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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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Higher fitness levels linked to lower risk of depression, dementia – Harvard Health

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Higher fitness levels linked to lower risk of depression, dementia – Harvard Health
research review

People with high cardiorespiratory fitness were 36% less likely to experience depression and 39% less likely to develop dementia than those with low cardiorespiratory fitness. Even small improvements in fitness were linked to a lower risk. Experts believe that exercise’s ability to boost blood flow to the brain, reduce bodywide inflammation, and improve stress regulation may explain the connection.

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These 20-Minute Burpee Workouts Replaced His Entire Gym Routine – and Transformed His Physique

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These 20-Minute Burpee Workouts Replaced His Entire Gym Routine – and Transformed His Physique

While many swear by them, most people see burpees as a form of punishment – usually dished out drill sergeant-style by overzealous bootcamp PTs. Often the final blow in an already brutal workout, burpees are designed to test cardiovascular fitness, muscular endurance and mental grit. Love them or loathe them, they deliver every time.

For Max Edwards – aka Busy Dad Training on YouTube – they became a simple but highly effective way to stay fit and lean during lockdown. Once a committed powerlifter, spending upwards of 80 minutes a day in the gym, he was forced to overhaul his approach due to fatherhood, lockdown and a schedule that no longer allowed for long, structured lifting sessions.

‘Even though I was putting in hours and hours into the gym and even though my physique was pretty good, I wasn’t becoming truly excellent at any physical discipline,’ he explained in a YouTube video.

‘I loved the intentionality of training,’ says Edwards. ‘The fact that every session has a point, every rep in every set is helping you get towards a training goal, and I loved that there was a clear way of gauging progression – feeling like I was developing competence and moving towards mastery.’

Why He Walked Away From Powerlifting

Despite that structure, Edwards began to question whether powerlifting was sustainable long-term.

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‘My sessions were very taxing on my central nervous system. I was exhausted between sessions. It felt as if I needed at least nine hours of sleep each night just to function.’

He also noted that his appetite was consistently high.

But the biggest drawback was time.

‘I could not justify taking 80 minutes a day away from my family for what felt like a self-centred pursuit,’ he says.

A Simpler Approach That Stuck

‘Over the course of that year I fixed my relationship with alcohol and I developed, for the first time in my adult life, a relationship with physical training,’ says Edwards.

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With limited time and no access to equipment, he turned to burpees. Just two variations, four times a week, with each session lasting 20 minutes.

‘My approach in each workout was very simple. On a six-count training day I would do as many six-counts as I possibly could within 20 minutes. On a Navy Seal training day I would do as many Navy Seal burpees as I could within 20 minutes – then in the next workout I would simply try to beat the number I had managed previously.’

This style of training is known as AMRAP – as many reps (or rounds) as possible.

The Results

Edwards initially saw the routine as nothing more than a six-month stopgap to stay in shape. But that quickly changed.

‘I remember catching sight of myself in the mirror one morning and I was utterly baffled by the man I saw looking back at me.’

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He found himself in the best shape of his life. His energy levels improved, his resting heart rate dropped and his physique changed in ways that powerlifting hadn’t quite delivered.

‘It has been five years since I have set foot in a gym,’ he says. ‘That six-month training practice has become the defining training practice of my life – and for five years I have trained for no more than 80 minutes per week.’

The Burpee Workouts

1/ 6-Count Burpees

20-minute AMRAP, twice a week

How to do them:

  • Start standing, feet shoulder-width apart
  • Crouch down and place your hands on the floor (count 1)
  • Jump your feet back into a high plank (count 2)
  • Lower into the bottom of a push-up (count 3)
  • Push back up to plank (count 4)
  • Jump your feet forward to your hands (count 5)
  • Stand up straight (count 6)

20-minute AMRAP, twice a week

How to do them:

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  • Start standing, feet shoulder-width apart
  • Crouch down and place your hands on the floor
  • Jump your feet back into a high plank
  • Perform a push-up (chest to floor)
  • At the top, bring your right knee to your right elbow, then return
  • Perform another push-up
  • Bring your left knee to your left elbow, then return
  • Perform a third push-up
  • Jump your feet forward
  • Stand or jump to finish

Headshot of Kate Neudecker

Kate is a fitness writer for Men’s Health UK where she contributes regular workouts, training tips and nutrition guides. She has a post graduate diploma in Sports Performance Nutrition and before joining Men’s Health she was a nutritionist, fitness writer and personal trainer with over 5k hours coaching on the gym floor. Kate has a keen interest in volunteering for animal shelters and when she isn’t lifting weights in her garden, she can be found walking her rescue dog.

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Six ways your smartwatch is lying to you, according to science

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Six ways your smartwatch is lying to you, according to science

You check your smartwatch after a run. Your fitness score has dropped. You’ve burnt hardly any calories. Your recovery score is really low. It’s telling you to take the next 72 hours off exercise.

The worst bit? The whole run felt amazing.

So why is your watch telling you the opposite?

Ultimately, it’s because smartwatches and other fitness trackers aren’t always accurate.

Smartwatches can shape how you exercise

Using wearable fitness technology, such as smartwatches, has been one of the top fitness trends for close to a decade. Millions of people around the world use them daily.

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These devices shape how people think about health and exercise. For example, they provide data about how many calories you’ve burnt, how fit you are, how recovered you are after exercise, and whether you’re ready to exercise again.

But your smartwatch doesn’t measure most of these metrics directly. Instead, many common metrics are estimates. In other words, they’re not as accurate as you might think.

1. Calories burned

Calorie tracking is one of the most popular features on smartwatches. However, the accuracy leaves a lot to be desired.

Wearable devices can under- or overestimate energy expenditure (often expressed as calories burned) by more than 20 per cent. These errors also vary between activities. For example, strength training, cycling and high-intensity interval training can lead to even larger errors.

This matters because people often use these numbers to guide how much they eat.

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For example, if your watch overestimates calories burned, you might think you need to eat more food than you really need, which could result in weight gain. Conversely, if your watch underestimates calories burned, it could lead you to under-eat, negatively impacting your exercise performance.

2. Step counts

Step counts are a great way to measure general physical activity, but wearables don’t capture them perfectly.

Smartwatches can under-count steps by about 10 per cent under normal exercise conditions. Activities such as pushing a pram, carrying weights, or walking with limited arm swing likely make step counts less accurate, as smartwatches rely on arm movement to register steps.

For most people, this isn’t a major problem, and step counts are still useful for tracking general activity levels. But view them as a guide, rather than a precise measure.

3. Heart rate

Smartwatches estimate your heart rate using sensors that measure changes in blood flow through the veins in your wrist.

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This method is accurate at rest or low intensities, but gets less accurate as you increase exercise intensity.

Arm movement, sweat, skin tone and how tightly you wear the watch can also impact the heart rate measure it spits out. This means the accuracy can vary between people.

This can be problematic for people who use heart rate zones to guide their training, as small errors can lead to training at the wrong intensity.

4. Sleep tracking

Almost every smartwatch on the market gives you a “sleep score” and breaks your night into stages of light, deep and REM sleep.

The gold standard for measuring sleep is polysomnography. This is a lab-based test that records brain activity. But smartwatches estimate sleep using movement and heart rate.

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This means they can detect when you’re asleep or awake reasonably well. But they are much less accurate at identifying sleep stages.

So even if your watch says you had “poor deep sleep”, this may not be the case.

5. Recovery scores

Most smartwatches track heart rate variability and use this, with your sleep score, to create a “readiness” or “recovery” score.

Heart rate variability reflects how your body responds to stress. In the lab it is measured using an electrocardiogram. But smartwatches estimate it using wrist-based sensors, which are much more prone to measurement errors.

This means most recovery metrics are based on two inaccurate measures (heart rate variability and sleep quality). This results in a metric that may not meaningfully reflect your recovery.

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As a result, if your watch says you’re not recovered, you might skip training — even if you feel good (and are actually good to go).

6. VO₂max

Most devices estimate your VO₂max — which indicates your maximal fitness. It’s the maximum amount of oxygen your body can use during exercise.

The best way to measure VO₂max involves wearing a mask to analyse the amount of oxygen you breathe in and out, to determine how much oxygen you’re using to create energy.

But your watch cannot measure oxygen use. It estimates it based on your heart rate and movement.

But smartwatches tend to overestimate VO₂max in less active people and underestimate VO₂max in fitter ones.

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This means the number on your watch may not reflect your true fitness.

What should you do?

While the data from your smartwatch is prone to errors, that doesn’t mean it is completely worthless. 

These devices still offer a way to help you track general trends over time, but you should not pay attention to daily fluctuations or specific numbers.

It’s also important you pay attention to how you feel, how you perform and how you recover. This is likely to give you even more insight than what your smartwatch says.

Hunter Bennett is a lecturer in exercise science at Adelaide University. This piece first appeared on The Conversation.

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