Exercise and Fitness

Howard LeWine, M.D.

New trial muddies the water about diet, exercise, and diabetes

Long-awaited results from a nearly 10-year trial exploring the effect of changes in diet and exercise among people with diabetes weren’t what most people expected. The Look AHEAD trial found that intensive efforts to lose weight by eating less and exercising more didn’t provide any more protection against heart disease—a common co-traveler with diabetes—than standard diabetes support and education. The spin from some media reports is that weight loss doesn’t reduce heart disease risk among people with type 2 diabetes, but I think that’s the wrong interpretation. The results of the Look AHEAD trial don’t contradict the value of lifestyle changes. People in the intensive change group improved their blood sugar with fewer drugs, saving an estimated $600 per year, they were also less likely to have developed chronic kidney disease and less self-reported vision problems. The Look AHEAD results reinforce for me that diabetes care needs to be tailored to the individual.

Patrick J. Skerrett

Exercise is good, not bad, for arthritis

When pain strikes, it’s human nature to avoid doing things that aggravate it. That’s certainly the case for people with arthritis, many of whom tend to avoid exercise when a hip, knee, ankle or other joint hurts. Although that strategy seems to make sense, it may harm more than help. Taking a walk on most days of the week can actually ease arthritis pain and improve other symptoms. It’s also good for the heart, brain, and every other part of the body. Yet a new survey from the Centers for Disease Control and Prevention shows that more than half of people with arthritis don’t walk at all for exercise, and only 23% meet the current recommendation for activity—walking for at least 150 minutes a week. Walking is good exercise for people with arthritis, but it isn’t the only one. A review of the benefits of exercise for people with osteoarthritis (the most common form of arthritis) found that strength training, water-based exercise, and balance therapy were the most helpful for reducing pain and improving function.

Peter Wayne

Tai chi improves balance and motor control in Parkinson’s disease

It isn’t every day that an effective new treatment for some Parkinson’s disease symptoms comes along. Especially one that is safe, causes no adverse side effects, and may also benefit the rest of the body and the mind. That’s why a report in the New England Journal of Medicine showing that tai chi may improve balance and prevent falls among people with Parkinson’s disease is so exciting. This and earlier studies are significant because they suggest that tai chi can be used as an add-on to current physical therapies and medications to ease some of the key problems faced by people with Parkinson’s disease. Since the appearance of the New England Journal of Medicine study, tai chi classes specifically for Parkinson’s disease patients have sprung up across the country, and the benefits of tai chi for Parkinson’s disease have been endorsed by the National Parkinson’s Foundation.

Daniel DeNoon

Benefit to improving diet and exercise at the same time

When you decide it’s time to live a healthier lifestyle, you’re likely to get better long-term results if you start improving your diet and increasing physical activity at the same time. It may seem better to improve just one thing at a time.  But while you don’t have to make drastic changes overnight, a new […]

Julie Silver, M.D.

Power training provides special benefits for muscles and function

Strength training is a popular term for exercises that build muscle by harnessing resistance against an opposing force. The resistance can come from your body, or from free weights, elasticized bands, or specialized machines. It makes muscles stronger. Another type of training, known as power training, is proving to be just as important as strength training in maintaining or restoring function. As the name suggests, power training is aimed at increasing power, which is the product of both strength and speed. Optimal power reflects how quickly you can exert force to produce the desired movement. Here’s an example: Faced with a four-lane intersection, you may have enough strength to walk across the street. But it’s power, not just strength, that can get you across all four lanes of traffic before the light changes. Likewise, power can prevent falls by helping you react swiftly if you start to trip or lose your balance. Some power moves are strength training exercises done at a faster speed. Others rely on the use of a weighted vest, which is worn while performing certain exercises that are typically aimed at improving functions such as bending, reaching, lifting, and rising from a seated position.

Heidi Godman

Which is better for keeping your mind fit: physical or mental activity?

Physical and mental activities are both important for protecting your thinking skills and warding off dementia. But does one trump the other? A study published yesterday in JAMA Internal Medicine tried to tease out if one was better than the other for brain health. Researchers recruited 126 older adults who felt that their memory or thinking skills had recently gotten worse, and divided them into four groups. All were asked to do an hour of mental activity three times a week and an hour of physical activity three times a week. What differed were the intensities of these activities. After 12 weeks, scores on thinking tests improved across the board. The big surprise was that there weren’t any real differences in improvement between the groups. The researchers concluded that the amount of activity is more important for stimulating the brain than the type of activity, because all of the participants both exercised and engaged in mental activities each week.

Anthony Komaroff, M.D.

Many miss prediabetes wake-up call

Type 2 diabetes doesn’t usually appear all of a sudden. Many people have a long, slow, invisible lead-in to it called prediabetes. During this period, blood sugar levels are higher than normal. However, they’re not high enough to cause symptoms or to be classified as diabetes. It’s still possible at this stage to prevent the slide into full-blown diabetes. Think of prediabetes as a wake-up call. Unfortunately, few people ever hear the alarm. A new report from the Centers for Disease Control and Prevention shows that among Americans age 20 and older, only 10% of those with prediabetes know they have it. Given that as many as 73 million Americans have prediabetes, that’s a lot of missed opportunities to prevent the ravages of diabetes. One reason many people don’t know that they may be headed toward diabetes is they’ve never had their blood sugar tested. This simple test isn’t part of routine preventive care, but perhaps it should be.

Patrick J. Skerrett

New concussion guidelines say “When in doubt, sit it out”

New guidelines for recognizing and managing sports-related concussions could help protect the brains of millions of athletes at all levels of play, from professional football to youth soccer. The guidelines, released today by the American Academy of Neurology (AAN), replace a now-outdated set published in 1997. The guidelines step away from trying to “grade” concussions or diagnose them on the field or sidelines. Instead, they focus on immediately removing from play athletes who are suspected of having a concussion until they can be evaluated. “When in doubt, sit it out.” The AAN estimates that concussions cause between 1.6 million and 3.8 million mild brain injuries each year. Many athletes don’t get medical attention for these injuries, often because they or their coaches don’t recognize the warning signs or take them seriously. The new guidelines should help better identify athletes who have suffered concussions and improve how concussions are managed and treated.

Patrick J. Skerrett

Shoveling snow can be hard on the heart

As a huge, snowy Nor’easter barrels into New England, I’m thinking about all the shoveling I’ll be doing over the next couple days. Luckily I have three teenagers to help. But now that I’m of an AARP age, I have to be more mindful of the cardiovascular effects of shoveling. Snow shoveling is a known trigger for heart attacks. Emergency rooms in the snowbelt gear up for extra cases during significant snow storms. What’s the connection? Many people who shovel snow rarely exercise. Picking up a shovel and moving hundreds of pounds of snow, particularly after doing nothing physical for several months, can put a big strain on the heart. Pushing a heavy snow blower can do the same thing. Cold weather also contributes. Tips for protecting the heart include shoveling many light loads instead of fewer heavy ones, taking frequent breaks, and hiring a teenager.

Edward Phillips, M.D.

Build your core muscles for a healthier, more active future

Many exercise programs these days spotlight the ever-present abs (abdominal muscles) but pay little attention to the other muscles that form the body’s core. Yet building up all of your core muscles is essential for staying strong and flexible and improving performance in almost any sport. It’s also vital for sidestepping debilitating back pain. Your core includes your back, side, pelvic, and buttock muscles, as well as the abdominal muscles. The core forms a sturdy central link between your upper and lower body. Much like the trunk of a tree, core muscles need to be strong yet flexible. A strong, flexible core underpins almost everything you do, from everyday actions like bending to put on shoes to on-the-job tasks, sports and sexual activity, and more. A strong core can also help you keep your back healthy or recover from back pain. It’s unwise to aim all your efforts at developing rippling abs. Overtraining abdominal muscles while snubbing muscles of the back and hip can set you up for injuries and cut athletic prowess.