxygen uptake and delivery. The stronger the heart, the more efficiently it pumps blood, keeping other tissues healthy and performing optimally.”

Lang noted additional reasons why a strong, healthy heart is key to overall health and longevity. He noted that robust circulation can help prevent heart attacks, strokes, and hypertension, “which are the leading causes of early death worldwide,” he said.

Exercise can also help keep cholesterol — a major risk factor for cardiovascular disease — under control, and a strong heart can help one respond “to the many stressors and demands of life,” Lang added.

Additionally, physical activity has been linked to a “reduced risk of some cancers, dementia, depression, kidney disease, and type 2 diabetes, but the mechanisms aren’t as well understood,” Lang said.

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According to Lang, there are several ways to gauge your level of cardio fitness, although he recommends, when possible, trying “a field-based measure of cardiorespiratory fitness to get a more accurate assessment.”

For children, youth, and fit adults, Lang said the most widely used field-based test is a 20-meter shuttle run.

“This involves running back and forth between two parallel lines to the accelerating pace of an audio recording [designed for this purpose]. “The longer the person lasts, the higher their cardiorespiratory fitness score,” he explained.

For people who may have lower levels of cardiorespiratory fitness, there is an alternative: a walk test that measures the distance covered in six minutes of continuous walking.

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Lang cited fitness wearables that monitor one’s heart rate following exercise. He also recommended a self-diagnostic questionnaire. He also cautioned the following:

“It’s important to note that while self-assessment methods can offer valuable insights into cardiorespiratory fitness levels, consulting a healthcare provider or fitness professional for a comprehensive assessment and personalized recommendations is advisable, especially for individuals with pre-existing health conditions or those new to exercise.”

It is always a good idea to speak with a physician before undertaking a new exercise regimen. A physician may ask for self-reports of weekly amounts of exercise or implement formal testing with treadmills, cycling, or bench step testing.

“An annual CRF measurement that is symptom-limited can be clinically useful to both guide and encourage wellness activity,” Lang said.

Another good reason to devise a heart-health exercise regimen with an expert is that different individuals may receive varying benefits from the same physical activities.

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“Many factors are important to consider when trying to improve cardiorespiratory fitness, including genetics, age, sex, overall health status, and lifestyle factors,” Lang said.

“A highly fit athlete may require a high frequency of exercise throughout the week, at high intensity, and for longer sessions to improve cardiorespiratory fitness. Someone just starting out might benefit substantially from a brisk walk at low intensity for 20–30 minutes a few times a week,” Lang added.

Morgan noted that the study “specifically excluded athletes with extremely high-performance levels, as well as the debilitated on the other end of the spectrum. And while 1-MET is the measure via which the mortality is decreased, even those who achieved less than 1-MET saw benefits in all-cause mortality and death.”

Lang said not everyone responds to exercise in the same way. As a result, “it’s important to explore options and discover what works best for you,” he suggested.

“The important thing to consider when embarking on a physical activity journey is that something is better than nothing,” Lang said.

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Fitness

New Year’s Fitness Goals: Avoid These Common Mistakes

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New Year’s Fitness Goals: Avoid These Common Mistakes

A new year usually brings new fitness goals, fueling spikes in gym memberships and social media feeds filled with workout selfies. Yet, just as quickly as this wave of motivation appears, it usually recedes.

Why does this cycle repeat itself year after year? Well-meaning individuals often start with intense, all-or-nothing approaches that are difficult to sustain, fitness experts say. Life gets in the way, motivation wanes, and the pressure to see immediate results leads to burnout.

A commitment to fitness is a common challenge, and finding a solution is crucial for long-term success, according to Steven Hale, M.D., a primary care sports medicine physician with Baptist Health Orthopedic Care. To get expert advice on this topic, award-winning journalist Johanna Gomez hosted a new Baptist Healthtalk podcast featuring Dr. Hale.

He emphasizes that the most effective plan is one that fits into one’s life seamlessly.

“If it’s in your schedule every day, then you’re going to have to do something active,” Dr. Hale explains. “Whether that’s mobility, maybe you only have 20 or 15 minutes to stretch. Maybe you have an hour this one day because you got off work early. Now you can do some more strength training and maybe some increased cardio.”

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This approach shifts the focus from overwhelming daily workouts to simply incorporating movement into your daily schedule. Building on this foundation of practical advice, Dr. Hale answered some of the most common questions about starting a new fitness routine.

I haven’t worked out in a long time. What’s a good way to start without getting overwhelmed or injured?

Dr. Hale: It really depends on your previous activity level and experience with exercise. Someone who was a college athlete or has a lot of experience can probably go back to the gym, start with lighter weights, and build from there. For someone who is less experienced or doesn’t enjoy the gym environment, I often recommend starting at home. You can look up fun follow-along exercise videos on platforms like YouTube.

Classes can also be a great option for those new to exercise, as they provide guidance from instructors. Personal trainers are another fantastic resource if they fit your budget. The key is to start slow to minimize your risk of injury. Don’t go too hard in the beginning. The first few workouts might not feel great as you get back in shape, so making it fun and enjoyable will help you stick with it longer.

Diet and exercise are both important, but which one should I focus on more if I want to see results?

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Dr. Hale: As a doctor, I have to say they go hand-in-hand; I can’t recommend one without the other. Diet is just as important, if not more important, than exercise when it comes to seeing results quickly. In the short term, diet probably has a slight edge. We often talk about creating a calorie deficit for weight loss, which means the calories you consume should be less than the calories you burn.

It’s much easier to consume calories than it is to burn them. A single high-calorie meal can easily undo the effort of an hour-long workout. However, for long-term health, diet and exercise are equally important. What you put into your body for nutrients is just as vital as staying active. Instead of overhauling your entire diet at once, which is hard to stick to, try making one small, manageable change each week. For example, cut out one specific snack food or fast-food meal. This slow progression helps you build sustainable habits.

How do I know the difference between normal muscle soreness and an actual injury?

Dr. Hale: It’s a great question because many people enjoy the feeling of being sore after a good workout — it’s like a victory. Soreness is typically a dull ache that you feel after exercise, and it usually goes away within a few days. Pain that should concern you is more severe. On a pain scale of one to ten, anything greater than a three is something to pay attention to.

Concerning pain might also be sharp, or you might have felt a ‘popping’ sensation during your workout. Other warning signs include mechanical symptoms like a joint feeling unstable or locking up. These are more serious symptoms that indicate you should probably see an orthopedic specialist. It’s important to listen to your body and not push through sharp or worsening pain.

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The phrase “no pain, no gain” is very popular. Is it true that I need to push through pain to make progress?

Dr. Hale: That is one of the first myths I address in my practice. The “no pain, no gain” philosophy is not a good approach for orthopedic health. If you feel pain, it’s a sign that there is inflammation in that area. Pushing through that pain will only worsen the inflammation and delay your recovery.

Instead of pushing through it, pain is a signal from your body to rest or modify your activities. Give the affected area time to heal and for the inflammation to calm down before you return to that specific exercise. If you continue to push through pain, you risk causing the issue to last longer or become more severe. You can likely push through discomfort that is less than a three out of ten on the pain scale, but anything more than that requires attention.

I want to stay consistent, but I’ve heard working out every day is bad. How often should I be exercising?

Dr. Hale: This depends on how you define ‘workout.’ If you’re doing intense strength training where you are really stressing your muscles, those muscles need time to recover. Overtraining can lead to inflammation, pain, and a higher risk of injury. In that case, you need to build recovery days into your schedule.

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However, you can and should do something active every day. I recommend having something in your schedule daily because it makes it harder to use excuses and push it off. We can think of these as ‘mobility days’ versus ‘strength days.’ A mobility day could be stretching, yoga, or going for a walk. A strength day involves more intense activity like lifting weights or jogging. For example, a good plan could be three or four strength training days per week with active recovery like walking on the other days. This way, you are moving your body every day while still giving your muscles time to recover. Any activity is beneficial.

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Here’s how strong your grip should be in each decade of your life

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Here’s how strong your grip should be in each decade of your life

I recently took a longevity fitness test, an element of which included a grip strength assessment with a hand dynamometer. Research links grip strength to longevity, as it is considered a good indicator of overall physical strength and risk of frailty, as well as neuromuscular function (or the connection between brain and muscle).

How is grip strength linked to longevity?

“Handgrip strength is measured with a handheld dynamometer as the peak force produced by a maximal isometric contraction of the forearm muscles. From research, it is proven to give a quick, reliable snapshot of global muscle strength and is considered a biomarker for physiological reserve, rather than just hand function,” explains Athanasios Tzoumaris, strength and conditioning coach at London-based gym and health clinic Hooke Fitness, where I took my test.

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This is how an expert coach builds the type of strength that makes you “feel like you can handle anything”

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This is how an expert coach builds the type of strength that makes you “feel like you can handle anything”

Many of us use the New Year as a fresh start and embark on a new fitness regime. If that sounds familiar, it pays to heed this tried-and-tested advice from strength coach and yoga teacher Alex Silver-Fagan.

The new star trainer on Chris Hemsworth’s Centr app recently launched a 12-week training program called The Foundation, which she says follows four key phases that will guarantee long-lasting success.

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