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Facts and Myths about Exercise Excellent physical condition is not equivalent to good health. Arnold Schwarzenegger needed to have a heart valve replaced. Jean-Claude Van Damme, a famous martial arts actor, suffers from a hearing loss. Chronic training for and competing in extreme endurance events such as marathons, ultra marathons, ironman distance triathlons, and very long distance bicycle races, can cause transient acute volume overload of the atria and right ventricle, with transient reductions in right ventricular ejection fraction and elevations of cardiac biomarkers, all of which return to normal within 1 week. Over months to years of repetitive injury, this process, in some individuals, may lead to patchy myocardial fibrosis, particularly in the atria, interventricular septum, and right ventricle, creating a substrate for atrial and ventricular arrhythmias. Additionally, long-term excessive sustained exercise may be associated with coronary artery calcification, diastolic dysfunction, and large-artery wall stiffening (1). The review by Wilhelm, M., in European Journal of Preventive Cardiology, 02/05/2013, focuses on the prevalence, risk factors, and mechanisms of atrial fibrillation (AF) in endurance athletes, and possible therapeutic options. The sports cardiologist should be aware of the distinctive features of AF in athletes. Therapeutic recommendations should be given in close cooperation with an electro-physiologist. Reduction of training volume is often not desired and drug therapy not well tolerated. An early ablation strategy may be appropriate for some athletes with an impaired physical performance, especially when continuation of competitive activity is intended. Running is more stressful on the body than walking and so is not recommended for the nonathlete. Especially, since walking produces similar health benefits to running. A study (2) used the National Runners’ (n=33 060) and Walkers’ (n=15 945) Health Study cohorts to examine the effect of differences in exercise mode and thereby exercise intensity on coronary heart disease (CHD) risk factors. It was discovered that equivalent energy expenditures by moderate (walking) and vigorous (running) exercise produced similar risk reductions for hypertension, hypercholesterolemia, diabetes mellitus, and possibly CHD. Any type of exercise that requires a movement to be repeated many times can also lead to repetitive strain injuries and eventually arthritis. Lifting more than half your body weight can raise your systolic pressure to 370 millimeters mercury. (Normal systolic pressure is below 120 and normal diastolic pressure, measured as the heart rests between beats, is below 80.). The increased pressure may cause an aortic dissection, in which the heart’s main artery tears. This requires immediate surgical intervention to stem blood loss resulting in death (3). The Nov. 14, 2012, online issue of the J. of the Amer. College of Cardiology contains a paper about the effects of moderate exercise. Certain biomarkers, which were tied to heart injury that was otherwise undetectable but was associated with a higher risk of death by cardiovascular disease, were used. The study consisted of 2900 subjects over the age of 65. They were tracked for their biomarkers along with their levels of physical activity.


The researchers concluded that not only did the biomarkers lower as physical activity went up, but even moderate amounts of exercise in seniors, dramatically lowered the risk of death by heart attack. Data from the Alzheimer's Association (4) show that: more than five million Americans are living with the disease; one in eight older Americans have it and it’s the sixth leading cause of death. A new report, prepared for the Ontario Brain Institute in Canada (5), has shown that one in seven cases of Alzheimer's disease in Ontario could be prevented if people got some exercise - only 30 minutes per day. The researchers reached this conclusion by studying over 900 recent Alzheimer's and dementia articles, focusing on older adults with and without dementia. The 30minute a day recommendation didn't even have to be done all at once. It could be broken into three 10-minute intervals throughout the day! Simply walking or doing some other light form of exercise was enough. One of the reasons why so many of the elderly get Alzheimer's is that 60% of the population age 65 and up are inactive. Daily activity can also improve depression amongst Alzheimer's patients and makes it easier to cope with daily tasks. Research has shown that physical activity engages the brain to create new neurons and blood vessels. Whether we gain, lose or maintain body weight is dependent upon three things: the number of calories: required to maintain life (our metabolism), burned through activity, and consumed. According to Macdonald’s calorie chart the calories in the following foods are: Big Mac 570, Large French Fries 540, Coca-Cola Classic 410, Salad 35 and Dressing 160. The total calories in such a meal are 1715. Two such similar meals would contain 3,430 calories. A 150 lb. person sitting for 15 hours (eating, driving, studying, watching television, etc.) burns an average of about 130 calories an hour. Hence 15 hours of sitting would burn 1,950 calories. If you sleep for 8 hours, you would burn about 552 calories. Exercising by vigorous cycling (1415.9 mph) for an hour would burn about 704 calories. The total calories burned in a day would be 3,104. Few people can or want to engage in such vigorous exercise. Thus, diet and not exercise is the primary factor in losing weight. Obese people can lose weight, probably due to the increased rate of metabolism, by practicing Senobi breathing. This breathing technique, which is simple to learn and only requires 1 minute of practice before each meal, is discussed in the book (7). Breathing exercise can also help a benign, enlarged prostate and arrhythmias are described in Chapter 6 (7). Healthful activities often recommended for non-athletes, the sedentary and the elderly are: Yoga, Tai Chi and Qigong (pronounced Chi Kung). Qigong is a Chinese mind/body/breath coordination exercise. These are also discussed in (7) to help readers decide which of these they might like. The reader will be made aware of the classical purpose of these activities and the difficulty in finding a classical Master. Then, they can decide if they want to learn the made up, shortened versions, devised for profit or the classical ones.


Another health effect of exercise is that it can preserve your vision! A study conducted at the University of Wisconsin School of Medicine analyzed data from the Beaver Dam Eye study, a long-term study that followed nearly 5,000 participants aged 43-84 years between 1988 and 2013. The researchers found that participants who exercised at least three times a week were at much less risk of suffering visual impairment. During a period of twenty years the team found that people who exercised three or more times a week were much less likely to get visual impairment. Approximately two percent of the physically active people became visually impaired, compared with 6.7% of people who led a sedentary lifestyle. When the researchers adjusted their findings for age, they found that physically active people were 58% less likely to develop visual impairment than sedentary people! Many doctors believe that menopausal women, who are at risk for fractures, require drugs to strengthen their bones. These drugs have side effects. Bones can be strengthened through exercise. Wolff's law is a theory developed by the German anatomist and surgeon Julius Wolff (1836– 1902) in the 19th century that states that bone in a healthy person or animal will adapt to the loads it is placed under. If loading on a particular bone increases, the bone will remodel itself over time to become stronger to resist that sort of loading. The internal architecture of the trabeculae undergoes adaptive changes, followed by secondary changes to the external cortical portion of the bone, perhaps becoming thicker as a result. The converse is true as well: if the loading on a bone decreases, the bone will become weaker due to turnover. Sclerostin, is a hormone, works by migrating to bone surfaces, where it impedes bone cell creation. IGF-1 is shorthand for insulin-like growth factor-1, a hormone that promotes growth. Researchers tracked 120 pre-menopausal women for an eight-week period. About half of the women were engaged in a supervised physical-activity routine, while the other half were not. Women who had participated in more than two hours of activity per week were found to have “significantly” lower sclerostin levels and higher IGF-1 levels. “Physical-activity training is conceptually simple and inexpensive, and can serve practical purposes including reducing the risk of low bone mass and osteoporosis, and, consequently, fractures,” the lead researcher Ardawi said. “Our study found that even minor changes in physical activity were associated with clear effects on serum levels of sclerostin, IGF-1 and bone-turnover markers.” See http://www.everydayhealth.com/osteoporosis/0815/a-few-hours-of-weekly-exercise-may-helpwomens-bones.aspx References


1. O'Keefe, J.H. et al. Potential Adverse Cardiovascular Effects from Excessive Endurance Exercise. Mayo Clinic Proceedings, June 2012. 2. Williams, P. T. and Thompson, P. D. Walking Versus Running for Hypertension, Cholesterol, and Diabetes Mellitus Risk Reduction. Arteriosclerosis, Thrombosis, and Vascular Biology, 04/17/2013 Clinical Article. 3. Intense Weight Lifting Linked to Fatal Heart Trouble. http://www.lifeclinic.com/fullpage.aspx?prid=516325&type=1 4. Alzheimer's Association, "Alzheimer's facts and figures," Alzheimer's and Dementia: The Journal of the Alzheimer's Association March 2012; 8: 131창 168.[WP1]. 5. Hauch, V., "Physical activity can prevent Alzheimer's, report finds," The Toronto Star March 2013. http://www.thestar.com/life/health_wellness/2013/03/08/physical_activity_can_prevent _alzheimers_report_finds.html. 6. Eisen, M. Healthy Exercise for Seniors and Non-Athletes, Amazon Kindle, 2013.


Facts and myths about exercise