Holiday weight gain–what can we do?

Anne Berit Johnsen. Photo: Lasse Berre.

I have sat down at the desk to write blog and trying to enjoy a little extra with a cup of coffee and I have pre started on my favorite Christmas chocolate. In a very few days Christmas is coming up and it is time to celebrate with all our favorite Christmas food and plenty of it!!!! I guess I am not the only one that is planning to go back to my normal healthier diet in January, but right now it is all about Christmas and food temptations. Still it has crossed my mind that I might struggle a bit with the extra pounds gained over Christmas.

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Can better fitness help to survive cancer?

Anne Marie Ormbostad BerreCancer is globally increasing and is one of the major threats to healthy aging.  To date we have no indications that this will change for decades. While the relationship between physical fitness and cardiovascular diseases is well documented, the relationship between cancer and cardiorespiratory fitness is less studied.

Physical activity has been shown to  benefit the cancer patients in many ways, such as improved quality of life, reduced fatigue and better cardiorespiratory fitness. In addition, it is well established that being physically active reduces the risk of developing several cancer types.  In fact, as much as one-fifth to one-third of several common cancer types, including breast- and colon cancer, are associated with low levels of physical activity together with obesity. However, the association between cardiorespiratory fitness and cancer survival is less well documented.

Four women running by river

Researchers from Denmark recently published a large long time follow up study where they investigated the association between cardiorespiratory fitness and death from cancer. The study included 5131 cancer free men and tested their cardiorespiratory fitness. The men were followed up for 42 years and during the follow up period 1527 (29.8%) of them died from cancer. Interestingly, the researchers found a highly significant association between cardiorespiratory fitness and death from cancer. For every 10 mL/kg/min increase of estimated cardiorespiratory fitness (measured as maximum oxygen uptake)  risk of death decreased by 17-24%. It must be mentioned that cardiorespiratory fitness was not associated with death from prostate cancer but associated with other groups of cancer.

Based on this study, it is clear that cardiorespiratory fitness should be considered in order to reduce the risk of dying from cancer. Recently a Scientific Statement on Cardiorespiratory Fitness released by the American Heart Association identified cardiorespiratory fitness  as a vital sign, which should be used in clinical practice.

Perhaps the clear association they found in this study between cardiorespiratory fitness and cancer survival can also encourage and inspire us to change our lifestyle.

Anne Marie Ormbostad Berre, PhD student at CERG

 

Stronger muscles – stronger brain?

ekaterina-zotcheva-ber2596Accumulating scientific evidence indicates that aerobic exercise is beneficial for cognitive functioning and brain plasticity. However, the possible benefits of resistance exercise (i.e. strength exercise, weight lifting) for brain health and functioning hasn’t received as much attention. Is it time we exchange our dumbbells for running shoes? Can stronger muscles provide you with a stronger brain?

According to recent studies, all your squatting and bench-pressing hasn’t been in vain. A randomized controlled study of 155 older women found that resistance exercise once or twice a week for one year promoted executive functions, which are cognitive processes such as attention, working memory, and problem solving. In addition, the women who exercised twice a week demonstrated better memory performance, and less cortical white matter atrophy, which is a loss of brain cells and connections between them. Another study examining effects of resistance exercise in older individuals found that resistance exercise twice a week for a year positively affected cognitive task performance and brain plasticity, which are essential for healthy aging. Even older individuals with mild cognitive impairment could significantly improve their cognitive functioning with resistance exercise and increased muscle strength, a recent study found.

However, you may not have to sweat through months of workouts before experiencing the benefits of resistance exercise. A study showed that just a single bout of resistance training can enhance episodic memory already 48 hours after your first exercise.

In other words, continue doing your push-ups and deadlifts because research shows that stronger muscles may also help you achieve a stronger brain.

Ekatarina Zotcheva, PhD student at CERG

Pokémon Go a no go?

Line Skarsem ReitloIn August a friend of mine told me he had started playing Pokémon Go. Pokémon Go is a smartphone game in which players search real world locations in order to “catch” imaginary cartoon characters appearing on their screen. Thanks to the game my friend was slowly but steadily increasing his physical activity level day by day. He was so eager to catch as many Pokémons as possible so he was actually jogging, not just walking, to the different Pokémon locations. Pokémon Go has been downloaded more than 500 million times since its launch in July and has been a source of motivation for physical activity for both children and adults.

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Measuring physical activity in older adults – one size does not fit all

np_hallgeirA study just published in PLOS ONE has compared adherence to physical activity recommendation in older adults when using absolute versus relative intensity definition of physical activity.

“I was walking with my father in a beautiful forest in Norway at a pace that was easy for me but left him breathless. The traditional method used to assess physical activity in research would not differentiate between the level of intensity my father experienced compared to myself while walking. And that’s when I had the idea to do this study”, says Nils Petter Aspvik, co-author of the study and PhD candidate at the Norwegian University of Science and Technology (NTNU) in Trondheim, Norway.

Physical activity is good for health and well-being. This is true for both the old and the young. For that reason, the public health agencies around the world advocate regular physical activity to maintain or improve health and well-being, delay onset of diseases and prolong life.

Current physical activity recommendations for both younger and older adults advocate 150 minutes of absolute or relative moderate to vigorous intensity activity per week. Absolute intensity physical activity refers to an activity that has the same energetic cost for young and old, fit and unfit. Relative intensity, on the other hand, is often given in terms of individual abilities such as fitness and is less costly for the very fit compared to the unfit individuals.

In order to evaluate the current physical activity recommendations in large populations, investigate the relationship between physical activity and health and generalize the findings, we must be able to assess adherence. Adherence to current recommendations was assessed in multiple studies, and depending on the method used, the estimates ranged from 1 % to 52 %. Comparisons between studies, populations and countries were often not possible because of differences in data analysis and methodology of physical activity assessment.

Treningsøkt i forskningsprosjektet Generasjon 100

While the public health agencies suggest that relative intensity physical activity can be used to meet the recommendations, only absolute intensity physical activity definition is applied when assessing adherence. This can be problematic, especially when it comes to older adults who are often unable to reach the absolute moderate to vigorous intensity due to declining health and fitness.

The NTNU study was part of a large randomized controlled clinical trial with the primary objective of investigating the effect of exercise training on disease and death in the older adult population. The team conducted a cross-sectional study of 1219 older adults from Norway aged 70-77 years. The scientists used accelerometers to measure adherence to recommendations while applying both the absolute and relative (adjusted for fitness and gender and derived specifically for older adults) intensity definition of physical activity.

“What we found was quite interesting. When using the absolute physical activity definition 29% of our older men and women met the recommendations, while a whopping 71% did so when relative physical activity method was applied.  We do not know if this new method will help us identify people at risk of health problems better. That is something that we need to investigate in the future”, says Aspvik. Furthermore, researchers showed that fit older adults were more likely to meet the recommendations, regardless of the method used in assessment and women were more active than men at relative but not absolute intensities.

According to Aspvik the take-home message of the study is that ”physical activity recommendations are there for a reason and should in no way be negated, but how me measure the adherence to those recommendations, especially among older adults, should be considered and adjusted to the individual, because clearly one size does not fit all”.

Hallgeir Viken, researcher at CERG and Nils Petter Aspvik, researcher at Department of Sociology and Political Science

Physical fitness & brain power: Congrats Magnus Carlsen!

Linda ErnstsenMillions of people all over the world have followed the 2016 World Chess Championship game between the reigning world champion Magnus Carlsen from Norway and a challenger Sergey Karjakin from Russia that took place in New York City, USA between 11th and 30th of November. After twelve games the result was 6-6, meaning that tie breaks were to decide the match. And finally, last night on his 26th birthday, Carlsen won the four-game rapid chess tie break with 3-1. This was somewhat surprising for many, who did not consider Carlsen to be at his best during the last 12 matches, and twho believed that Karjakin was a great opponent throughout the championship.  When asked about the game by a Norwegian journalist, Karjakin said It was perhaps a mistake that I prepared for both the black and the white portions. I looked at many varieties. But in rapid chess it’s better to be in good shape. And I was not in good shape”.

 Chess is a game that involves many aspects of high level cognition such as memory, attention, focus and problem solving. It is a demanding game that favors the physically fit during long matches and tournaments. Thus, the simple question many of us raise today is if Magnus Carlsen`s physical fitness level better than Sergey Karjakin`s? Research does support the association between cardiorespiratory fitness and cognitive function in healthy pre-adolescent children and middle-aged and older people.

Exercise is important as medicine for treatment of heart and lifestyle related diseases and for increasing the likelihood and preservation of good heart and brain throughout life. This is true even for the winners of the World Chess Championship.

We congratulate Magnus Carlsen who yet again is the world’s best chess player, and probably the world’s fittest chess player as well.

Linda Ernstsen, Associate Professor, CERG

It’s time for doctors to routinely assess their patients’ fitness level – it may save lives

ulrik-wisloffThe New Scientific Statement from the American Heart Association (AHA) has just been published and it identifies cardiorespiratory fitness (CRF) as a vital sign, which should be used in clinical practice. Plethora of evidence points to CRF as a better predictor of adverse health outcomes than the traditionally utilized risk factors such as high blood pressure, smoking, obesity and type 2 diabetes. CRF is either directly measured as maximal oxygen uptake (VO2max) using cardiopulmonary exercise testing or it is estimated as exercise capacity from an exercise test.

Even very small improvements in CRF were found to associate with significant reductions in risk of developing heart disease and dying prematurely, improved cardiovascular outcomes, and improved outcomes for certain forms of cancer, surgical risk, dementia, Alzheimer’s disease, depression and Type 2 diabetes.

Yet, while low CRF is one of the most important factors when determining health outcomes, it is often neglected by clinicians in the risk assessment of patients.

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“With the increase in lifestyle-related diseases around the world, estimated fitness is an easy, cost-effective method that could significantly help medical professionals identify people at high risk and improve patient management,” says co-author Carl J. Lavie, MD, and lead cardiologist from the John Ochsner Heart and Vascular Institute, New Orleans, US.

“Routine estimation of CRF in clinical practice is no more difficult than measuring blood pressure. The addition of CRF for risk classification presents health professionals with unique opportunities to improve patient management and encourage lifestyle-based strategies designed to reduce cardiovascular risk”, says Dr. Wisloff, Head of K.G. Jebsen Center of Exercise in Medicine at Norwegian University of Science and Technology, and the last author of the statement.

“The evidence reviewed by our writing group clearly demonstrates that more than half the reduction in cardiovascular disease mortality occurs in response to a very modest increase in CRF.  This is good news as for many people, moderate levels of physical activity that increase fitness level may be all that is needed to derive a clinically significant benefit for habitually sedentary individuals,” says Dr. Ross of Queen’s University in Kingston, Canada and first author of the statement.

One of the calculators for estimating fitness that the AHA suggests should be used on a regular basis by both the medical professionals and the general public was created by the researchers at K.G. Jebsen Center for Exercise in Medicine at NTNU.  The calculator has been used by more than 5 million people worldwide, with the number of users increasing daily. The fitness calculator is freely available online and as App for Android and iOS.

Ulrik Wisløff, head of CERG