daily exercise

Daily exercise at age 70 may help prevent heart disease later

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Exercising for at least 20 minutes daily at age 70 years was associated with reduced risk for CV outcomes later in life, researchers reported in Heart.

The effect was most prominent in men and lessened at age 75, 80 and 85 years, according to the researchers.

Graphical depiction of data presented in article
Data were derived from Amidei CB, et al. Heart. 2022;doi:10.1136/heartjnl-2021-320013.

Claudio Barbiellini Amidei, MD, preventive medicine specialist in the department of cardio-thoraco-vascular sciences and public health at the University of Padua in Padova, Italy, and colleagues analyzed 2,754 participants aged at least 65 years (mean age, 75 years; 60% women) from the Progetto Veneto Anziani cohort study.

The participants were stratified into the following categories based on physical activity: stable-low, low-increasing, high-decreasing and stable-high. Those who exercised at least 20 minutes per day were categorized as physically active.

The outcome of interest was prevalent and incident CVD, including CHD, HF and stroke.

Rates of incident CHD and HF were lower throughout the study period for physically active men and women compared with those who were not physically active, the researchers wrote.

In a fully adjusted model, physical activity was associated with reduced risk for CVD (adjusted HR = 0.74; 95% CI, 0.58-0.94), CHD (aHR = 0.66; 95% CI, 0.5-0.87) and HF (aHR = 0.72; 95% CI, 0.53-0.98) in men, but not in women, according to the researchers.

In addition, physical activity was associated with reduced risk for all-cause mortality in men (aHR = 0.72; 95% CI, 0.62-0.84) and women (aHR = 0.81; 95% CI, 0.72-0.92), Amidei and colleagues found.

In an analysis by age, physical activity in men was associated with reduced risk for CVD at age 70 years (aHR = 0.58; 95% CI, 0.39-0.84), but the association was attenuated at age 75 years (aHR = 0.74; 95% CI, 0.52-1.05) and not present at all at age 80 and 85 years.

In men, reduced risk for CVD (P for trend = .002), CHD (P for trend = .005) and HF (P for trend = .038) progressively improved from the stable-low group to the stable-high group, Amidei and colleagues wrote.

There was no relationship between physical activity and stroke risk. Adding prevalent cases of CVD at baseline did not change the results.

“When stratifying by age, we found that the association between physical activity and cardiovascular risk was significantly reduced among participants aged 70 years, and with marginal significance at 75 years, while no association was found among the oldest age groups, suggesting greater cardiovascular benefits might be achieved by improving physical activity earlier in late life,” the researchers wrote.

In a related editorial, Enrico Fabris, MD, and Gianfranco Sinagra, MD, both from the University of Trieste, Italy, wrote: “This study reveals important concepts: the persistence of an active life, or an increasing level of physical activity in older people may improve prognosis; however, this potential benefit is mostly evident when an active lifestyle is present early in late life.”

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Obstacles to riding safely through pregnancy revealed: Study

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In the UK, the National Institute for Clinical Excellence (NICE) and the National Health Service (NHS) both recommend pregnant women engage in daily exercise, but when it comes to cycling, the advice dries up: there are no clear recommendations women can use to decide whether to continue cycling.

Riding During Pregnancy
During pregnancy, depending on women’s proportions and the type of bike, the growing belly can feel physically restrictive.

Pregnant women could get on their bikes and stay healthy with better support, but according to a new study, they are encountering obstacles to riding.

Medical advice from risk-averse health professionals may contribute to some women’s decisions to stop cycling to work during pregnancy, meaning they miss out on the potential benefits of the active commute. The recent research revealed the reasons why women decide to stop or continue cycling to work when they are pregnant, including often ambiguously worded or overly-cautious advice from medical guidelines, midwives and obstetricians.

More people than ever are commuting to work by bicycle in London. According to data from the 2011 census, the city saw a 144% increase in cycle-commuting over the previous decade. This has big health benefits, for the health of the individual cyclist as well as for public health more broadly, as it helps people move more as part of their everyday activities.

In the UK, the National Institute for Clinical Excellence (NICE) and the National Health Service (NHS) both recommend pregnant women engage in daily exercise to help manage common discomforts, reduce pregnancy complications like preeclampsia, reduce discomfort and improve mood. But when it comes to cycling, the advice dries up: there are no clear recommendations women can use to decide whether to continue cycling.

“Despite the clear health benefits of cycling and the push to get more people commuting by bike, especially in cities like London, the medical advice on cycling during pregnancy remains murky,” commented author Davara Lee Bennett. “My research aimed to explore why women do – and don’t – cycle to work when they’re pregnant, with a view to supporting informed decision-making – including, if women so wish, rocking the rust off their chains, and bringing their bikes out from under the stairs and into the light.”

Bennett conducted three individual interviews and held three focus group discussions: with a group of women who had stopped cycling early, a group that had carried on into later pregnancy and a mixed group. She recorded and transcribed all of them, and analyzed the transcripts line-by-line to develop themes.

 

The resulting factors that affected women’s decisions fell into a few main areas: physical obstacles and enablers, perceptions of risk and of pregnancy itself and advice. The idea of risk was a key factor in decisions about continued cycling: women adjusted their cycling practices to minimize risk, taking partners’ support or concern into account. Although some women had positive encounters with health professionals, the medical advice they received was often noncommittal or risk-averse.

During pregnancy, depending on women’s proportions and the type of bike, the growing belly can feel physically restrictive. Some women stopped cycling because of this, while others found comfort from their daily aches and pains when they commuted by bike. Either way, more comfortable bikes helped: women preferred Dutch-style, upright designs with a low crossbar and a wide, supportive seat.

Perceptions of pregnancy also had an impact on women’s decisions: some preferred to abandon their active commute, opting for a more peaceful state, while others continued to cycle in a bid to remain connected to their authentic selves.

“Understanding the obstacles to women’s cycling during pregnancy can support the development of safer cycling infrastructure and informed medical guidelines, ultimately offering more women the opportunity to benefit from an active commute,” said Bennett. “By addressing some of the more socially prohibitive public discourses on the topic, I hope that my research will not just enable informed decision-making by women, but also encourage more constructive support and advice for women from health professionals.” The study appears in the Journal of Transport & Health.