For the past sixty plus years, we have known that exercise—in almost all forms—is beneficial to health. The European Guidelines on Cardiovascular Disease Prevention, the World Health Organization, and the Physical Activity Guidelines for Americans all recommend that healthy individuals engage in 150 minutes per week of moderate intensity exercise, such as brisk walking, or 75 minutes of high intensity exercise, such as jogging. But recent research has also hinted that there may be added benefit from pushing yourself intermittently, at least a little extra, bringing about changes deep within our body’s cells—those tiny building blocks that constitute all of us. Exemplifying this idea is the case of Robert Marchand, a diminutive French centenarian who took up competitive cycling as a retiree and began setting age-group records. After he was advised to add intermittent strenuous pedaling, Mr. Marchand decisively bettered his own records and, at the age of 103, set a new world mark for the most miles pedaled in an hour by a centenarian.

His efforts help to refute entrenched beliefs about older people, that physical performance and aerobic capacity inevitably decline with age and that intense exercise is inadvisable and does not apply to the elderly.

For instance, one study disclosed that frail elderly mice were capable of completing high-intensity running on little treadmills. After four months of this kind of training, the exercised animals were stronger and more aerobically fit than other mice of the same age, especially if that exercise was supplemented with high-intensity interval training.

Extending these observations to people, scientists at the Mayo Clinic compared differences in gene expression inside muscle cells after younger and older people had completed various types of workouts. The greatest differences were seen in the operations of genes after people had practiced high-intensity interval training for 12 weeks. In younger people who exercised this way, almost 275 genes were firing differently now than they had been before the exercise. But in people older than 64, more than 400 genes were working differently now and many of those genes are known to be related to the health and aging of cells. In effect, the intense exercise seemed to be changing muscle cells in ways that theoretically could affect biological aging.

At this point, I should probably pause and explain that intensity in exercise is a relative concept. The word intense can seem daunting, but in practice, it simply means physical activity that is not a cinch for you.

For medical purposes, intensity is based on percentages of someone’s heart rate maximum. But you can ignore these technicalities and pay attention to how you feel. Exercise is easy if you can talk and sing while participating in it.

During relatively moderate exercise, singing becomes difficult.

And during intense exercise, you will find it difficult to speak without gasping.

We all should get regular exercise, but no matter what your routine, you might consider increasing its pace for a few minutes at a time, until you no longer can easily converse. The latest science suggests that your cells will thank you.

But as always, the most compelling exercise-related research this year reminds us that activity of any kind is essential for human well-being. One study of 2017 found that people reported feeling happiest during the day when they had been up and moving compared to when they had remained seated and still. The benefits of exercise extend even to those suffering from various degrees of depression, providing with another means to combat this malady.

Another memorable study concluded that, statistically, an hour spent running could add about seven hours to our life spans. These gains are not infinite. They seem to be capped at about three years of added life for people who run regularly.

But these results should inspire all of us. If Mr. Marchand can gain fitness and speed after turning 100, that should be incentive to all of us with still a half-century or more to spare.

And even if we don’t succeed in adding years to our lives, we can at least add life to our years!



Regular exercise may alter how a person experiences pain, according to a recent study. For some time, scientists have known that strenuous exercise briefly and acutely dulls pain. As muscles begin to ache during a prolonged workout, the body typically releases natural opiates, called endorphins, and other substances that can slightly dampen the discomfort. This effect usually begins during the workout and lingers for perhaps 20 or 30 minutes afterward.

But whether exercise alters the body’s response to pain over the long term and, more pressing for most of us, whether such changes will develop if people engage in moderate, less draining workouts, have been unclear.

So for the new study, which was published recently in Medicine & Science in Sports & Exercise, (Aug, 2014) researchers recruited 12 young and healthy but inactive adults who expressed interest in exercising, and another 12 who were similar in age and activity levels but preferred not to exercise. They then brought all of them into the lab to determine how they reacted to pain. They measured pain thresholds by using both a direct pressure device and an inflatable cuff that, applied to a person’s arm, exerting increasing pressure against the skin. The volunteers were told to say “stop” when that pressure became painful.

Then the volunteers who had said that they would like to begin exercising did so, undertaking a program of moderate stationary bicycling for 30 minutes, three times a week, for six weeks. In the process, the volunteers became more fit, as measured by their measured aerobic capacities. The other volunteers (“control group”) continued with their lives as they had before the study began.

After six weeks, both groups of volunteers returned to the lab for retesting. As expected, the volunteers in the control group showed no changes in their responses to pain. But the volunteers in the exercise group displayed a substantially greater ability to withstand pain. Although they felt pain at similar threshold levels, their tolerance had risen. Those volunteers whose fitness had increased the most also showed the greatest increase in pain tolerance.

These results suggest that the participants who exercised did not find the pain as threatening after exercise training, although discomfort was still experienced, an idea that fits with entrenched, anecdotal beliefs about the physical fortitude of athletes.

Since pain tolerances were tested using people’s arms and the exercisers trained primarily their legs, this suggests that something occurring in the brain was probably responsible for the change in pain thresholds, a really intriguing idea.

The study’s implications are considerable and indicate that the longer we stick with an exercise program, the less physical pain of any type we will feel. The brain probably begins to accept that we are tougher than it had thought, and it allows us to continue longer, although the pain itself is still present.

This study also could be applicable to people struggling with chronic pain of all types, such as those suffering from “fibromyalgia”, a poorly defined condition characterized by widespread muscular pains. Although anyone suffering from chronic pains of any cause should consult a doctor before starting to exercise, the experiment suggests that at least moderate amounts of exercise can change people’s perception of their pain and help them to be able to better perform activities of daily living. When coupled with the other multiple health advantages of exercise, the implications should be obvious to all of us!





      Today the fastest growing category in the food industry is so-called ‘functional food” – fortified food that’s supposed to reduce your risk of disease or boost your chances of optimal health, according to the marketers. There is some support for adding certain elements to standard foods, such as calcium, fiber, omega-3 fatty acids, and certain vitamins. Overall, such altered foods account for $20 to $30 billion in annual sales, says PriceWaterhouseCoopers. And sales of fortified foods are predicted to grow at an annual rate of 8.5 to 20 percent, much more than the 1 to 4 percent forecast for the food industry overall.

    So, what’s the catch? In most cases, the health claims accompanying these products are based on flimsy or absent facts. Unfortunately, the industry seems to equate health claims with those promoting general products such as household cleansers, etc. We all know that such commercial claims are either wildly over hyped or simply bald-faced lies, but serious consequences seldom result from having a dingy floor or clothing that bears a faint shade of gray. Obviously, sloppy labeling does not carry over to issues of health.

     Fortunately for all of us, the Food and Drug Administration (FDA) doesn’t recognize functional food as an actual food category. As defined by the FDA’s Federal Food, Drug, and Cosmetic Act, products with claims of treating specific diseases are considered to be drugs and therefore must meet the agency’s rigorous regulatory requirements, including proof that they are safe and effective for their intended use. Thus if manufacturers wish to claim that its products have health-promoting properties, they must have credible science to back it up.

    For example, the maker of POM Wonderful 100% Pomegranate Juice and POMx liquid supplement maintains that it has scientific proof to support the claim that its products prevent or treat heart disease, prostate cancer, and erectile dysfunction. Now anyone in his/her right mind must question the validity of such claims. Happily, the Federal Trade Commission (FTC) cracked down on the company for making what it calls false and unsubstantiated claims. “Any consumer who sees POM Wonderful products as a silver bullet against disease has been misled,” says David Vladeck, director of the FTC’s Bureau of Consumer Protection. “When a company touts scientific research in its advertising, the research must squarely support the claims made. Contrary to POM Wonderful’s advertising, the available scientific information does not prove that POM Juice or POMx effectively treats or prevents these illnesses.” In response, the company has filed a federal lawsuit contending that the agency is overstepping its authority by setting new standards for advertising food and dietary supplements. I seriously doubt that they can make much of a case.

     In response to industrial lobbying for the right to promote the benefits of their products, Congress passed some ill-advised legislation: the Nutrition Labeling and Education Act forced the FDA to permit health claims on food packages, and in 1994 they passed the Dietary Supplement Health and Education Act, which made it easier to put health claims on vitamins, minerals, and herbal products.
     “We expected to see nutritional supplements or dietary supplements making health claims,” says Mary K. Engle, associate director of the FTC’s Advertising Practices division. “But then, about five years ago, we started to see those kinds of claims on foods—claims like ‘metabolism-enhancing’ and ‘immune-boosting,’ or something having to do with brain health or heart health.”
     More recently, there have been claims about digestive health. For example, claims by Dannon that a daily serving of Activia yogurt could help with constipation caught the FTC’s attention in 2010, and the agency accused the company of deceptive marketing practices. Dannon said it had scientific proof, but regulators concluded that many of its studies actually found that Activia was no more helpful than a placebo. Also, the probiotics (a type of healthful bacteria) in Activia might help digestion, but only if the yogurt is eaten three times a day—something not mentioned in the ads or on the packaging. Dannon eventually settled with the FTC, but admitted no wrong-doing.

What’s a health-conscious shopper to do?

     “Know thyself,” says Elizabeth Rahavi, R.D., director of health and wellness at the International Food Information Council Foundation, an industry group. “Consumers can ask: ‘Is this a food that I would commonly consume?’ Often the benefit of a functional food comes through repeated consumption.”

     If any product—food, supplement, or otherwise—is accompanied by the following label: “This treatment has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease”, run the other direction; it is almost certainly a scam!
    If you’re still not sure about a given food, check the website of the Academy of Nutrition and Dietetics and the IFIC Foundation to see if a product’s claims are backed up by credible research. And don’t just read marketing claims; look at nutrition panels and ingredient lists.
     Above all, always be skeptical and, whenever possible, avoid excessive expenditures!



Stretching Before Exercise: Another Myth


Almost all of us see—or participate personally in—static stretching before engaging in strenuous exercise of most types.  By stretching, I mean slowly moving muscles until they just start to hurt and then holding the stretch briefly. The reasons for stretching are presumably to reduce the chances for injury and to increase performance. Although we in medicine have long recognized that little scientific evidence supports these assumptions, recent evidence indicates that stretching not only fails to prevent injuries, but actually impairs strength and speed in some athletes. Thus stretching should be limited or excluded before most physical activity.

    One recent study, published in the Journal of Strength and Conditioning Research, concluded that if you stretch before you lift weights, you may actually feel weaker and wobblier than you would have otherwise experienced. This added to accumulating prior data that support a scientific consensus that stretching is not only useless but actually likely counterproductive.

    With regard to exercises of strength, e.g., weightlifting, reviews of multiple past studies have shown that prior stretching actually reduced lifting power by as much as 5-8% when those who stretched were compared with those who didn’t.

     This information merely confirms what most physical trainers have already long put into practice. Most suggest just a little light and brief stretch beforehand, and spending more time on recovery stretching afterwards. This group has long felt that the best time to stretch is after exercise, but even this assumption lacks a sound scientific basis.

     So stretching has long occupied an indelible part of the preworkout routine for misguided reasons: Although it seems to help in a limited degree with flexibility and improve range of motion, many falsely equate stretching with the warming up of muscles. This latter activity is useful and well established. For example, tennis players require a few minutes of prior motions of various strokes, and relief pitchers need a few minutes in the bull pen before entering a game. Thus the warm-up phenomenon is well established in virtually all sports in order to enhance initial performance. But there is little evidence that either warming up or stretching prevents injuries. In contrast to warming up, stretching is potentially harmful to muscles because they may actually lose flexibility when they are overworked, and this can lead to reduction of power.

    But stretching isn’t all bad, for it can give non-competitive people a wider range of motion in their joints, which can help them to perform their daily activities and improve balance and posture, which can aid in preventing falls and other injuries as people age. But, as noted, the risks of stretching include decreased strength, especially in weight-bearing activities. Those who are recovering from injuries, in which there may be considerable scar tissue that limits range of motion, may also require a bit more stretching to prevent further damage to the areas involved.

   So, in summary, when it comes to preparing for a workout, one should consider warming up the body rather than simply stretching muscles. That means adding exercises in addition to light stretching, like motions simulating the imminent activity, which can prepare the body for intensive motion without making the muscles vulnerable to overwork.




    We have long known that regular exercise can prevent cardiovascular disease. For the past 20 years, however, evidence has been accumulating that such exercise can prevent some cancers, especially those involving the colon and breast. The list of potentially preventable cancer types has been growing, with evidence now suggesting that the prevention may also include cancers of the lung, uterus, and prostate gland.

    Regarding cancer in men, prostate cancer is the most prevalent form, being diagnosed in approximately 223,000 men yearly, but fatalities are relatively low, at 29,000.

    Lung cancer is found in about 110,000 yearly, and causes death in 88,000

    Colorectal cancers are diagnosed in 72,700 men, and fatal in 27,000.

   In women, a whopping 230,480 new cases of invasive breast cancer are being diagnosed yearly in the U.S. A total of 39,500 are expected to die from this disorder.


                             THE ROLE OF EXERCISE

   In 2003, a paper in the journal Medicine & Science in Sports & Exercise reported that more than a hundred population (epidemiologic) studies on the role of physical activity and cancer prevention have been published. The authors noted that:

    “The data are clear in showing that physically active men and women have about a 30-40 percent reduction in the risk of developing colon cancer, compared with inactive persons … With regard to breast cancer, there is reasonably clear evidence that physically active women have about a 20-30 percent reduction in risk, compared with inactive women. It also appears that 30-60 min/day of moderate- to vigorous-intensity physical activity is needed to decrease the risk of breast cancer, and that there is likely a dose-response relation.”

    These studies were collected mainly by questionnaires about exercise regularity and subsequent development of cancers. Although this type of information is convincing, we now have even more conclusive results derived from careful assessment of physical fitness and development of cancer, at least in men.

    According to a 20-year, prospective study of more than 17,000 men at the Cooper Institute in Dallas, Texas, measured levels of cardiorespiratory fitness appear to be as predictive of cancer risk and survival as they are of heart disease risk and survival.

   Their data showed that the risks of lung and colorectal cancer were reduced 68% and 38%, respectively, in men with the highest level of cardiorespiratory fitness, compared with those who were the least fit.

    Although cardiorespiratory fitness did not significantly reduce prostate cancer incidence, the risk of dying was significantly lower among men with prostate, lung, or colorectal cancer if they were more fit in middle age.

   Although prior studies have shown that being physically active is protective against cancer, this study is unique because it looked at a very specific marker – cardiorespiratory fitness as measured by maximal exercise tolerance testing.

What was unexpected was that evidence of fitness not only predicts prevention of cancer but also even mortality after cancer has already been diagnosed.

    Thus quantitative measurements of fitness might be compared with measuring your cholesterol, providing us with a very specific number to target. Merely asking someone about his/her physical activity doesn’t provide that information.

     The 17,049 men in the study underwent exercise tolerance testing with a treadmill or bicycle and risk factor assessment at an average age of 50 years as part of a long term study. Metabolic equivalents (METs) were used to record the men’s cardiorespiratory fitness (CRF) and to place them into five CRF quintiles. Lung, colorectal and prostate cancers were assessed using Medicare claims data at Medicare age, and cause-specific mortality was determined after cancer diagnosis.

    Over the 20 years of follow-up, 2,885 men had been diagnosed with prostate, lung, or colorectal cancer, and of these, 769 died. .

    Compared with men in the lowest CRF fitness quintile, hazard ratios for developing lung and colorectal cancer men in the highest fitness group were 68% lower for lung cancer and 32% lower for colorectal cancer, after researchers adjusted for such risk factors as smoking, body mass index, and age.

    In men who had already developed all these cancers, mortality also declined across the higher the fitness groups.

   Even a single MET increase in fitness reduced the risk of dying from cancer and cardiovascular disease by 14% and 23%, respectively.

   Another striking finding is that even if men aren’t obese, they still have an increased risk of cancer if they aren’t fit, suggesting that everyone can benefit from improving their fitness. The findings also suggest that, ideally, individuals should be advised that they need to achieve a certain fitness level, and not just be told that they need to exercise

   The study did not evaluate whether a particular type of exercise contributed more consistently to cardiovascular fitness, but in general, activities performed at high intensity, regardless of type, are the best way to improve fitness.

    Additional research is needed to determine fitness and cancer risk in women, fitness and risk of all major site-specific cancers and the necessary change in fitness to prevent cancer.

   In the meantime, plenty of exercise is fit for all!

Cancer Fitness



6R27SJPMJJ99               What is hypertension?

Hypertension is blood pressure that persistently stays higher than normal. Blood pressure is the force of blood against artery walls as the heart pumps blood through the body. Blood pressure can be unhealthy if it exceeds 140/90. (140 refers to the highest level reached with each heartbeat, and the 90, the low between these beats.) The higher your blood pressure, the greater the health risks. If you think that’s not your problem, think again, for this condition affects at least one third of our adult population!

High blood pressure can be controlled or prevented if you take these steps:

  • Maintain a healthy weight.
  • Be physically active.
  • Follow a healthy eating plan, which includes foods that do not contain a lot of salt (sodium}, often referred to as the DASH diet..
  • Do not drink a lot of alcohol.

Diet affects high blood pressure. “DASH” stands for “dietary approaches to stop hypertension.” Following the DASH diet and reducing the amount of sodium in your diet will help lower your blood pressure. If pressure is presently normal, this diet will also help prevent high blood pressure, which, as noted, is extremely common.

What is the DASH diet?

The DASH diet is a diet that is low in saturated and trans fat, cholesterol, and total fat. It is rich in fruits, vegetables, and low-fat dairy foods. The DASH diet also includes whole-grain products, fish, poultry, and nuts. It encourages fewer servings of red meat, sweets, and sugar-containing beverages. It is rich in magnesium, potassium, and calcium, as well as protein and fiber.

How do I get started on the DASH diet?

The DASH diet requires no special foods and has no hard-to-follow recipes. Start by seeing how DASH compares with your current eating habits.

The DASH eating plan illustrated below is based on a diet of 2,000 calories a day. Your healthcare provider or a dietitian can help you determine how many calories a day you need. Most adults need somewhere between 1600 and 2800 calories a day, which varies according to physical activity. Serving sizes for different foods vary from 1/2 cup to 1 and 1/4 cups. Check product nutrition labels for serving sizes and the number of calories per serving.

Make changes gradually. Here are some suggestions that might help:

  • If you now eat fewer than 1 or 2 servings of vegetables a day, add a serving at lunch and another at dinner.
  • Puree vegetables and add them into soups, stews, and sauces.
  • If you have not been eating fruit regularly, or have only juice at breakfast, add a serving to your meals or have it as a snack.
  • Drink milk or water with lunch or dinner instead of soda, sugar-sweetened tea, or alcohol. Choose low-fat (1%) or fat-free (nonfat) dairy products so that you are eating fewer calories and less saturated and trans fat, total fat, and cholesterol.
  • Read food labels on margarines and salad dressings to choose products lowest in fat and sodium.
  • If you now eat large portions of meat, slowly cut back—by a half or a third at each meal. Limit meat to 6 ounces a day (two 3-ounce servings). Three to 4 ounces is about the size of a deck of cards.
  • Have 2 or more meatless meals each week. Increase servings of vegetables, rice, pasta, and beans in all meals. Try casseroles, pasta, and stir-fry dishes, which have less meat and more vegetables, grains, and beans.
  • Use fruits canned in their own juice. Fresh fruits require little or no preparation. Dried fruits are a good choice to carry with you or to have ready in the car.
  • Try these snacks ideas: unsalted pretzels or nuts mixed with raisins, graham crackers, low-fat and fat-free yogurt or frozen yogurt, popcorn with no salt or butter added, and raw vegetables.
  • Choose whole-grain foods to get more nutrients, including minerals and fiber. For example, choose whole-wheat bread, whole-grain cereals, or brown rice. Although whole grains are a healthy choice, large portions can lead to weight gain. A portion of grain is 1/2 to 1 cup. A cup of food is about the same size as your fist.
  • Use fresh, frozen, or no-salt-added canned vegetables.

·        Remember to also reduce the salt and sodium in your diet. Try to have no more than 2300 milligrams (mg) of sodium per day, with a goal of further reducing the sodium to 1500 mg per day. Two thirds of a teaspoon of table salt equals about 1500 mg of sodium. However, even if you can’t achieve these goals, recent research shows that even modest reductions in salt intake can produce lesser, but beneficial, reductions in blood pressure.

Some important ways to reduce sodium are the following:

  • Eat food products with reduced-sodium or no salt added. In general, canned soups contain far too much sodium.
  • Use less salt when you prepare foods and do not add salt to your food at the table.
  • Read food labels. Aim for foods that contain less than 5% of the daily value of sodium
  • Watch out for sodium hidden in canned sauces, instant soups, salad dressings, frozen dinners and packaged foods in general.
  • Avoid large portions of baked goods, such as pancakes and biscuits, which are extremely high in sodium due to the baking soda content.
  • When eating at restaurants or grocery shopping, choose low sodium alternatives.

The DASH eating plan is not designed for weight loss. But it contains many lower-calorie foods, such as fruits and vegetables. You can make it lower in calories by replacing high-calorie foods with more fruits and vegetables. Some ideas to increase fruits and vegetables and decrease calories include:

  • Eat a medium apple instead of 4 shortbread cookies. You’ll save 80 calories.
  • Eat 1/4 cup of dried apricots instead of a 2-ounce bag of pork rinds. You’ll save 230 calories.
  • Have a hamburger that’s 3 ounces instead of 6 ounces. Add a 1/2 cup serving of carrots and a 1/2 cup serving of spinach. You’ll save more than 200 calories.
  • Instead of 5 ounces of chicken, have a stir fry with 2 ounces of chicken and 1 and 1/2 cups of raw vegetables. Use just a small amount of vegetable oil. You’ll save 50 calories.
  • Have a 1/2 cup serving of low-fat frozen yogurt instead of a 1-and-1/2-ounce chocolate bar. You’ll save about 110 calories.
  • Use low-fat or fat-free condiments, such as fat-free salad dressings.
  • Eat smaller portions. Cut back gradually.
  • Use food labels to compare fat and calorie content in packaged foods. Items marked low fat or fat free may be lower in fat but not lower in calories than their regular versions.
  • Limit foods with lots of added sugar, such as pies, flavored yogurts, candy bars, ice cream, sherbet, regular soft drinks, and fruit drinks.
  • Drink water or club soda instead of cola or other soda drinks.

For more information, see the Guide to Lowering your Blood Pressure with DASH at: http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/dash_brief.pdf