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TomBAvoider

Exercise increases all cause mortality

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We'll bring politics into this, because this is the way we roll :)... Trump famously doesn't believe in exercise, or more to the point, thinks exercise is actively unhealthy. Through the years, we've come across a few studies that found the same effect, including strong studies in identical twins, which should be particularly concerning to those of us who exericise (I do). Here is another one, just posted by Al P., PMID: 28940659. 

 

The conclusion from that study - if you have heart disease, exercise is even worse for you:

 

"OPA was positively associated with both all-cause and CHD mortality. LTPA was not protective. Among men with CHD, LTPA increased mortality risks."

 

OPA - Occupational Physical Activity

LTPA - Leisure Time Physical Activity

 

"In fully adjusted models, each 10% of relative aerobic workload increased all-cause mortality by 13% and CHD mortality 28% (P < 0.01). Compared to healthy subjects, men with CHD experienced lower mortality risks due to OPA and higher risks due to LTPA. While LTPA had no effect among healthy men, in men with CHD each weekly hour of conditioning LTPA increased all-cause mortality risks by 10% and CHD mortality by14%."

 

And remember how various CR studies showed no advantage to exercise for CR'd subjects? The idea was that in Ad Lib people, exercise might square the survival curve (not slow aging, of course), but what's the excuse for CR'd people? And this study seems to say that it's not even great shakes for folks with CHD (at least not LTPA). 

 

No wonder there is so much confusion out there when it comes to health advice - it seems like there's almost nothing that we can state with confidence (other than maybe smoking is bad for you most of the time). So before we laugh at Trump, we should first laugh at ourselves (btw. I do not exempt myself from this - after all, I do exercise, even if not super fanatically).

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Its a fascinating topic to me.  I get the sense that many people think so highly of exercise only because they either mentally (or in actual studies) are comparing stereotypical couch potatoes against "active people".  .  It seems to me that when you are talking about extreme health conscious people like most active members here, there is little to no additional benefit to significant amounts of exercise (assuming you have a healthy BMI and diet).  That said I still think pushing your heart to near its limit for a couple minutes a day has some benefits, as do casual activities like walking/hiking/biking/gardening.  I don't think long periods of intense exercise is beneficial at all and probably wears down your body and joints and compromises your immune system

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Dont put much faith in research asking people how much they exerciseLOL!! They are basically useless. The Cooper institute studies used tradmills to measure fitness and then followed participants for many years with follow up treadmill testing. Fitness was a slam dunk for avoiding disease and early mortality. Here is an analysis of some similiar studies using measurable outcomes

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811477/

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If they were studying typical Americans weren't they just comparing crappie diet with no exercise vs. crappie diet with exercise? Do the people found to be "fit" also eat better?

Edited by Gordo

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If they were studying typical Americans weren't they just comparing crappie diet with no exercise vs. crappie diet with exercise? Do the people found to be "fit" also eat better?

 

Good point, It depends which confounding factors were considered and how.

 

There is such a strong beneficial a priori knowledge on exercise that a negative experiment has practically no bearing on the bayiesian posterior.

 

In a few words, this is like the single article which proves that smoking is beneficial to cardio vascular health.

Edited by mccoy

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I believe the benefits of exercise are well documented. Everything from reducing stress and inflammation, blood pressure, etc... However, I do wonder about the muscle mass and aging. Having bigger muscles means more maintenance, more micro-tearing, more growth, more energy/calories needed. More, more, more, and consequently the machinery should break down sooner. So I wonder if muscle mass is really a good thing regarding the pace of aging (ignoring the obvious fact muscles keep you from breaking bones at older age).. I mean, different studies have also confirmed that taller people die sooner than short individuals.

 

I don't know. Just my layman's logic.

 

Will also cite something from the above link (perhaps something for Dean to think about):

 

 

 

We can also look at the issue another way, which I have discussed many times before. Let us say we have two identical people.

- one maintains a BMI of 18.5 and does so through a very healthy diet. They exercise moderately about 30 minutes a day, 5x a week and burn a total of about 2000 calories per day. To maintain their BMI, they consume about 2000 calories per day.

- the other identical person also maintains a BMI of 18.5 and does so through a very healthy diet. However, they exercise vigorously about 1.5 - 2 hours a day (or more) and burn a total of about 3000-3500 calories per day. To maintain their BMI, they consume about 3000-3500 calories per day.

All the studies in animals and the recent ones in humans show the first one will do much better and live longer and healthier.

 

Also this talk, worth the watch:

 

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Hi,

 

Here's my take on optimal exercise for longevity. Activities could be combined, but assume unlimited time for exercise.

 

Any thoughts are appreciated. 

 

 

1. Low Intensity activity and movement

 

Everyday. As much as possible.

 

 

2. Moderate Low Impact Aerobic (60-70% Max heart rate)

 

30 minutes. 5 x per week.

 

3. Resistance Training

 

2-3 x per week. To maintain muscle mass and strength for daily activities.

 

4.Flexibility, mobility and balance exercises

 

2-3 times per week

 

5. Movement pattern. Any activity that makes your brain learn a new movement pattern (ex. Dancing)

 

2-3 times per week

 

6.  High Intensity Training.

 

2-3 times per week.

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The schedule is good, the hypothesis of unlimited time though, unfortunately does not stand true for the most of us.

 

Unlimited time actually may be detrimental. For example, given unlimited time I'd be exercising for hours every day and this presently would cause wear and tear of joints and connective tissues with constant nagging pains and eventually resulting in forced inactivity.

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http://www.mayoclinicproceedings.org/article/S0025-6196(17)30577-3/fulltext

25-Year Physical Activity Trajectories and Development of Subclinical Coronary Artery Disease as Measured by Coronary Artery Calcium

 

The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Published Online: October 16, 2017

 

I like how they included an explanatory video with the online publication, I’d love to see that become standard practice.

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Interesting. More evidence to avoid high volume cardiovascular exercise.

 

 

The intensity threshold of 3 METs seems a bit low.

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Perhaps the majority of the people in this study on exercise had other factors impacting their health such as eating processed foods, lives with too many chronic stresses, poor sleep habits, exposures to pollution and toxic chemicals, etc.?  Maybe the pro-inflammatory aspects of exercise in combination with other factors leads to more arterial plaque formation?

 

There are places with many people who have lived demanding physical lives of manual labor into old age with essentially zero cardiovascular disease.  Here's a video trailer for a book I recently read about one such place, "The Longevity Plan" by Dr. John Day.

https://www.youtube.com/watch?v=Gj_KvFpO688

 

And here is a Dateline news story on the same place in China.

https://www.youtube.com/watch?v=IMpQQyJ_tn4 

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The recommended PA levels are 150 minutes of moderate- vigorous-intensity PA per week.

Does this mean 150 minutes of non-stop actual activity time (i.e. 150 minutes running, swimming, etc) while excluding time spent in rest periods in the middle of your workout? or is it more in regards to the elevation of heart rate from high MET activities, so the entire workout period would be considered "high intensity"?
 

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Generally 150 total a week simply means activities equivalent to brisk walking. Those activities should be at least 10 minutes in order to get an aerobic effect

The recommended PA levels are 150 minutes of moderate- vigorous-intensity PA per week.

Does this mean 150 minutes of non-stop actual activity time (i.e. 150 minutes running, swimming, etc) while excluding time spent in rest periods in the middle of your workout? or is it more in regards to the elevation of heart rate from high MET activities, so the entire workout period would be considered "high intensity"?

 

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I liked the run for your life Ted talk. Thanks for posting.

 

I always hit over 150min a week of moderate and that's just doing my daily walks not counting the 2-3 days a week of weight training and the walking I do at work.

I've never been into running or long distance type endurance stuff so I guess that's a good thing according to that video

Edited by Pryme

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http://www.jsams.org/article/S1440-2440(17)31748-6/fulltext

 

So if Im reading this post by Al Pater correctly it is about as good as it gets for an exercise study. Using accelerometers they measured activity over a very long time period both men and woman. The results are so impressive that if a drug did this it would be a trillion dollar deal! The gemstone is that we can look at this and say gee wiz it, PA, was actually measured literally.

 

Of course its still an association because there are a multitude of confounders in any human study where they are not in cages???? but still its about as good as we are going to get

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BTW THE US NHANES study came to virtually the same conclusions and it used a much larger sample and also measured activity with accellormeter.

Both of these studies support moderate to vigourous activity in lowering of overall mortality and also both support light physical activity and the more of each the better.

AMA

Fishman EI, Steeves JA, Zipunnikov V, et al. Association between Objectively Measured Physical Activity and Mortality in NHANES. Medicine and science in sports and exercise. 2016;48(7):1303-1311. doi:10.1249/MSS.0000000000000885

Edited by mikeccolella

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