Poor sleep is really bad for your health. But we found exercise can offset some of these harms

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Bo-Huei Huang, University of Sydney and Emmanuel Stamatakis, University of SydneyDespite the well-known links between poor sleep and poorer health, getting enough good quality sleep has become a luxury in modern society.

Many of us struggle to improve our sleep, while amid the COVID pandemic and recurring lock-downs, our sleep has deteriorated.

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We’re sleeping more in lockdown, but the quality is worse

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But our new study, published today in the British Journal of Sports Medicine, bears some encouraging news.

We found doing enough physical activity (including exercise such as running or going to the gym) may counter some of the adverse health effects of unhealthy sleep patterns.

Let us explain.

Does poor sleep really harm our health?

Unhealthy sleep patterns include:

• not sleeping for long enough (less than seven hours per night for adults)
• sleeping for too long (more than nine hours per night for adults)
• snoring
• insomnia
• being a night owl, also known as “late chronotype”. This is people who naturally feel most awake and motivated in the evening, and are sluggish in the morning.

They are all associated with poorer health.

Recent research shows poor sleep may:

• cause inflammation
• impair the metabolism of glucose (also known as blood sugar) and reduce the number of calories burned, thereby increasing the risk of obesity
• increase the risk of heart disease and premature death.

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However, very few studies have examined how sleep and physical activity interact and impact our health.

We set out to answer the question: if I have poor sleep but I do quite a lot of physical activity, can that offset some of the harms of my poor sleep in the long-term? Or would this not make any difference?

Unhealthy sleep is associated with poorer health.
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What did we do?

We analysed the information provided by 380,055 middle-aged adults in the UK Biobank study, recruited between 2006 and 2010. Participants reported their level of physical activity and five aspects of their sleep.

We grouped people based on their sleep behaviour into healthy, intermediate or poor.

We categorised people’s level of physical activity based on the World Health Organization (WHO) guidelines. People who met the upper bounds of the guidelines did 300 minutes of moderate intensity physical activity a week, or 150 minutes of vigorous exercise, or a combination of both. Those who met the lower bound did 150 minutes of moderate intensity exercise a week, or 75 minutes of vigorous exercise, or a combination.

Moderate intensity physical activity usually makes you slightly out of breath if sustained for a few minutes and includes brisk walking or cycling at a leisurely pace.

Vigorous exercise usually makes you breath hard and can include running, swimming, and playing sports like tennis, netball, soccer or footy.

Doing at least 150 minutes of moderate intensity physical activity a week, or 75 minutes of vigorous exercise, can offset some of the health harms of poor sleep.
World Health Organization, CC BY-NC-SA 3.0 IGO

What did we find?

We followed up with the participants after 11 years. By May 2020, 15,503 participants had died, of which 4,095 died from heart disease and 9,064 died from cancer.

We found that, compared to healthy sleepers, people with poor sleep had a 23% higher risk of premature death, a 39% higher risk of dying from heart disease, and a 13% higher risk of dying from cancer.

We then compared the data of people who slept well with those who slept poorly, and how much they exercised. We found people who had the highest risk of dying from heart disease and cancer were those who had poor sleep and didn’t meet the WHO physical activity guidelines. On the other hand, those who had poor sleep but did enough physical activity to meet the WHO guidelines didn’t have as high a risk of dying from heart disease or cancer, compared to those who slept poorly and didn’t meet the physical activity guidelines.

For example, let’s look at the risk of dying from cancer. Those who had poor sleep and did no physical activity had a 45% higher risk of dying from cancer compared to those who had healthy sleep and exercised a lot. But among those who met the physical activity guidelines, despite poor sleep, they didn’t really have a higher risk of dying from cancer any more.

We found physical activity levels which met at least the bottom threshold of the WHO guidelines could reduce or eliminate some of the health harms of poor sleep. So people who did at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise per week were to some extent protected against the detrimental health effects of poor sleep.

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How much sleep do you really need?

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Those who had both poor sleep and did no moderate-to-vigorous intensity physical activity had the highest risks of premature death.

Our study wasn’t designed to find out how and why physical activity may counteract some of the bad physiological impacts of poor sleep. But other research provides theories. For example, adequate physical activity may reduce inflammation, help maintain a healthy glucose metabolism, and increase the number of calories burned.

It’s important to note our study was what’s called an “observational study”. It shows an association between adequate physical activity and reduced harms from poor sleep, but we must be careful in interpreting causation. It can’t conclusively say adequate physical activity causes the reduction of harms from poor sleep, though there’s strong evidence for an association in the right direction.

There are many ways to work out even if coronavirus restrictions mean you can’t enjoy your favourite activity.
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Our study offers a hopeful message, that even if you haven’t been able to improve your sleep, you can still offset some of the health harms by doing enough exercise. Our previous research has also shown physical activity may help improve poor sleep patterns, which are a serious health problem across the world.

In addition to combating some of the negative outcomes of poor sleep, physical activity can also provide many other health benefits and extend our lives. For example, a 2019 study found people who met WHO’s physical activity target above lived three years longer on average than those who didn’t.

During lockdowns, access to parks, gyms, and swimming pools might be limited in many places. But there are still many ways to to stay fit and active at home during the coronavirus.

Bo-Huei Huang, PhD candidate, University of Sydney and Emmanuel Stamatakis, Professor of Physical Activity, Lifestyle, and Population Health, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Feeling sore after exercise? Here’s what science suggests helps (and what doesn’t)

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Andrea Mosler, La Trobe University and Matthew Driller, La Trobe University

Have you been hitting the gym again with COVID restrictions easing? Or getting back into running, cycling, or playing team sports?

As many of you might’ve experienced, the inevitable muscle soreness that comes after a break can be a tough barrier to overcome.

Here’s what causes this muscle soreness, and how best to manage it.

What is muscle soreness and why does it occur?

Some muscle soreness after a workout is normal. But it can be debilitating and deter you from further exercise. The scientific term used to describe these aches is delayed onset muscle soreness, or DOMS, which results from mechanical disruption of the muscle fibres, often called “microtears”.

This damage causes swelling and inflammation in the muscle fibres, and the release of substances that sensitise the nerves within the muscle, producing pain when the muscle contracts or is stretched.

This pain usually peaks 24-72 hours after exercise. The type of exercise that causes the most muscle soreness is “eccentric” exercise, which is where force is generated by the muscle as it lengthens — think about walking downhill or the lowering phase of a bicep curl.

Soreness in the days after exercise is normal, and actually results in stronger muscles.
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There’s good news about this pain though. When the muscle cell recovers from this “microtrauma”, it gets stronger and can produce that force again without the same damage occurring. So although this strengthening process is initially painful, it’s essential for our body to adapt to our new training regime.

The inflammatory component of this process is necessary for the muscle tissue to strengthen and adapt, therefore the repeated use of anti-inflammatory medication to manage the associated pain could be detrimental to the training effect.

Will recovery gadgets put me out of my misery? Not necessarily

Before we even think about recovery from exercise, you first need to remember to start slow and progress gradually. The body adapts to physical load, so if this has been minimal during lockdown, your muscles, tendons and joints will need time to get used to resuming physical activity. And don’t forget to warm up by getting your heart rate up and the blood flowing to the muscles before every session, even if it’s a social game of touch footy!

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Heading back to the gym? Here’s how to avoid injury after coronavirus isolation

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Even if you do start slow, you may still suffer muscle soreness and you might want to know how to reduce it. There are heaps of new recovery gadgets and technologies these days that purport to help. But the jury is still out on some of these methods.

Some studies do show a benefit. There have been analyses and reviews on some of the more common recovery strategies including ice baths, massage, foam rollers and compression garments. These reviews tend to support their use as effective short-term post-exercise recovery strategies.

So, if you have the time or money — go for it! Make sure your ice baths are not too cold though, somewhere around 10-15℃ for ten minutes is probably about right.

And a word of caution on ice baths, don’t become too reliant on them in the long term, especially if you are a strength athlete. Emerging research has shown they may have a negative effect on your muscles, blunting some of the repair and rebuilding processes following resistance training.

New recovery methods and gadgets are marketed everywhere, but most of them require further research.
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But the efficacy of other recovery strategies remain unclear. Techniques like recovery boots or sleeves, float tanks and cryotherapy chambers are newer on the recovery scene. While there have been some promising findings, more studies are required before we can make an accurate judgement.

However, these recovery gadgets all seem to have one thing in common: they make you “feel” better. While the research doesn’t always show physical benefits for these techniques or gadgets, often using them will result in perceived lower levels of muscle soreness, pain and fatigue.

Is this just a placebo effect? Possibly, but the placebo effect is still a very powerful one — so if you believe a product will help you feel better, it probably will, on some level at least.

The ‘big rocks’ of recovery

Some of the above techniques could be classified as the “one-percenters” of recovery. But to properly recover, we need to focus on the “big rocks” of recovery. These include adequate sleep and optimal nutrition.

Sleep is one of the best recovery strategies we have, because this is when most of the muscle repair and recovery takes place. Ensuring a regular sleep routine and aiming for around eight hours of sleep per night is a good idea.

Ultimately, adequate sleep and optimal nutrition are the best ways to recover after exercise.
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When it comes to nutrition, the exact strategy will vary from person to person and you should always seek out nutrition advice from a qualified professional, but remember the three R’s:

• refuel (replacing carbohydrates after exercise)

• rebuild (protein intake will aid in the muscle repair and rebuilding)

• rehydrate (keep your fluid intake up, especially in these summer months!).

Enjoy your newfound freedom when returning to sport and exercise, but remember to focus on a slow return, and to make sure you’re eating and sleeping healthily before spending your hard-earned cash on the hyped-up recovery tools you may see athletes using on Instagram.

Andrea Mosler, Post-Doctoral Research Fellow, Sport and Exercise Medicine Research Centre, La Trobe University and Matthew Driller, Associate Professor, Sport and Exercise Science, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How much exercise is too much?

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Paul Millington, University of Bradford; Ally Briggs, University of Bradford; Colin Ayre, University of Bradford, and Jamie Moseley, University of Bradford

The COVID-19 pandemic has made many of us reevaluate our health and take up new exercise regimes. Running and cycling have become increasingly popular as activities that can be carried out by most people without much equipment, while observing social distancing.

There are, of course, a wealth of benefits to cycling and running, but a sudden change in activity levels can put people at increased risk of injury. Muscles, tendons and bones all need time to adapt to increases in activity. And if too much stress is applied strains, tears and even bone injuries – such as stress fractures – can occur.

This shock to the tissues often leads to painful conditions, can thwart people’s well-intentioned plans to exercise and may lead to long-term injury. This can happen anywhere in the body – particularly if you suddenly decide to play two hours of tennis, take an extra-long yoga class or go out for an extra-long run after months of decreased activity.

Injury risk and training loads

Your training should maximise health outcomes while limiting negative consequences, such as injury, illness or fatigue. So how do you know if you are doing too much?

This is where the concept of training loads comes in – which is essentially the impact your training has on the body. Training loads can be affected by lots of things and include factors like how far you run, how long you spend doing yoga or the intensity of your zoom boxercise class.

It is possible to do too much exercise.
pio3/Shutterstock

To start off, it’s important to think about the amount of energy your new exercise regime requires. This is because the energy available to the human body is like currency – there is a finite supply. And it’s the brain’s job to prioritise how this energy is spent.

Tissues and organs that keep us alive need a constant energy supply and so take priority. The rest of the energy can then be distributed between other bodily functions such as physical activity, mental stress, healing and recovery.

Excessively demanding exercise regimes that don’t allow time for adequate recovery demand high volumes of energy, and this can leave you with an “energy debt”. This is when there is a lack of energy to support the recovery, healing and adaptation of muscles, tendons, the heart, blood vessels and the brain. This puts your body at increased risk of injury.

How to avoid overload

For many, lockdown has been a fantastic opportunity to incorporate regular exercise into their lifestyle and the benefits of this should not be underestimated. But, of course, while it’s generally believed that when it comes to exercise more is better, there can be too much of a good thing.

To try to reduce your risk of injury it’s important to track and analyse your average daily workload. This should be over the course of a week that you can then compare to the previous four weeks This could be in distance or time and is referred to as the acute:chronic workload (ACWL).

There are two methods to analysing the ACWL – one method is to calculate the percentage difference of the most recent week workload average (acute workload) compared to the past four weeks workload average (chronic workload). The second method divides the one-week acute workload by the four-week chronic workload to provide a ratio. This is known as the acute:chronic workload ratio (ACWR).

To reduce the risk of injury, it’s recommended that novice athletes keep any increase in load within a 5% margin over the course of the month. This could extend to a 10% increase for more experienced or higher-performing athletes.

If using the ACWR method, the recommendation is to keep the ratio in the sweet spot between 0.8 and 1.3 and avoid the danger zone of greater than 1.5, as shown in the graph below.

Figure 1. The U Shape relationship between ACWR and injury risk.

The table below shows three examples of both methods with a traffic light system of green for ideal, amber for borderline – with a relatively higher risk of injury – and red for the highest risk.

Table 1. Example workloads.

It’s also important to consider the intensity of your workouts and where possible use your heart rate as a guide to drive a mixture of low- and high-intensity exercise over the course of a week.

You should aim for around four to five low-intensity workouts for every high-intensity workout. This is the training practice of most elite athletes across multiple sports. This allows for better recovery from intense workouts which probably contribute to consistency of training and reduced risk of injury.

Wearable tech, such as Apple watches, Fitbits, Garmin devices, along with apps such as Strava and Runtastic, are also fantastic tools to help you monitor your activity levels and help manage training loads.

Paul Millington, Lecturer in Physiotherapy, University of Bradford; Ally Briggs, Lecturer in Sport and Exercise, University of Bradford; Colin Ayre, Lecturer in Physiotherapy, University of Bradford, and Jamie Moseley, Clinical Lead and Lecturer in Physiotherapy, University of Bradford

This article is republished from The Conversation under a Creative Commons license. Read the original article.

While we wait for a coronavirus vaccine, eating well, exercising and managing stress can boost your immune system

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Julia J Rucklidge, University of Canterbury and Grant Schofield, Auckland University of Technology

Social distancing may remain necessary during the 18 months or more we’ll have to wait for a coronavirus vaccine.

This can feel like we have little control, but there are several evidence-based protective measures we can take in the interim to ensure we are as healthy as possible to fight off infection and prevent mental health problems that escalate with uncertainty and stress.

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Coronavirus and underlying medical conditions

There is recent evidence that some younger people suffer strokes after contracting the virus, but the majority of people who end up hospitalised, in intensive care or dying from COVID-19 have an underlying medical condition. One study showed 89% of those hospitalised in the US had at least one.

These underlying medical conditions include high blood pressure, high blood sugar (especially type 2 diabetes), excessive weight and lung conditions. An analysis of data from the UK National Health Service shows that of the first 2,204 COVID-19 patients admitted to intensive care units, 72.7% were either overweight or obese.

All of these health issues have been associated with our lifestyle including poor diet, lack of exercise, smoking, excessive alcohol and high stress.

It’s obvious we have created a society where being active, eating healthily, drinking less and keeping our stress under control is difficult. Perhaps it’s time to push back. This may be important for major conditions like heart disease and diabetes as well as the added threat we face from emerging infectious diseases.

One study shows only 12% of Americans are in optimal metabolic health, which means their blood pressure, blood glucose, weight and cholesterol are within a healthy range. This rate is likely similar in many Western countries.

There is now a body of evidence linking our unhealthy lifestyle with viral, especially respiratory diseases. High blood sugar reduces and impairs immune function. Excessive body fat is known to disrupt immune regulation and lead to chronic inflammation. Insulin resistance and pre-diabetes can delay and weaken the immune response to respiratory viruses.

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Regular exercise has long-term benefits for immunity – it’s important to stay active

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Improving immunity through lifestyle choices

If we are going to restrict and change our lifestyles for 12 to 18 months while we wait for a vaccine, and if we want to protect ourselves better now and in the future, we could address these lifestyle factors. They not only affect our recovery from viruses and respiratory infections, but are also the biggest cost to the quality of life in most countries.

Optimising the health of the nation must be at the forefront. And this is long overdue. There has been a substantial under-investment by most developed countries in preventive medicine to reduce chronic diseases and improve both longevity and quality of life through healthy lifestyles.

Healthy organisms are naturally resistant to infections. This is true in plants, animals and people. Maintaining optimal health is our best defences against a pandemic until a vaccine is available.

We identify three modifiable risk factors:

1. Diet

Research shows better nourished people are less likely to develop both mental and physical problems. Certain nutrients, such as vitamins C and D and zinc have been identified as essential for improving immunity across the lifespan. A better diet is associated with a lower chance of developing mental health problems in both children and adults. Low levels of specific nutrients, such as vitamin D, have been recognised as risk factors for COVID-19. These nutrients are easy (and cheap) to replenish.

What does it mean to be better nourished? Eating real whole foods – fruits and vegetables, nuts, legumes, fish and healthy fats and reducing the intake of ultra-processed foods.

2. Exercise

Being physically fit adds years to your life – and quality of life. High cardiorespiratory (lung and heart) fitness is also associated with less respiratory illness, and better survival from such illnesses.

How do you get fit? Set aside time and prioritise walking at a minimum, and more vigorous activity if possible, every day. Ideally, you would get outside and be with important others. The more the better, as long as you are not overdoing it for your individual fitness level.

3. Stress

Stress impairs our immunity. It disrupts the regulation of the cortisol response which can suppress immune function. Chronic stress can decrease the body’s lymphocytes (white blood cells that help fight off infection). The lower your lymphocyte count, the more at risk you are of catching a virus.

How do we lower stress? Meditation, yoga, mindfulness, cognitive-behaviour therapy, optimising sleep and eating well can all help in mitigating the negative impact of stress on our lives. Taking additional nutrients, such as the B vitamins, and the full breadth of minerals like magnesium, iron and zinc, during times of stress has a positive impact on overall stress levels.

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Sleep won’t cure the coronavirus but it can help our bodies fight it

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Modifying lifestyle factors won’t eliminate COVID-19 but it can reduce the risk of death and help people to recover. And these factors can be in our control if we and our governments take the initiative.

Julia J Rucklidge, Professor of Psychology, University of Canterbury and Grant Schofield, Professor of Public Health and Director of the Human Potential Centre, Auckland University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

140th out of 146: Australian teens do close to the least physical activity in the world

Teenagers across the world are failing to meet physical activity targets – but Australian teens are doing worse than most.
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Brendon Hyndman, Charles Sturt University

In a study published in The Lancet today, we find out how 1.6 million adolescent school students from across 146 countries are faring in terms of the World Health Organisation’s (WHO) physical activity recommendations.

The answer: pretty dismally. And Australia is among the worst, ranked 140 out of the 146 countries studied.

The WHO guidelines for this age group recommend a minimum of one hour of moderate to vigorous physical activity each day. That’s a jogging-like intensity that gets you sweating and puffing.

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How much physical activity should teenagers do, and how can they get enough?

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This benchmark has been set based on what we know about the benefits of regular movement for good physical health (fitness, strong muscles and bones) and preventing disease (such as type 2 diabetes, cancer, and heart disease). Not getting enough physical activity is one of the leading causes of death worldwide.

So if young Australians are losing out on these benefits, it’s concerning. While it’s a huge problem to tackle, we can take important steps at school and at home.

The study

The researchers analysed data from students aged 11 to 17 provided in surveys. Although movement devices (such as accelerometers and pedometers) are generally the most accurate way to measure physical activity, surveys can reach large populations and provide valuable insights on a national and even global scale.

The study provided figures for two time points – 2001 and 2016. In 2016, an average of just one in five adolescents across the 146 countries met the recommended physical activity levels. More boys meet these guidelines than girls.

Australia came in seventh from the bottom when it came to the proportion of adolescents not getting enough physical activity. This placed Australia ahead of only Cambodia, Philippines, South Korea, Sudan, Timor-Leste and Zambia.

Kids’ physical activity levels tend to decline when they move from primary school to high school.
From shutterstock.com

These findings align with recent national report cards that graded Australian adolescents’ physical activity as a lowly “D-”.

The researchers predicted just over one in ten Australian adolescents were meeting global physical activity recommendations in 2001 (87% were not) and in 2016 (89% were not). So if anything, things are getting worse.

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Why is this age group doing so poorly?

Research continues to show a child’s physical activity participation has often peaked in primary school, before they transition into secondary school.

In high school, there tend to be less areas conducive to outdoor physical activities, like playgrounds. High school students are often exposed to more spaces for sitting and socialising, and research shows they can start to develop negative attitudes towards physical education.

Sedentary behaviour also increases during secondary schooling, with a higher proportion of students using electronic devices for longer than the recommended two hours per day for recreation and entertainment.

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Teenagers who play sport after school are only 7 minutes more active per day than those who don’t

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By secondary school, teenagers have had seven years of primary schooling to develop fundamental movement skills, so will require more advanced movement opportunities to test themselves. This can be difficult if schools don’t prioritise facilities to encourage physical activity.

The blocks of recess time for physical activity can be less in secondary school, with guidance for 30 minute periods, compared with an hour for primary. This can vary according to the priorities of each school, particularly when recess time is competing with lessons, time to eat, and other activities.

Health and physical education requires improved status, resources and time allocation across the board.

How can we improve things?

The WHO is aiming to increase the number of young people meeting physical activity guidelines by 15% in 2030. So we need to consider how we can make some positive changes.

A new national physical literacy framework and campaign is a good start.

According to Sport Australia, physical literacy is about more than playing sport – it’s about holistic development.

Here are some other things we should be focusing on:

1. we need to place more value on recess periods by ensuring there is at least one hour of mandatory recess time scheduled each day for teenagers to be as active as possible. We also need to prioritise quality and accessible facilities for students to test themselves physically (for example, climbing and fitness facilities)

2. families should dedicate one hour after school each day to turning off electronic devices with the goal of moving more

3. school teachers should work to identify teenagers’ physical activity interests, levels and needs as they enter secondary school, looking to provide more physical challenges. If facilities are not available, they should plan for and include relevant excursions

4. schools should encourage more opportunities for safe active transport (travelling to and from school by walking or cycling), organised sport and recreation, student-centred PE classes (promoting choice for more enjoyable activities), and activity opportunities before and after school

5. during unavoidable and prolonged periods of using digital devices (like during classroom lessons), teachers should provide short bursts of movement tasks for even one minute, such as moving to music

6. school staff and training teachers should receive professional development for learning about, accommodating and encouraging physical activities within the context of secondary schools (especially beyond scheduled classes)

7. schools should be engaged with stakeholders such as families and community leaders in a collective effort to improve and model the value of physical activity opportunities in secondary schools.

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Adapting to secondary school: why the physical environment is important too

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Leaders from across sectors need to prioritise the development of physical activity strategies and resources for secondary schools. This is not a new concept, but the findings of this research make it impossible to ignore. Trialled programs or policies that encourage physical activity in secondary schools should now be brought in on a larger scale.

Brendon Hyndman, Senior Lecturer in Personal Development, Health & Physical Education / Course Director of Postgraduate Studies in Education, Charles Sturt University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Even short periods of physical inactivity are damaging to our health

That two-week beach vacation you’ve been dreaming of could have long-term effects on your health.
PVStudio/ Shutterstock

Tori Sprung, Liverpool John Moores University and Kelly Bowden Davies, Newcastle University

As a society, we aren’t getting as much exercise as we should. In fact, current activity guidelines state that adults should get at least 150 minutes of moderately intense activity – or 75 minutes of vigorous activity – every week. But research has found that one in four adults aren’t active enough.

It’s easy to see why. Many of us drive to work instead of walking – and for those of us who work desk jobs, many are often so focused on what we’re doing we rarely get up from our desks except to visit the bathroom or get a drink. In short, though we might be busy, we aren’t moving very much. But after dealing with the stress of work week after week, it’s easy to daydream about unwinding on a warm beach, doing nothing but lounge around for a fortnight. But this might not be what our bodies need. In fact, it might actually be more harmful than we realise.

Our research looked at what effect even short periods of physical inactivity had on our bodies. We found that even just two weeks of low activity actually increased participants’ risk of later developing serious health conditions such as cardiovascular disease.

Keeping active

We know that physical activity is good for us. This is irrefutable, and we’ve known this for a long time. As far back as the 1950s, the link between day-to-day physical activity and health was first identified in the London transport workers study.

The study found that bus drivers were more likely to experience a heart attack compared to their bus conductor counterparts. The main difference between these two groups was that conductors spent their working day on their feet collecting fares from commuters, while bus drivers spent their days sitting down.

Since then, some have branded physical activity a “miracle cure” for cardiovascular risk. Yet, as a society, we are more sedentary than ever, and cardiovascular-related deaths remain the leading cause of death worldwide.

While we know that having a physically active lifestyle will improve our health, surely we aren’t doing any additional harm, even if we choose not to be physically active? We decided to examine exactly what the harmful effects of being physically inactive are.

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Q&A: How often do we need to go to the gym? (And other exercise questions answered)

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For our study, we recruited young (aged 18-50 years), healthy weight (BMI less than 30), physically active individuals (meaning that they take more than 10,000 steps per day on average). After carrying out assessments to measure blood vessel health, body composition and blood sugar control, we asked them to become inactive for two weeks.

To achieve this, participants were provided with a step counter and asked not to exceed 1,500 steps per day, which equates to approximately two laps of a full sized football pitch. After two weeks, we reassessed their blood vessel health, body composition and blood sugar control to examine what effects two weeks of inactivity had on them. We then asked them to resume their usual routine and behaviours. Two weeks after resuming their normal daily lifestyles, we checked participants’ health markers to see if they’d returned to where they were when they’d started the trial.

Our group of participants successfully reduced their step count by an average of around 10,000 steps per day and, in doing so, increased their waking sedentary time by an average of 103 minutes per day. Artery function decreased following this two-week period of relative inactivity, but returned to their normal levels after two weeks following their usual lifestyles.

Decreased artery function is an early sign of cardiovascular disease.
Rost9/ Shutterstock

We were interested in seeing how activity levels influenced blood vessel health, since this is where most cardiovascular disease starts. Most of us don’t realise that our blood vessels are a complex system. They’re lined with muscle and constantly adapt to our needs by dilating (opening) and constricting (closing) to distribute blood where it’s most needed. For example, during exercise vessels feeding organs such as the stomach will constrict, as it is inactive at this time, and so blood is redistributed to our working muscles to fuel movement. One of the earliest detectable signs of cardiovascular risk is a reduced function of this dilatory capacity.

To measure this, we used an imaging technique called flow-mediated dilation or FMD. FMD measures how well the arteries dilate and constrict, and it has been found to predict our future cardiovascular risk.

Heart health

We found that after as little as two weeks of inactivity there was a reduction in artery function. This indicates the start of cardiovascular disease development as a result of being inactive. We also observed an increase in traditional risk factors, such as body fat, waist circumference, fitness and diabetes markers, including liver fat, and insulin sensitivity.

Something we also observed – which we initially weren’t researching – was that resuming normal activity levels following two weeks of being physically inactive was below baseline. That is to say, our participants did not return back to normal within two weeks of completing the intervention.

This is interesting to consider, especially regarding the potential longer-term effects of acute physical inactivity. In real-world terms, acute physical inactivity could mean a bout of flu or a two-week beach holiday – anything that can have a potential longer-term effect on our usual habits and behaviour.

These results show us that we need to make changes to public health messages and emphasise the harmful effect of even short-term physical inactivity. Small alterations to daily living can have a significant impact on health – positively, or negatively. People should be encouraged to increase their physical activity levels, in any way possible. Simply increasing daily physical activity can have measurable benefits. This could include having a ten-minute walk during your lunch hour, standing from your desk on an hourly basis to break up sitting time or parking your car at the back of the supermarket car park to get more steps in.

The impact of spending a large proportion of the day being inactive has received a lot of research in recent years. In fact, it has become a hot point of discussion among exercise scientists. As technology advances and our lives become increasingly geared towards convenience, it’s important this kind of research continues.

The health consequences of sedentary behaviour are severe and numerous. Moving more in everyday life could be key in improving your overall health.

Tori Sprung, Senior Lecturer in Sport & Exercise Sciences, Liverpool John Moores University and Kelly Bowden Davies, Teaching Fellow in Sport and Exercise Science, Newcastle University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

It’s easy to get us walking more if we have somewhere to walk to near our home and work

It doesn’t take much to get us walking more.
Flickr/alina gnerre , CC BY

Rebecca Bentley, University of Melbourne and Hannah Badland, RMIT University

We know walking more and increasing our levels of exercise are good for our health.

But how can we walk more in our busy lives?

Our research shows people walk more if the city’s design provides them with places to walk to near where they live, work or study.

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The research also shows people walk even more if they live in a place that has good public transport and plenty of jobs or employment opportunities they can easily access.

What gets us walking

Our study examined walking behaviours in nearly 5,000 adult commuters in Melbourne, drawn from the Victorian Integrated Survey of Travel and Activity between 2012 to 2014.

We looked at what level of access they had for destinations to walk to, typically within about 800 metres, close to their home, work or study place. This could be local cafes, shops, supermarkets, libraries and other services, often referred to as local accessibility.

The amount walked on an average day by those with good local accessibility at home or near where they worked or studied was around 12 minutes. Those with limited access to local facilities walked only seven minutes.

People with good local accessibility near their homes walked five minutes more per day than those with poor local accessibility. People with good local accessibility near where they worked or studied walked nine minutes more.

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But to get our activity to the next level we needed to look beyond what was locally accessible to people.

We looked at people’s relative travel commute time by public transport compared with driving, the level of public transport service accessible from where they lived, worked or studied, and the number of jobs within 30 minutes of people’s homes by public transport. These are sometimes referred to as measures of regional accessibility.

We found that the greater access people had to resources and public transport regionally, the more they walked.

For example, after accounting for local accessibility, people living in places with a higher number of jobs available within a 30-minute public transport journey walked just over four minutes more on average than people in areas with very low job availability.

People living in places where taking public transport was more efficient timewise than driving, walked more than seven minutes extra a day compared with people with low levels of public transport.

A little extra help

Our study also looked at the combination of local and regional accessibility to see if they encouraged people to walk even more.

We found that high exposure to both local accessibility and public transport accessible opportunities beyond the immediate neighbourhood was associated with greater walking benefits than exposure to just one or the other alone.

This combination of factors supported people to do around ten minutes more (give or take depending on the measures used) of walking on average per day.

We know people who travel by public transport are likely to walk more than those who travel by car.

Public transport effectively separates people from their own vehicle, be it at home or a park-and-ride stop. Public transport delivers them as pedestrians close to their destination, which in turn promotes walking throughout the day.

If people walk more in their residential environment (say to the shops, library, or post office), take public transport to their workplace or place of study and then walk more in this environment too (at lunchtime for example), they do ten more minutes of physical activity in a day than their counterparts who drive.

A message to planners

The message this new research tells us is simple.

City and urban design and transport planning have the potential to deliver a regular extra dose of what’s been described as the “miracle cure” of exercise by encouraging us to walk more.

A variety of walkable destinations that support people’s daily living needs to be designed into existing and, more importantly, new developments. That means at locations where we live, work, and study.

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This can be done by locating shops, schools, post offices, GPs and public transport stops within good walking distance. Jobs need to be located close to where people live. This will encourage walking, cycling and public transport commuting. When this is not possible, employment opportunities should be embedded within well connected and efficient public transport networks.

Cities that support people to walk more will provide population health benefits through increased physical activity, helping them to become truly smart and healthy cities.

Rebecca Bentley, Associate Professor, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne and Hannah Badland, Principal Research Fellow, Centre for Urban Research, RMIT University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

It’s not just athletes who get Achilles tendon pain, but exercising is the answer

Sean Docking, La Trobe University; Ebonie Rio, La Trobe University, and Jill Cook, La Trobe University

Basketball fans around the world were recently sickened by the footage of NBA star Kevin Durant’s Achilles tendon rupturing during a game.

But while many think it’s only elite athletes who suffer from Achilles tendon issues, a fifth of the over-50 population actually suffers from Achilles tendinopathy (pain). And while very few of these will be ruptures, the pain can be frustratingly persistent and limit our ability to exercise and enjoy life.

What is Achilles tendinopathy?

The Achilles tendon is one of the strongest tendons in the human body. It attaches the calf muscles to the heel bone of the foot, helping you to run fast, jump high, and change direction quickly. During these types of exercises the tendon acts like a spring that propels you forward more efficiently.

Many labels are used to describe what’s going on when the tendon is injured. People are often told their tendon is torn and may think of it as a rope hanging on by a thread. These descriptions are unhelpful and inaccurate, often leading to expensive and unnecessary treatments.

We know words are extremely powerful and influence what treatment you think you need. For example, would you do the exercises your physiotherapist gave you if you believed your tendon was hanging on by a thread? Probably not.

Our work has found a painful tendon is not like a torn rope at all. It’s more like doughnuts stacked on top of each other. Even though changes in tendon structure are seen as a “hole” in the middle of the tendon, there is still a lot of delicious doughnut (in other words healthy tendon) surrounding the damaged area. The tendon adapts by getting thicker, making it stronger and allowing you to exercise.

Critically, pain poorly reflects damage. Tendon pain is not present because the tendon is damaged, weak or hanging on by a thread. More than 30% of AFL players have a “hole” in their tendon when we scan them but are able to play at the highest level with no pain.

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Who gets it?

Achilles tendinopathy can affect athletes who participate in sports that involve running or explosive movements (Australian football, track and field). Most players do not miss competition as a result of Achilles tendon pain.

But our research found more than 20% of AFL players report that pain in their Achilles tendon significantly affects their training and performance. That’s four or five of your favourite 22 athletes playing this weekend.

Some 20% of AFL players suffer from pain in the Achilles tendon that affects their performance.
http://www.shutterstock.com

But most people who experience this type of pain are aged 40-64 years.

That’s because the Achilles tendon bears the brunt of activities like running, playing golf, walking the dog, and stepping off the kerb throughout life. Being overweight, having diabetes, and high cholesterol all increase the risk of developing Achilles tendon pain. Tendon pain can lead to further weight gain and a greater impact on someone’s health beyond just their ability to run and exercise.

Overcoming tendon pain

The good news is that painful Achilles tendons rarely rupture. Some 80-90% of people who rupture their tendon have never had Achilles tendon pain. Your brain is clever as it uses pain to protect your Achilles tendon by changing your behaviour. But it’s easy to become overprotective.

Completely resting the tendon, either by using crutches or a walking boot, is one thing that should be avoided. This is because of the “use it or lose it” principle. With even two weeks’ rest, your tendon and calf muscles become weaker, meaning a longer recovery time.

Just like muscles, tendons get stronger with exercise. Starting exercise that produces no or minimal pain and progressively increasing the intensity of exercise is by far the best option, based on research.

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In consultation with an experienced physiotherapist, this program should include strength training to help strengthen the tendon and the calf muscles. If you want to get back to running, slowly introduce exercise that requires the tendon to act like a spring, such as skipping and jumping.

It can be tempting to look for a quick fix for your pain. But interventions such as surgery or injections are often ineffective, costly, and can be harmful.

These approaches should be a last resort, and actually all still require exercise to strengthen the tendon. Unfortunately, there are no shortcuts when recovering from a tendon injury.

Unlike Achilles in Greek mythology, your Achilles tendon does not have to be a point of weakness. Consulting with an experienced physiotherapist to develop a progressive exercise program is the best protection you can have against further injury.

Sean Docking, Post-doctoral researcher, La Trobe University; Ebonie Rio, NHMRC Research Fellow, La Trobe University, and Jill Cook, Professor, Sports Medicine Research, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Health Check: do we really need to take 10,000 steps a day?

Walking has a variety of health benefits.
From shutterstock.com

Corneel Vandelanotte, CQUniversity Australia; Kerry Mummery, University of Alberta; Mitch Duncan, University of Newcastle, and Wendy Brown, The University of Queensland

Regular walking produces many health benefits, including reducing our risk of heart disease, type 2 diabetes and depression.

Best of all, it’s free, we can do it anywhere and, for most of us, it’s relatively easy to fit into our daily routines.

We often hear 10,000 as the golden number of steps to strive for in a day. But do we really need to take 10,000 steps a day?

Not necessarily. This figure was originally popularised as part of a marketing campaign, and has been subject to some criticism. But if it gets you walking more, it might be a good goal to work towards.

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Where did 10,000 come from?

The 10,000 steps concept was initially formulated in Japan in the lead-up to the 1964 Tokyo Olympics. There was no real evidence to support this target. Rather, it was a marketing strategy to sell step counters.

There was very little interest in the idea until the turn of the century, when the concept was revisited by Australian health promotion researchers in 2001 to encourage people to be more active.

Based on accumulated evidence, many physical activity guidelines around the world – including the Australian guidelines – recommend a minimum of 150 minutes of moderate intensity physical activity a week. This equates to 30 minutes on most days. A half hour of activity corresponds to about 3,000 to 4,000 dedicated steps at a moderate pace.

In Australia, the average adult accumulates about 7,400 steps a day. So an additional 3,000 to 4,000 steps through dedicated walking will get you to the 10,000 steps target.

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One size doesn’t fit all

Of course, some people accumulate a lot fewer steps per day – for example, older people, those with a chronic disease, and office workers. And others do a lot more: children, runners, and some blue-collar workers. So the 10,000 goal is not suitable for everyone.

Setting a lower individual step goal is fine as long as you try to add about 3,000 to 4,000 steps to your day. This means you will have done your 30 minutes of activity.

People measure their daily steps using a variety of activity trackers.
From shutterstock.com

Studies that examine how the number of daily steps relates to health benefits have mainly been cross-sectional. This means they present a snapshot, and don’t look at how changes in steps affect people’s health over time. Therefore, what we call “reverse causality” may occur. So rather than more steps leading to increased health benefits, being healthier may in fact lead to taking more steps.

Nonetheless, most studies do find taking more steps is associated with better health outcomes.

Several studies have shown improved health outcomes even in participants who take less than 10,000 steps. An Australian study, for example, found people who took more than 5,000 steps a day had a much lower risk of heart disease and stroke than those who took less than 5,000 steps.

Another study found that women who did 5,000 steps a day had a significantly lower risk of being overweight or having high blood pressure than those who did not.

The more the better

Many studies do, however, show a greater number of steps leads to increased health benefits.

An American study from 2010 found a 10% reduction in the occurrence of metabolic syndrome (a collection of conditions that increase your risk of diabetes, heart disease and stroke) for each 1,000-step increase per day.

An Australian study from 2015 demonstrated that each 1,000-step increase per day reduced the risk of dying prematurely of any cause by 6%, with those taking 10,000 or more steps having a 46% lower risk of early death.

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The faster you walk, the better for long term health – especially as you age

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Another Australian study from 2017 showed people with increasingly higher step counts spent less time in hospital.

So the bottom line is the more steps, the better.

Step it up

It’s important to recognise that no public health guideline is entirely appropriate for every person; public health messages are aimed at the population at large.

That being said, we shouldn’t underestimate the power of a simple public health message: 10,000 steps is an easily remembered goal and you can readily measure and assess your progress. You can use an activity tracker, or follow your progress through a program such as 10,000 Steps Australia.

Increasing your activity levels, through increasing your daily step count, is worthwhile; even if 10,000 steps is not the right goal for you. The most important thing is being as active as you can. Striving for 10,000 steps is just one way of doing this.

Corneel Vandelanotte, Professorial Research Fellow: Physical Activity and Health, CQUniversity Australia; Kerry Mummery, Dean, Faculty of Kinesiology, Sport and Recreation, University of Alberta; Mitch Duncan, , University of Newcastle, and Wendy Brown, Professor of Human Movement Studies, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The faster you walk, the better for long term health – especially as you age

OK, you don’t need the poles. But you should pick up the pace.
from http://www.shutterstock.com

Emmanuel Stamatakis, University of Sydney

Some of us like to stroll along and smell the roses, while others march to their destination as quickly as their feet will carry them. A new study out today has found those who report faster walking have lower risk of premature death.

We studied just over 50,000 walkers over 30 years of age who lived in Britain between 1994 and 2008. We collected data on these walkers, including how quickly they think they walk, and we then looked at their health outcomes (after controlling to make sure the results weren’t due to poor health or other habits such as smoking and exercise).

We found any pace above slow reduced the risk of dying from cardiovascular disease, such as heart disease or stroke. Compared to slow walkers, average pace walkers had a 20% lower risk of early death from any cause, and a 24% lower risk of death from heart disease or stroke.

Australian Science Media Centre.

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Those who reported walking at a brisk or fast pace had a 24% lower risk of early death from any cause and a 21% lower risk of death from cardiovascular causes.

We also found the beneficial effects of fast walking were more pronounced in older age groups. For example, average pace walkers aged 60 years or over experienced a 46% reduction in risk of death from cardiovascular causes, and fast walkers experienced a 53% reduction. Compared to slow walkers, brisk or fast walkers aged 45-59 had 36% lower risk of early death from any cause.

In these older age groups (but not in the whole sample or the younger age groups), we also found there was a linearly higher reduction in the risk of early death the higher the pace.

What it all means

Our results suggest walking at an average, brisk or fast pace may be beneficial for long term health and longevity compared to slow walking, particularly for older people.

But we also need to be mindful our study was observational, and we did not have full control of all likely influences to be able to establish it was the walking alone causing the beneficial health effects. For example, it could be that the least healthy people reported slow walking pace as a result of their poor health, and also ended up dying earlier for the same reason.

Fast walking for some might not seem it for others.
from http://www.shutterstock.com

To minimise the chances of this reverse causality, we excluded all those who had heart disease, had experienced a stroke, or had cancer when the study started, as well as those who died in the first two years of follow up.

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Another important point is that participants in our study self-reported their usual pace, which means the responses were about perceived pace. There are no established standards for what “slow”, “average” or “brisk” walking means in terms of speed. What is perceived as “fast” walking pace by a very sedentary and physically unfit 70-year-old will be very different from a sporty and fit 45-year-old.

For this reason, our results could be interpreted as reflecting relative (to one’s physical capacity) intensity of walking. That is, the higher the physical exertion while walking, the better health results.

For the general relatively healthy middle-aged population, a walking speed between 6 and 7.5 km/h will be fast and if sustained, will make most people slightly out of breath. A walking pace of 100 steps per minute is considered roughly equivalent to moderate intensity physical activity.

We know walking is an excellent activity for health, accessible by most people of all ages. Our findings suggest it’s a good idea to step up to a pace that will challenge our physiology and may even make walking more of a workout.

Long term-health benefits aside, a faster pace will get us to our destination faster and free up time for all those other things that can make our daily routines special, such as spending time with loved ones or reading a good book.

Emmanuel Stamatakis, Professor of Physical Activity, Lifestyle, and Population Health, University of Sydney

This article was originally published on The Conversation. Read the original article.