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January 28, 2010

Fitness Fades Fast After 45

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The declines in fitness that accompany growing old typically speed up after the age of 45, new research shows.

But people can slow the inevitable by staying lean, exercising and refraining from smoking.

The findings, appearing in the Oct. 26 issue of the Archives of Internal Medicine, are not so surprising in light of the piles of other research that have drawn similar conclusions.

But the new study has broad implications, given the rising number of older adults in the United States and the explosion in the sedentary, overweight and aging population.

“The Social Security Administration actually has an aerobic capacity threshold. If you’re below the threshold, you are considered disabled,” said study author Andrew Jackson.

This means more people could qualify for government disability benefits at a younger age, further draining an already strained economy.

This study group included 3,429 women and 16,889 men aged 20 to 96 who had undergone two to 33 health exams with lifestyle counseling between 1974 and 2006.

Reductions in cardiorespiratory fitness (CRF) were not seen as a straight downward line. Instead, after the age of 45, the slope became much steeper, accelerating even further with increases in body-mass index (BMI), smoking and lower levels of physical activity.

“We’ve known that, as you age, your aerobic capacity goes down, and the exercise physiology literature indicates it’s a linear relationship. We found that this is not the case,” said Jackson, who is professor emeritus of health and human performance at the University of Houston. “It makes sense to me. When things aren’t working right, we tend to go down at faster rates. This was true for both men and women [although the rate of decline was faster for men than for women].”

Taking care of yourself could make you, in a sense, younger than your years.

“If you were overweight, inactive and smoked, your aerobic capacity would be lower at a given age as compared to other people who were healthy weight, active and nonsmokers,” Jackson said. “The data showed that if people had that advantage when they were in their 30s and 40s and maintained that lifestyle, their aerobic capacity as they aged was, in fact, higher.”

“It could delay the age when these health problems start to spring up,” he continued. “If people are very overweight, inactive and smoke, they might see these health problems in their 50s and 60s, whereas people who maintain a healthy lifestyle, it’s going to be more like their 70s, 80s and possibly even their 90s.”

“You have to exercise. It’s now becoming established fact, and if you don’t incorporate it, you’re going to see the effects. You will get sicker sooner,” added Dr. Suzanne Steinbaum, director of women and heart disease for Lenox Hill Hospital in New York City and a spokeswoman for the American Heart Association. “Exercise is the most potent medication around, and the Social Security Administration agrees with me.”

A second study in the same issue of the journal provides a measure of good news. Researchers at the University of Pennsylvania School of Medicine in Philadelphia found that blacks who partnered with a family member or friend to lose weight actually did lose pounds — but only if the partner also lost weight.

January 21, 2010

Exposure to Holocaust May Have Raised Cancer Risks

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Among Jewish survivors of World War II, those who were potentially exposed to the Holocaust have an increased risk of cancer, likely due to physical and mental stress, an Israeli study has found.

University of Haifa researchers compared cancer rates in more than 300,000 Israeli Jews who were born in Europe and immigrated to Israel either before World War II (non-exposed) or after the war (potentially exposed).

Compared to the non-exposed group, those in the potentially exposed group had a statistically significantly increased risk for cancer, especially breast and colorectal cancer, the researchers found. The younger a person was when they were exposed to the Holocaust, the greater their risk of cancer.

“These observations may have direct impact on the health of World War II Jewish survivors and thus the care required from their caregivers in Israel and elsewhere,” wrote Dr. Lital Keinan-Boker, of the University of Haifa School of Public Health, and colleagues. “These findings warrant further epidemiological studies [such as case-control studies] of past and present risk factors that use individual data.”

The study is published in the Oct. 26 online edition of the Journal of the National Cancer Institute.

The findings add to a growing body of knowledge about the links between cancer risk and severely restricted calorie intake and severe psychosocial and physical suffering, explained the authors of an accompanying editorial.

“Taken together, data from animal and human studies suggest that while [calorie reduction] typically decreases cancer risk, the anticancer effects of [calorie reduction] may be neutralized or overwhelmed in the presence of extreme stressors,” wrote the editorialists, Stephen D. Hursting, of the nutritional sciences department at the University of Texas, Austin and Michele R. Forman, of the epidemiology department at the University of Texas M.D. Anderson Cancer Center in Houston.

“From this unique cohort we can learn lessons about adaptation to extreme hardships in early life, resilience during life, and cancer susceptibility later in life,” they added.

January 14, 2010

Cell Phone May Reduce Bone Density in Hips

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Wearing a cell phone on your hip may reduce bone density in an area of the pelvis commonly used for bone grafts, a new study suggests.

Turkish researchers used dual X-ray absorptiometry to measure bone density at the upper rims of the pelvis (iliac wings) in 150 men who carried their cell phones on their belts. The men carried their phones for an average of 15 hours a day, and had used cell phones for an average of six years.

Bone density was slightly reduced on the side of the pelvis where the men carried their cell phones, the study found. The difference wasn’t statistically significant and didn’t approach bone level density reductions seen in people with osteoporosis. However, the men were relatively young (average age 32), and further bone weakening may occur, said Dr. Tolga Atay and colleagues at Suleyman Demirel University in Isparta.

The study, published in the September issue of the Journal of Craniofacial Surgery, suggests that electromagnetic fields emitted by cell phones may have a harmful effect on bone density.

However, the researchers emphasized that their findings are preliminary and noted that future generations of cell phones may reduce users’ exposure to electromagnetic fields. In the meantime, it “would be better to keep mobile phones as far as possible from our body during our daily lives,” Atay and colleagues concluded.

The iliac wings of the pelvis are widely used for bone grafting, which means any reduction in bone density there may affect reconstructive surgery. In procedures where bone density is important for good outcomes, surgeons may want to consider the possible effects of exposure to electromagnetic fields from cell phones, the researchers suggested.

January 8, 2010

Big, Beefy Football Players May Face Heart Problems Later

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Crushing the notion that you can be both fat and fit, new research has found that current professional football linemen already have some risk factors for heart disease.

In a study comparing professional football players to minor and major league baseball players, researchers found that football linemen were more likely to have higher fasting blood sugar levels, larger waist circumferences and a greater waist-to-height ratio.

Although the idea that a football player could be at risk for heart disease might seem paradoxical because football players have to be in top physical condition, the lineman position also requires players to bulk up, with many tipping the scales at more than 300 pounds. All that extra weight may put players at risk later in life.

“We’ve identified a subset of players that are exercising like crazy and they’re extremely fit, but the exercise isn’t completely protective,” said one of the study’s authors, Dr. John Helzberg, co-director of the division of gastroenterology at Saint Luke’s Hospital in Kansas City, Mo.

Helzberg was quick to point out that the study was not designed to look at the rates of heart disease or deaths from heart disease later in life but to identify only current risk factors. The hope is that by identifying the risk factors, steps could be taken to tackle the risk factors now, and interventions could be designed to help players when they retire.

Results of the study were scheduled to be presented Oct. 26 at the American College of Gastroenterology’s annual scientific meeting in San Diego.

Previous research has suggested that football players face myriad risks later in life, such as higher rates of chronic pain, depression and even dementia. Helzberg said the idea for the current study came from a news report that suggested that football players were twice as likely to die before the age of 50 as baseball players.

To get an idea of how football players’ health really compared with that of baseball players, Helzberg and his colleagues assessed a range of risk factors in 69 professional football players and 155 baseball players — both minor and major league.

Many football players, such as quarterbacks and receivers, have heart disease risk profiles similar to those of baseball players. However, the 19 men playing lineman positions — including guards, tackles, centers and defensive ends — had significantly higher fasting blood sugar levels, waist circumferences and waist-to-height ratios, which are all considered risk factors for cardiovascular disease. And, when three such risk factors are combined, it’s considered metabolic syndrome, which often indicates an increased risk for heart disease.

Of the linemen, 26 percent had fasting glucose levels above 100 milligrams per deciliter (mg/dL) compared with 7 percent of the baseball players. That level is considered prediabetic, according to the American Diabetes Association.

Nearly 100 percent of the linemen had a waist circumference greater than 100 centimeters (39.4 inches), which is considered a risk factor for heart disease, whereas only 8 percent of the baseball players had waists that size. Having a waist-to-height ratio greater than 0.5 also increases the risk for cardiovascular disease, and 95 percent of the linemen had a ratio greater than that, compared with 24 percent of the baseball players, according to Helzberg.

“These guys are very big, and yes, they have more muscle, but a lot of the weight is fat, and anyone at a higher weight is at risk of metabolic syndrome,” said Dr. Jonathan Whiteson, co-director of the Joan and Joel Smilow Cardiopulmonary Rehabilitation and Prevention Center at the NYU Langone Medical Center in New York City.

“What happens is that you don’t have to have rip-roaring abnormalities, but when you put these factors together, you create metabolic syndrome,” Whiteson said. “This can put them at risk for premature heart disease, stroke, vascular disease in the legs and sudden death,” he explained.

“The message is clear,” he said. “Being fat is not fit. It’s a medical condition.”

But there are other worries as well, he added. “What’s always a concern of mine is that these people are role models for children, and you see young boys who want to play football bulking up,” Whiteson said. “We should be promoting a better health profile than linebackers.”

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