tag:theconversation.com,2011:/us/topics/exercise-670/articlesExercise – The Conversation2024-03-14T04:34:35Ztag:theconversation.com,2011:article/2241592024-03-14T04:34:35Z2024-03-14T04:34:35ZOnly walking for exercise? Here’s how to get the most out of it<figure><img src="https://images.theconversation.com/files/581817/original/file-20240314-18-so6oe8.jpg?ixlib=rb-1.1.0&rect=97%2C315%2C4914%2C2938&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/senior-man-exercising-green-1812006481">west_photo/Shutterstock</a></span></figcaption></figure><p>We’re living longer than in previous generations, with <a href="https://www.aihw.gov.au/reports/older-people/older-australians/contents/demographic-profile">one in eight</a> elderly Australians now aged over 85. But the current <a href="https://pubmed.ncbi.nlm.nih.gov/26561272/">gap</a> between life expectancy (“lifespan”) and health-adjusted life expectancy (“healthspan”) is about ten years. This means many of us live with significant health problems in our later years.</p>
<p>To increase our healthspan, we need planned, structured and regular physical activity (or exercise). The <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">World Health Organization recommends</a> 150–300 minutes of moderate-intensity exercise – such as brisk walking, cycling and swimming – per week and muscle strengthening twice a week.</p>
<p>Yet few of us meet these recommendations. <a href="https://doi.org/10.1186/s12966-019-0797-2">Only 10%</a> meet the strength-training recommendations. <a href="https://pubmed.ncbi.nlm.nih.gov/32488898/">Lack of time</a> is one of the most common reasons. </p>
<p>Walking is cost-effective, doesn’t require any special equipment or training, and can be done with small pockets of time. <a href="https://link.springer.com/epdf/10.1007/s00421-024-05453-y?sharing_token=1vDsDJTN5WzPxi5YmSEkOfe4RwlQNchNByi7wbcMAY5hnPeFvF3FY4v2z1P9M2M0oiR78kXv1Yzj0ODMgckqhKOGHUABEd9UOPOfV5kPAj1jf1IYMIYkdIBv-DUEcKCOiDdNyj6MFypeDhSyeYQrWu_bvlAYtPUmOSaldFpmycA%3D">Our preliminary research</a>, published this week, shows there are ways to incorporate strength-training components into walking to improve your muscle strength and balance. </p>
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Read more:
<a href="https://theconversation.com/am-i-too-old-to-build-muscle-what-science-says-about-sarcopenia-and-building-strength-later-in-life-203562">Am I too old to build muscle? What science says about sarcopenia and building strength later in life</a>
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<h2>Why walking isn’t usually enough</h2>
<p>Regular walking <a href="http://theconversation.com/health-check-in-terms-of-exercise-is-walking-enough-78604">does not appear</a> to work as muscle-strengthening exercise. </p>
<p>In contrast, exercises consisting of “eccentric” or muscle-lengthening contractions <a href="http://theconversation.com/its-ok-to-aim%20lower-with-your-new-years-exercise-resolutions-a-few-minutes-a-day-can-improve-your-muscle-strength-193713">improve</a> muscle strength, <a href="https://pubmed.ncbi.nlm.nih.gov/31130877/">prevent muscle wasting</a> and improve other functions such as balance and flexibility. </p>
<p>Typical eccentric contractions are seen, for example, when we sit on a chair slowly. The front thigh muscles lengthen with force generation.</p>
<figure class="align-center ">
<img alt="Woman sits on chair" src="https://images.theconversation.com/files/581801/original/file-20240313-24-zjbiei.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/581801/original/file-20240313-24-zjbiei.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/581801/original/file-20240313-24-zjbiei.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/581801/original/file-20240313-24-zjbiei.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/581801/original/file-20240313-24-zjbiei.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/581801/original/file-20240313-24-zjbiei.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/581801/original/file-20240313-24-zjbiei.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">When you sit down slowly on a chair, the front thigh muscles lengthen.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-who-trains-using-chair-1631210659">buritora/Shutterstock</a></span>
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<h2>Our research</h2>
<p>Our <a href="https://pubmed.ncbi.nlm.nih.gov/31055678/">previous research</a> found body-weight-based eccentric exercise training, such as sitting down on a chair slowly, improved lower limb muscle strength and balance in healthy older adults. </p>
<p>We also <a href="https://pubmed.ncbi.nlm.nih.gov/28291022/">showed</a> walking down stairs, with the front thigh muscles undergoing eccentric contractions, increased leg muscle strength and balance in older women more than walking up stairs. When climbing stairs, the front thigh muscles undergo “concentric” contractions, with the muscles shortening. </p>
<p>It can be difficult to find stairs or slopes suitable for eccentric exercises. But if they could be incorporated into daily walking, lower limb muscle strength and balance function could be improved. </p>
<p>This is where the idea of “eccentric walking” comes into play. This means inserting lunges in conventional walking, in addition to downstairs and downhill walking. </p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/wAI7z3XdY9o?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Eccentric walking means incorporating deep lunges into your movement.</span></figcaption>
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<p>In our <a href="https://link.springer.com/epdf/10.1007/s00421-024-05453-y?sharing_token=1vDsDJTN5WzPxi5YmSEkOfe4RwlQNchNByi7wbcMAY5hnPeFvF3FY4v2z1P9M2M0oiR78kXv1Yzj0ODMgckqhKOGHUABEd9UOPOfV5kPAj1jf1IYMIYkdIBv-DUEcKCOiDdNyj6MFypeDhSyeYQrWu_bvlAYtPUmOSaldFpmycA%3D">new research</a>, published in the European Journal of Applied Physiology, we investigated the effects of eccentric walking on lower limb muscle strength and balance in 11 regular walkers aged 54 to 88 years. </p>
<p>The intervention period was 12 weeks. It consisted of four weeks of normal walking followed by eight weeks of eccentric walking. </p>
<p>The number of eccentric steps in the eccentric walking period gradually increased over eight weeks from 100 to 1,000 steps (including lunges, downhill and downstairs steps). Participants took a total of 3,900 eccentric steps over the eight-week eccentric walking period while the total number of steps was the same as the previous four weeks. </p>
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Read more:
<a href="https://theconversation.com/its-ok-to-aim-lower-with-your-new-years-exercise-resolutions-a-few-minutes-a-day-can-improve-your-muscle-strength-193713">It's OK to aim lower with your new year's exercise resolutions – a few minutes a day can improve your muscle strength</a>
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<p>We measured the thickness of the participants’ front thigh muscles, muscle strength in their knee, their balance and endurance, including how many times they could go from a sitting position to standing in 30 seconds without using their arms. We took these measurements before the study started, at four weeks, after the conventional walking period, and at four and eight weeks into the eccentric walking period.</p>
<p>We also tested their cognitive function using a digit symbol-substitution test at the same time points of other tests. And we asked participants to complete a questionnaire relating to their activities of daily living, such as dressing and moving around at home. </p>
<p>Finally, we tested participants’ blood sugar, cholesterol levels and complement component 1q (C1q) concentrations, a potential <a href="https://faseb.onlinelibrary.wiley.com/doi/abs/10.1096/fj.14-262154">marker of sarcopenia</a> (muscle wasting with ageing).</p>
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<img alt="Person walks with small dog" src="https://images.theconversation.com/files/581816/original/file-20240314-16-le4nu3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/581816/original/file-20240314-16-le4nu3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/581816/original/file-20240314-16-le4nu3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/581816/original/file-20240314-16-le4nu3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/581816/original/file-20240314-16-le4nu3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/581816/original/file-20240314-16-le4nu3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/581816/original/file-20240314-16-le4nu3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Regular walking won’t contract your muscles in the same way as eccentric walking.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/dog-walker-strides-his-pet-on-1399290365">alexei_tm/Shutterstock</a></span>
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<h2>What did we find?</h2>
<p>We found no significant changes in any of the outcomes in the first four weeks when participants walked conventionally. </p>
<p>From week four to 12, we found significant improvements in muscle strength (19%), chair-stand ability (24%), balance (45%) and a cognitive function test (21%).</p>
<p>Serum C1q concentration decreased by 10% after the eccentric walking intervention, indicating participants’ muscles were effectively stimulated. </p>
<p>The sample size of the study was small, so we need larger and more comprehensive studies to verify our findings and investigate whether eccentric walking is effective for sedentary people, older people, how the different types of eccentric exercise compare and the potential cognitive and mental health benefits. </p>
<p>But, in the meantime, “eccentric walking” appears to be a beneficial exercise that will extend your healthspan. It may look a bit eccentric if we insert lunges while walking on the street, but the more people do it and benefit from it, the less eccentric it will become. </p>
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Read more:
<a href="https://theconversation.com/health-check-in-terms-of-exercise-is-walking-enough-78604">Health Check: in terms of exercise, is walking enough?</a>
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<p class="fine-print"><em><span>Ken Nosaka does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>There are ways to incorporate strength-training components into walking to improve your muscle strength and balance.Ken Nosaka, Professor of Exercise and Sports Science, Edith Cowan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2236762024-03-13T14:23:30Z2024-03-13T14:23:30ZAre you sitting too long in your office job? South African study offers some health tips<p>Sedentary behaviour can result in chronic health conditions such as obesity and heart diseases, bad news for the millions of office workers who are forced to sit behind their desks every day.</p>
<p>In its simplest form, the term “sedentary behaviour” describes sitting for too long and not breaking this up with movement. </p>
<p>Sitting for more than one hour without a break can be considered as <a href="https://doi.org/10.1007/s40279-023-01915-z">too much</a> sitting time.</p>
<p>Existing evidence shows that about 25% of adults and over 75% of adolescents worldwide are not meeting the World Health Organization physical activity recommendations.</p>
<p>The WHO’s latest <a href="https://www.who.int/publications/i/item/9789240015128">guidelines on physical activity and sedentary behaviour</a> recommend physical inactivity by around 15% in all age groups by 2030.</p>
<p>The WHO guidelines, released in 2020, are <a href="https://doi.org/10.1136/bjsports-2020-102955">particularly important</a> for office workers who spend a significant portion of their work day sitting. </p>
<p>As a specialist in the epidemiology of physical activity I took part in a new study into sedentary behaviour among a group of office-based workers in South Africa. </p>
<p>We found that conscious movement – even if this means standing instead of sitting – helped office workers stay healthy.</p>
<h2>What we found</h2>
<p>In our <a href="https://doi.org/10.1177/15598276231210479">study</a>, published in the American Journal of Lifestyle Medicine, colleagues and I collected data from 122 office workers based in Johannesburg. </p>
<p>The majority of the participants were female (68%) with an average age of 40 years. All had completed high school.</p>
<p>We measured body mass index, waist circumference, blood pressure and other key medical indicators of health and wellbeing.</p>
<p>Participants were asked to record their own sitting times. </p>
<p>We also used wrist-worn <a href="https://www.sciencedirect.com/topics/engineering/accelerometer-sensor">accelerometers</a> to collect data. This innovative method gave us a more accurate understanding of physical activity and sedentary behaviour compared to self-reported questionnaires.</p>
<p>The self-reported data by participants averaged 1.3 hours a day sitting for mealtimes, 3.9 hours a day related to work, 1.4 hours a day for transport, 1.7 hours a day for screen time, and 3.4 hours a day for other activities. This amounted to about 12 hours of sitting per day. </p>
<p>This was significantly higher than the three hours a day recorded by accelerometers. The discrepancy could partly be explained by participants – consciously or unconsciously – feeling more motivated to move when wearing these smart devices.</p>
<p>The blood pressure, cholesterol and <a href="https://medlineplus.gov/lab-tests/triglycerides-test/#:%7E:text=A%20triglycerides%20test%20is%20used,the%20risk%20of%20heart%20disease.">serum triglyceride levels</a> of our study participants were within normal ranges.</p>
<p>This finding is encouraging because they seemed to be at less risk of cardiovascular diseases. It could possibly be explained by the fact that these office workers were engaged in light physical activity for about two hours a day.</p>
<p>This also supports the WHO’s message emphasising that any movement is better than none. </p>
<p>They engaged in moderate to vigorous physical activity for about 50 minutes a day. This was less than the WHO recommendation of at least 60 minutes of moderate to vigorous physical activity a day. </p>
<p>In terms of overall health for South African office workers, our findings show that conscious efforts to move during the day can help them keep them healthier.</p>
<h2>Keep standing and keep moving</h2>
<p>Light intensity physical activity, sometimes referred to as gentle exercise, can include movement such as getting up, and walking to make a cup of coffee.</p>
<p>Office workers should stand whenever possible, as there is a growing body of evidence showing that standing is better than prolonged sitting, particularly for <a href="https://doi.org/10.1177/2047487317752186">energy expenditure</a> and reducing the risk of <a href="https://doi.org/10.1016/s0140-6736(16)30370-1">cardiovascular disease</a>.
It also activates muscle activity. </p>
<p>In practical terms, light physical activities during the workday could include:</p>
<ul>
<li><p>standing up to take a break</p></li>
<li><p>using a standing workstation</p></li>
<li><p>standing during meetings. </p></li>
</ul>
<p>Moderate to vigorous physical activities could include:</p>
<ul>
<li><p>using the stairs instead of the lifts</p></li>
<li><p>parking further from the office building entrance and walking at a brisk pace to the entrance</p></li>
<li><p>introducing fun activity breaks</p></li>
<li><p>engaging in various types of activities at a private gym close to work.</p></li>
</ul>
<p>Office workers should make conscious efforts to engage in physical activities during recreational times. </p>
<p>These could include: </p>
<ul>
<li><p>participating in weekly park runs</p></li>
<li><p>walking groups</p></li>
<li><p>structured sporting activities such as organised cycling, especially with safety and security in mind.</p></li>
</ul>
<p>In general, the more physically active people are, the better the health outcomes. </p>
<h2>Moving forward</h2>
<p>By 2021 worldwide obesity had nearly <a href="https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight">tripled</a> since 1975.</p>
<p>Physical inactivity is the leading modifiable risk factor for cardiometabolic diseases and all-cause mortality.</p>
<p>Studies such as ours help policymakers, businesses and companies formulate strategies to keep office workers healthier, promote a positive work-life balance and contribute to a more efficient work environment.</p>
<p>Our research underscores the urgent need to include more opportunities for movement into our everyday lives, especially important for South African office workers. </p>
<p>More studies from the global south are needed to develop context-relevant workplace interventions that can be easily integrated into employee health and wellness policy.</p><img src="https://counter.theconversation.com/content/223676/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Philippe Gradidge receives funding from the National Research Foundation (South Africa) and The South African Medical Research Council.</span></em></p>Office workers are sedentary for hours at a time. Our research looked at what they should do to stay healthy.Philippe Gradidge, Associate Professor, Department of Exercise Science and Sports Medicine, University of the WitwatersrandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2192942024-03-11T18:34:34Z2024-03-11T18:34:34ZPaying people to exercise can be motivating, but the financial rewards don’t have to last forever to work<figure><img src="https://images.theconversation.com/files/580781/original/file-20240308-28-6wpn62.jpg?ixlib=rb-1.1.0&rect=7%2C132%2C4442%2C3032&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Digital solutions like fitness apps have the same stumbling blocks as other exercise programs: it's hard to form healthy habits.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>If physical activity came in a bottle, it would be the most prescribed medicine of all. Just walking 10 more minutes a day may yield <a href="https://doi.org/10.1186/s12966-020-00978-9">clinically significant</a> outcomes such as improved mental health, less pain and better sleep. It can also help prevent and manage more than <a href="https://doi.org/10.1136/bjsports-2020-102955">100 chronic diseases</a> like cancer, arthritis and diabetes. </p>
<p>And yet, many people do not reap the benefits of just a little more movement — about 10 more walking minutes per day, or an extra 1,000 steps.</p>
<p>There are many digital solutions to help people meet physical activity goals, like fitness apps such as MyFitnessPal and Noom. Unfortunately, the challenges of <a href="https://theconversation.com/the-science-behind-building-healthy-habits-can-help-you-keep-your-new-years-resolution-219947">forming healthy habits</a> remains, and use of fitness apps can fall into a familiar pattern reflecting the <a href="https://theconversation.com/got-health-goals-research-based-tips-for-adopting-and-sticking-to-new-healthy-lifestyle-behaviours-173740">difficulty of meeting new fitness goals</a>.</p>
<p>With apps, it might look something like this: the app is downloaded with the best of intentions and is used for a couple of weeks. Gradually, the app becomes neglected and begins to collect dust on a smartphone screen, and eventually is abandoned or deleted. </p>
<h2>Encouraging activity</h2>
<p>As a physical activity expert, I have made it my life’s work to encourage more people to be more active more often. A hunch eventually led me to explore the idea of actually paying people to exercise as part of my <a href="https://tspace.library.utoronto.ca/bitstream/1807/71601/3/Mitchell_Marc_201511_PhD_thesis.pdf">PhD research</a>. That began in 2010 with a small group of cardiac patients. </p>
<p>Fast forward almost 15 years, and it turns out this idea — paying people to exercise — has legs. </p>
<p><a href="https://doi.org/10.1136/bjsports-2019-101662">Governments</a> and <a href="https://www.jnj.com/innovation/employee-benefits-that-help-make-johnson-johnson-a-great-company">companies</a> all over the world, for instance, have been paying people to exercise for years. And it works! Sort of. In the <a href="https://doi.org/10.1136/bjsports-2019-100633">short-term</a>, at least.</p>
<p>Predictably, when delivered on a population scale, paying people to exercise can get quite expensive, which is a critical limitation. I experienced this limitation firsthand while developing the <a href="https://doi.org/10.1136/bjsports-2019-101662">Carrot Rewards</a> app in partnership with Canadian federal and provincial governments from 2016 to 2019. </p>
<p>In 2019, due to some fiscal constraints, the financial rewards for exercise offered to Canadians for over a year via Carrot Rewards were mostly withdrawn in Ontario (Canada’s largest province) but not in British Columbia and Newfoundland and Labrador (the other two Canadian provinces where the app was available).</p>
<p>This natural variation in financial reward exposure set up an interesting behaviour experiment, which provided the opportunity to answer the question: Can financial rewards be mostly scaled back without negatively impacting physical activity?</p>
<h2>Phasing out financial rewards</h2>
<p>In <a href="https://doi.org/10.1001/jamanetworkopen.2023.42663">our large study</a> of 584,760 Carrot Rewards app users, my colleagues and I found that physical activity improvements (about 1,000 steps per day, or 10 more walking minutes) largely remained in Ontario after financial rewards faded away. This was a notable finding, especially since many years of <a href="https://doi.org/10.1037/0033-2909.125.6.627">psychology research</a> suggested the opposite; that people revert to baseline behaviours, their “old ways,” once financial rewards fade. </p>
<p>One reason for this might be that rewards for daily physical activity achievements were provided for over a year before withdrawal began, which is likely enough time for <a href="https://doi.org/10.1073/pnas.2216115120">habit formation</a>. </p>
<p>It may also be because the Carrot Rewards app rewarded the achievement of realistic and adaptive physical activity goals — which increase confidence — with micro-rewards worth only about US$0.05 per day.</p>
<p>Others have found that rewards as small as <a href="https://doi.org/10.1016/j.jebo.2016.12.012">US$0.09 per day</a> have boosted physical activity in more controlled clinical trial settings. </p>
<h2>Applying rewards</h2>
<p>What does this mean for those who have fitness apps collecting dust on their home screens? </p>
<p>In a nutshell, this new research suggests people can potentially take a short dose of financial reward to increase physical activity, and once that activity is established (it usually takes about <a href="https://doi.org/10.1073/pnas.2216115120">six to 12 months</a>), it may be maintained longer-term with much less expensive financial reinforcement. </p>
<p>So practically speaking, if someone is interested in this approach, it would make sense to seek out financial rewards for exercise — as an impetus, a nudge, a spark. </p>
<p>Some governments have financial rewards-based mobile health programs, such as <a href="https://www.gov.uk/government/news/new-pilot-to-help-people-exercise-more-and-eat-better">England</a> and <a href="https://www.totalwellbeingdiet.com/au/">Australia</a>. Employers may offer financial rewards as part of their extended health benefits, which is common in the <a href="https://www.federalregister.gov/documents/2013/06/03/2013-12916/incentives-for-nondiscriminatory-wellness-programs-in-group-health-plans#:%7E:text=The%20reward%20for%20a%20health,to%20prevent%20or%20reduce%20tobacco">United States</a> </p>
<p>If neither of those options are available, there are commercially-available financial rewards-based fitness apps like <a href="https://sweatco.in">Sweatcoin</a> or <a href="https://waybetter.com">WayBetter</a>. With Sweatcoin, goal achievements earn coins that can be redeemed for commercial products in Sweatcoin’s online store. With WayBetter, you deposit some of your own money and earn it back plus some if you achieve your goals.</p>
<p>While financial rewards may not work for everyone, our research and that of others is increasingly suggesting they may be one way of stimulating and sustaining a more active lifestyle.</p><img src="https://counter.theconversation.com/content/219294/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Marc Mitchell provides consulting services for Caterpillar Health Inc. He also receives funding from SSHRC.</span></em></p>Offering financial incentives for exercise may be one way of stimulating, and sustaining, a more active lifestyle. Research suggests that even after rewards stop, exercise gains mostly persist.Marc Mitchell, Associate Professor, School of Kinesiology, Western UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2250562024-03-11T17:18:46Z2024-03-11T17:18:46ZSitting is bad for your health and exercise doesn’t seem to offset the harmful effects<figure><img src="https://images.theconversation.com/files/580115/original/file-20240306-22-cd9nl9.jpg?ixlib=rb-1.1.0&rect=43%2C0%2C5710%2C3829&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/guy-shirt-lying-on-couch-eating-1285351615">Marko Aliaksandr/Shutterstock</a></span></figcaption></figure><p>Advances in technology in recent decades have obviated the need and desire for humans to move. Many of the world’s population sit for long periods throughout the day, whether in front of a computer at work or in front of a TV at home. Given that the human body is made to move, all this sitting is clearly bad for our health. A <a href="https://www.ahajournals.org/doi/10.1161/JAHA.123.031156">new study</a> from the University of California, San Diego (UCSD), confirmed this – and then some.</p>
<p>A total of 5,856 female participants aged 63 to 99 years were asked to wear an activity monitor on their hip for seven days at the start of the study. The researchers then followed them for a decade, during which 1,733 participants died. </p>
<p>The researchers used artificial intelligence to work out from the activity monitor how much time the participants were sitting and then linked this to their risk of death. The data showed that participants who sat more than 11 hours a day had a 57% higher risk of dying during the study period than those who sat less than nine and a half hours a day.</p>
<p>But regular exercise will undo the health risks of sitting too much, right? Not according to the UCSD study. The risk of an early death was still there even with higher amounts of moderate-to-vigorous exercise. A <a href="https://www.sciencedirect.com/science/article/pii/S0749379719302090?via%3Dihub">2019 study</a> also found that higher amounts of exercise didn’t undo the risk of diseases such as type 2 diabetes, heart disease and stroke that come with sitting too much. </p>
<p>However, <a href="https://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2023-107221">a study</a> from Australia found that doing between 9,000 and 10,500 steps each day lowered the risk of premature death, even in people who sat a lot. </p>
<p>The contradictory findings could be explained by the activity monitors being worn on the hip in the UCSD study and on the wrist in the Australian study, which might lead to different estimates of sitting time. </p>
<p>The Australian study also didn’t use any special software in the activity monitor data to work out when participants were sitting or standing, meaning that standing would have been incorrectly picked up as sitting. For example, if a participant stood still for half an hour, this would be picked up as half an hour of sitting. This could mean that the Australian study overestimated the time its participants spent sitting.</p>
<p>The evidence from the UCSD study looks to be better, highlighting the need to sit less. Current <a href="https://www.who.int/publications/i/item/9789240015128">guidelines</a> from the World Health Organization support this, recommending that adults should limit the amount of time sitting and break up long periods of sitting.</p>
<h2>How much sitting is too much?</h2>
<p>So how much sitting is too much? The UCSD study says 11 hours per day. Other research says just <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1062-2">seven hours</a> each day could be too much. There is lots of research too, that shows you shouldn’t sit for <a href="https://diabetesjournals.org/care/article/39/1/130/31522/Breaking-Up-Prolonged-Sitting-With-Standing-or">longer than 30 minutes</a> in one go as this can increase your blood sugar levels and blood pressure.</p>
<p>So what can you do to avoid sitting for long periods?</p>
<p>A sit-stand desk could help if you’re an office worker. Or you could get up and move around between job tasks or while on a call. At home, you could stand up during TV ad breaks or while the kettle is boiling. Some smart devices and wearables buzz if you have been sitting for too long as well.</p>
<p>But what if you can’t stand or walk? A <a href="https://onlinelibrary.wiley.com/doi/10.1111/sms.13671">2020 study</a> found that small bursts of arm exercise (for example, two minutes every 20 minutes) lowered blood sugar levels in wheelchair users. As long as you are doing something that means you aren’t sitting still, there are health benefits to be had. </p>
<p><em>Correction: A previous version of the article said: ‘This could mean that the Australian study underestimated the time its participants spent sitting.’ It should have said ‘overestimated’.</em></p><img src="https://counter.theconversation.com/content/225056/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Daniel Bailey does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>We really ought to be sitting less. Seriously.Daniel Bailey, Senior Lecturer in Sport, Health and Exercise Sciences, Brunel University LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2245102024-03-07T19:23:53Z2024-03-07T19:23:53ZWorking from home can make us healthier and happier. Employers benefit too. Here’s the evidence if you need any convincing<figure><img src="https://images.theconversation.com/files/580287/original/file-20240306-20-2qvls8.jpg?ixlib=rb-1.1.0&rect=23%2C23%2C7786%2C5187&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/woman-writing-on-her-notebook-3059747/">RF Studio/Pexels</a></span></figcaption></figure><p>Some of us used to imagine a world where the morning commute was a short stroll from your bedroom, the dress code included comfy slippers, and the closest coffee shop was your kitchen. Then working from home became a reality for many during the COVID pandemic, reshaping our work-life balance.</p>
<p>During the early days of the pandemic in 2020, our team was partway through a year-long <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0248008">study</a> examining lifestyle and wellbeing in Australian adults. Our findings, captured during the early COVID period, revealed that people working from home slept nearly half an hour more and drank slightly more alcohol. Dietary habits and mental health indicators were unchanged. </p>
<p>Fast forward to today. Many <a href="https://www.abs.gov.au/statistics/labour/earnings-and-working-conditions/characteristics-employment-australia/aug-2023">employees</a> still work from home and <a href="https://melbourneinstitute.unimelb.edu.au/data/taking-the-pulse-of-the-nation-2022/ttpn-11-july-2022">many more want to</a>. The Fair Work Commission is <a href="https://www.smh.com.au/politics/federal/work-from-home-battle-begins-and-the-decision-could-affect-millions-20240221-p5f6kb.html">reviewing</a> whether it needs to create basic rights for flexibility, allowing people to work from home. </p>
<p>While some of the health evidence about working from home is mixed, overall it shows giving workers the flexibility to choose to work from home can be good for their physical and mental health.</p>
<h2>It saves time commuting</h2>
<p>Before the pandemic, the typical Australian spent <a href="https://melbourneinstitute.unimelb.edu.au/__data/assets/pdf_file/0010/3398464/HILDA-Statistical-Report2019.pdf">4.5 hours commuting</a> each week, a grind linked with <a href="https://doi.org/10.1002/hec.3199">poorer mental health</a> and lower scores of how we rate our own health. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/australian-city-workers-average-commute-has-blown-out-to-66-minutes-a-day-how-does-yours-compare-120598">Australian city workers' average commute has blown out to 66 minutes a day. How does yours compare?</a>
</strong>
</em>
</p>
<hr>
<p>In Australia, the transition to home offices has given us <a href="https://www.nber.org/papers/w30866">about an hour and 18 minutes a week</a> of extra time. </p>
<p>Yet, intriguingly, <a href="https://www.nber.org/papers/w30866">43% of this newfound time is channelled into more work</a>, with a fraction (9%) to caregiving activities and leisure pursuits (33%). So are we optimising this shift? </p>
<h2>We move and snack more when working from home</h2>
<p>With extra time dedicated to leisure when working from home, there is more opportunity to be physically active and less sedentary.</p>
<p>In a <a href="https://doi.org/10.1016/j.jth.2018.03.008">study from the United States</a> of 108,000 people, work-from-home days were more likely to include significant bouts of walking or cycling.</p>
<p>By having more time available, slower yet <a href="https://doi.org/10.1016/j.jtrangeo.2020.102777">active transport options become viable</a> for short trips, such as cycling to the supermarket or walking to pick up children from care. </p>
<p>However, this silver lining is clouded by findings from <a href="https://doi.org/10.1002/1348-9585.12212">Japan</a>, where remote workers reported less movement and more sitting during office hours, hinting at a complex trade-off between work and leisure-time physical activity.</p>
<p>Dietary habits, too, are evolving with working from home. The convenience of proximity to our kitchen pantries has led to an increase in <a href="https://doi.org/10.3390/ijerph182211882">snacking</a>. </p>
<figure class="align-center ">
<img alt="Person gets chip out of packet" src="https://images.theconversation.com/files/580296/original/file-20240306-20-mzwlfv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/580296/original/file-20240306-20-mzwlfv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=407&fit=crop&dpr=1 600w, https://images.theconversation.com/files/580296/original/file-20240306-20-mzwlfv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=407&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/580296/original/file-20240306-20-mzwlfv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=407&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/580296/original/file-20240306-20-mzwlfv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=512&fit=crop&dpr=1 754w, https://images.theconversation.com/files/580296/original/file-20240306-20-mzwlfv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=512&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/580296/original/file-20240306-20-mzwlfv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=512&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">We tend to snack more at home.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/hand-takes-out-potato-chips-inside-1732920281">Oleg Krugliak/Shutterstock</a></span>
</figcaption>
</figure>
<p>However, as we snack more and see a rise in our overall energy intake at home, there’s also a noticeable shift towards a <a href="https://www.mdpi.com/1660-4601/18/22/11882">broader selection</a> of healthier food options. Consumption of vegetables, fruits and dairy has gone up, complemented by a surge in preparing meals at home.</p>
<p>In the office, limited by the constraints of a packed communal fridge or the wait to use the microwave, opting for a less nutritious but quicker takeaway lunch often seems the better choice. </p>
<h2>What about mental health and wellbeing?</h2>
<p>When considering mental health and wellbeing, the results are nuanced. </p>
<p>Generally, when working from home is compulsory, as was common during the early pandemic lockdowns, mental health and wellbeing <a href="https://doi.org/10.3390/ijerph182211882">tend to decline</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/most-of-us-will-recover-our-mental-health-after-lockdown-but-some-will-find-it-harder-to-bounce-back-169029">Most of us will recover our mental health after lockdown. But some will find it harder to bounce back</a>
</strong>
</em>
</p>
<hr>
<p>Conversely, when people choose to work from home, their mental health and wellbeing often improve. This is especially the case when they’re well supported by colleagues and their organisation, and can manage their isolation level, meaning they have <a href="https://doi.org/10.1111/jomf.12633">flexibility</a> in their work-from-home arrangements. </p>
<p>There are concerns working from home can <a href="https://doi.org/10.1016/j.jss.2022.111552">negatively impact</a> team cohesion and collaboration, feelings of attachment and social ties within the workplace, and opportunities for promotion.</p>
<figure class="align-center ">
<img alt="Workers look at a laptop, laughing" src="https://images.theconversation.com/files/580298/original/file-20240306-26-ueqem6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/580298/original/file-20240306-26-ueqem6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/580298/original/file-20240306-26-ueqem6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/580298/original/file-20240306-26-ueqem6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/580298/original/file-20240306-26-ueqem6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/580298/original/file-20240306-26-ueqem6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/580298/original/file-20240306-26-ueqem6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Some employers worry staff can’t collaborate as well when working from home.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/three-men-laughing-while-looking-in-the-laptop-inside-room-XkKCui44iM0">Priscilla du Preez/Unsplash</a></span>
</figcaption>
</figure>
<p>While connecting with colleagues is difficult to replicate remotely, it’s important to note job performance and productivity appear to be stable or, in most cases, <a href="https://doi.org/10.3390/su15054529">improved</a> when working from home. </p>
<p>Additionally, those working full time at home or in a hybrid model report job satisfaction and wellbeing to be stable or improved. They also report a reduction in work-family conflict – this is particularly so for <a href="https://doi.org/10.2139/ssrn.4393288">women</a>.</p>
<h2>Some people need more flexibility than others</h2>
<p>For some people, the flexibility to work from home alleviates some of the structural barriers to working.</p>
<p>Women, especially mothers and caregivers, report <a href="https://doi.org/10.2139/ssrn.4393288">improved wellbeing</a> with the option to work from home. The added flexibility helps to balance paid employment with unpaid caregiving and household duties, which disproportionately <a href="https://doi.org/10.1111/1467-8462.12538">fall on women’s shoulders</a>. </p>
<p>Similarly, workers with disabilities <a href="https://doi.org/10.1007/s10926-020-09936-5">tend to favour working from home</a>, as a solution to overcoming <a href="https://doi.org/10.1111/bjir.12645">transportation and accessibility challenges</a> posed by traditional workplaces. Providing alternative working arrangements allows a greater number of people living with disabilities to engage in paid employment, which is linked to improvements in <a href="https://doi.org/10.1136/jech-2014-204147">mental health</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/working-from-home-has-worked-for-people-with-disability-the-back-to-the-office-push-could-wind-back-gains-209870">Working from home has worked for people with disability. The back-to-the-office push could wind back gains</a>
</strong>
</em>
</p>
<hr>
<p>Working from home is not a one-size-fits-all approach and appears best positioned as one choice among many to support a better, more inclusive, and flexible work environment. Just as our homes transformed into makeshift offices overnight, our approach to work must evolve, embracing the diversity of needs and lifestyles. </p>
<p>Let’s hope a legacy of COVID will be a healthier, more balanced workforce.</p><img src="https://counter.theconversation.com/content/224510/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Carol Maher receives funding from the Medical Research Future Fund, the National Health and Medical Research Council, the National Heart Foundation, the SA Department for Education, Preventive Health SA, the SA Department for Innovation and Skills, Healthway, Hunter New England Local Health District, the Central Adelaide Local Health Network, LeapForward.</span></em></p><p class="fine-print"><em><span>Rachel Curtis receives funding from the Medical Research Future Fund, National Health and Medical Research Council, SA Department for Education, Healthway, Hunter New England Local Health District, and SA Department for Innovation and Skills.</span></em></p><p class="fine-print"><em><span>Ty Ferguson does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The Fair Work Commission is considering basic rights to work from home. Here’s what the evidence says about the impacts of working from home on physical health and mental wellbeing.Ty Ferguson, Research Associate, University of South AustraliaCarol Maher, Professor, Medical Research Future Fund Emerging Leader, University of South AustraliaRachel Curtis, Research fellow, University of South AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2202532024-02-28T18:02:06Z2024-02-28T18:02:06ZPersistent shoulder pain: Are exercises always necessary to relieve symptoms?<figure><img src="https://images.theconversation.com/files/566901/original/file-20231206-19-pkjjrg.jpg?ixlib=rb-1.1.0&rect=2%2C0%2C986%2C667&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The presence of pain, especially when it persists over time, is not necessarily a sign that your condition is deteriorating.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>It is estimated that <a href="https://pubmed.ncbi.nlm.nih.gov/15163107/">close to 70 per cent</a> of the population will experience shoulder pain at some point in their lives. </p>
<p>In itself, this pain would not pose a problem if it disappeared as quickly as it appeared. Unfortunately, it tends to persist over time. In half of patients, <a href="https://pubmed.ncbi.nlm.nih.gov/8806252/">the pain persists or reoccurs one year</a> after its initial appearance. It can even persist for several years in some cases.</p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/8917870/">Approximately 70 per cent</a> of shoulder pain episodes requiring consultation with a health-care provider can be identified as <a href="https://pubmed.ncbi.nlm.nih.gov/27083390/">rotator cuff related shoulder pain</a>. This refers to pain and loss of function in the shoulder, mainly during movements requiring the arm to be lifted. Although a number of effective options are available to patients, <a href="https://pubmed.ncbi.nlm.nih.gov/10226960/">a third of them</a> will not experience any significant improvement in their condition, regardless of the interventions used. </p>
<p>There are several possible reasons for this limited success. <a href="https://academic.oup.com/ptj/article/101/7/pzab072/6145046?login=true">Exercise selection</a> and some <a href="https://bjsm.bmj.com/content/52/4/269">psychological and contextual characteristics</a> specific to each individual have been identified as potential hypotheses.</p>
<p>As experts in the field of shoulder pain, we propose to shed light on the effectiveness of various interventions for the management of shoulder pain, and the role that some variables may play in the resolution of this pain.</p>
<h2>Some important questions</h2>
<p>Our research team therefore set out to find out: </p>
<ol>
<li><p>Whether one type of exercise should be prioritized over another in the management of shoulder pain.</p></li>
<li><p>Whether the addition of exercises (the pet peeve of many people who consult a rehabilitation provider) lead to additional benefits compared with an intervention comprising only of education and advice to foster pain self-management.</p></li>
<li><p>Whether some psychological and contextual characteristics, such as participants’ expectations of the intervention effectiveness and pain self-efficacy, are associated with a better prognosis.</p></li>
</ol>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/16446108/">Pain self-efficacy</a> is the level of confidence someone has in their ability to carry out their activities and achieve their goals despite pain.</p>
<h2>How did we go about answering those questions?</h2>
<p>In our <a href="https://bjsm.bmj.com/content/57/8/457">new study</a> published in the <em>British Journal of Sports Medicine</em>, 123 people with shoulder pain lasting for more than three months were randomly assigned to one of three 12-week interventions: </p>
<ul>
<li><p>Education </p></li>
<li><p>Education combined with motor control exercises </p></li>
<li><p>Education combined with strengthening exercises </p></li>
</ul>
<p>Questionnaires were used to monitor changes in participants’ condition over time, particularly in terms of their pain and functional capacity. </p>
<p>Before the start of the intervention, we also used <a href="https://journals.lww.com/painrpts/fulltext/2021/11000/measurement_properties_of_the_pain_self_efficacy.21.aspx">questionnaires</a> to measure participants’ expectations of the effectiveness of the intervention they were about to receive, as well as their level of pain self-efficacy. </p>
<h2>The content of each group</h2>
<p><em>Education</em></p>
<p>Participants in this group received two sessions of education and advice with a physiotherapist. The information was about the shoulder and pain, and the advice included strategies for the self-management of their condition. </p>
<p>Participants were also told about the importance of being active and adopting a healthy lifestyle to optimize the management of persistent pain, including proper diet, hydration, stress management and sleep hygiene. </p>
<p>Finally, participants were asked to watch six short videos on these themes. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/5bUf9VcYLmI?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Example of a video that study participants were asked to watch.</span></figcaption>
</figure>
<p>After viewing, they were asked to identify the aspects they felt were important and those that raised questions in order to discuss them with the physiotherapist.</p>
<p><em>Education combined with motor control exercises</em></p>
<p>As well as receiving this education, the participants in this group completed a 12-week exercise program. </p>
<p>The exercises included modifications in the way they performed their movements to enable them to move their arm with less pain. These modifications were integrated with exercises reproducing gestures involving the shoulder during daily activities.</p>
<p><em>Education combined with strengthening exercises</em></p>
<p>Again, participants in this group received the same education component. </p>
<p>They also received a shoulder muscle strengthening program to be performed daily for 12 weeks.</p>
<h2>The results of our study</h2>
<p><a href="https://blogs.bmj.com/bjsm/2023/04/17/does-the-addition-of-motor-control-or-strengthening-exercises-to-education-result-in-better-outcomes-for-rotator-cuff-related-shoulder-pain/">At the end of the study</a>, participants in all three groups showed improvements in pain and function. However, the addition of exercises (motor control or strengthening) to the education intervention did not lead to additional benefits. </p>
<p>People recruited into the study whose symptoms were considered resolved following the 12-week intervention had more positive expectations regarding the effectiveness of their intervention and had higher levels of pain self-efficacy. </p>
<h2>Key messages</h2>
<p>Adding strengthening or motor control exercises to an educational intervention did not result in additional benefits compared to an approach based solely on education and advice. For some people with persistent shoulder pain, education and advice focusing on pain self-management may be sufficient to promote symptom resolution. </p>
<p>Exercise, in any form, remains a highly relevant intervention for <a href="https://www.jospt.org/doi/full/10.2519/jospt.2022.11306">shoulder pain management</a>, as well as for <a href="https://bjsm.bmj.com/content/53/14/856">maintaining independence</a> and <a href="https://bjsm.bmj.com/content/57/18/1203">optimizing long-term health</a>. </p>
<p>Participants’ pain self-efficacy and expectations of the effectiveness of the intervention they receive may play a role in the prognosis of their shoulder pain. </p>
<h2>But above all…</h2>
<p>When you’re experiencing shoulder pain, it can be beneficial to temporarily reduce certain activities that can aggravate your pain. However, it’s important not to delay gradually reintegrating these activities into your daily routine. </p>
<p>The presence of pain, especially when it persists over time, <a href="https://pubmed.ncbi.nlm.nih.gov/32694387/">is not necessarily a sign that your condition is deteriorating</a>. It could simply indicate that the gestures or activities performed exceed the <a href="https://therunningclinic.com/mechanical-stress-quantification/">shoulder’s current ability to tolerate the load imposed on it</a>. </p>
<p>In any case, don’t hesitate to consult a health professional, such as a <a href="https://oppq.qc.ca/">physiotherapist</a>, who will be able to help you “shoulder” the responsibility of managing your condition.</p><img src="https://counter.theconversation.com/content/220253/count.gif" alt="La Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Marc-Olivier Dubé is a member of the Ordre Professionnel de la Physiothérapie du Québec (OPPQ). He is the recipient of a postdoctoral fellowship from the Fonds de recherche du Québec - Santé (FRQS).</span></em></p><p class="fine-print"><em><span>Jean-Sébastien Roy received funding from Canadian Institutes of Health Research, Fonds de recherche du Québec - Santé (FRQS), Arthritis Society Canada and Natural Sciences and Engineering Research Council of Canada. </span></em></p><p class="fine-print"><em><span>François Desmeules ne travaille pas, ne conseille pas, ne possède pas de parts, ne reçoit pas de fonds d'une organisation qui pourrait tirer profit de cet article, et n'a déclaré aucune autre affiliation que son organisme de recherche.</span></em></p>Education and advice, as well as exercise, can play a role in the management of shoulder pain.Marc-Olivier Dubé, Physiothérapeute, Chercheur postdoctoral en réadaptation, Université LavalFrançois Desmeules, Professeur titulaire en physiothérapie et en santé musculosquelettique, École de réadaptation, Université Montréal, Université de MontréalJean-Sébastien Roy, Professeur titulaire à l'École des sciences de la réadaptation, Université LavalLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2243122024-02-27T12:32:52Z2024-02-27T12:32:52ZE-bike incentives are a costly way to cut carbon emissions, but they also promote health, equity and cleaner air<figure><img src="https://images.theconversation.com/files/577761/original/file-20240225-22-nb9e6p.jpg?ixlib=rb-1.1.0&rect=7%2C15%2C5019%2C2916&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A man pulls his kids behind an electric bicycle near the pier in Huntington Beach, Calif.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/man-pulls-his-kids-behind-an-electric-bicycle-near-the-pier-news-photo/1311180585">Paul Bersebach/Orange County Register via Getty Images</a></span></figcaption></figure><p>E-bikes have captured <a href="https://velo.outsideonline.com/ebike/ebike-gear/5-e-bike-trends-we-expect-to-see-in-2024/">widespread attention</a> across the U.S., and for good reason. They are <a href="https://cleantechnica.com/2023/12/11/e-bikes-are-radically-more-efficient-than-electric-cars/">the most energy-efficient way</a> to move from place to place, providing exercise in the process, and offer enough assistance while pedaling uphill or into headwinds to make them usable for many types of riders. </p>
<p>Greenhouse gas emissions from e-bikes are much lower than those from either gasoline-powered or <a href="https://www.itf-oecd.org/good-go-assessing-environmental-performance-new-mobility">electric cars</a>. Some cities and states are encouraging the use of e-bikes by providing purchase incentives, often drawing on public funds dedicated to curbing climate change.</p>
<p>Currently, over 100 cities and states <a href="https://trec.pdx.edu/news/e-bike-incentive-programs-north-america-new-online-tracker">have or plan to launch e-bike incentive programs</a>, most funded by energy or environment initiatives. However, there has been little research on the effectiveness of these types of programs, how to design them or how to define goals. </p>
<p>We study transportation from many angles, including <a href="https://scholar.google.com/citations?user=I3wi1-EAAAAJ&hl=en">innovation</a>, <a href="https://www.researchgate.net/profile/John-Macarthur-4">sustainability</a> and <a href="https://scholar.google.com/citations?user=JltA3IAAAAAJ&hl=en">economics</a>. Our new study, published in the journal <a href="https://doi.org/10.1016/j.trd.2024.104114">Transportation Research Part D</a>, investigates the effectiveness of several types of e-bike purchase incentives and the investment required to induce additional e-bike purchases. </p>
<p>We found that incentives do spur extra e-bike purchases, but at a relatively high cost compared with narrowly defined climate benefits. We find that a public agency using a point-of-purchase discount would have to distribute about US$4,000 in incentives to generate one additional e-bike purchase. This is because over 80% of people who buy an e-bike would likely have bought one even without the discount. For perspective, it takes <a href="https://doi.org/10.1016/j.jeem.2017.01.002">about $30,000 worth of incentives</a> to induce an electric car purchase. </p>
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<figcaption><span class="caption">California initiated a $10 million statewide program in 2023 that offers voucher incentives to low-income residents for purchasing electric bikes.</span></figcaption>
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<p>Nonetheless, e-bikes provide many other benefits. They make mobility easier and more affordable for many people, including <a href="https://doi.org/10.1016/j.trip.2023.100940">older adults and people with disabilities</a>. They bolster the case for <a href="https://orbit.dtu.dk/en/publications/cost-benefit-of-bicycle-infrastructure-with-e-bikes-and-cycle-sup">investing in bike paths and infrastructure</a>, which produce <a href="https://www.urban.org/urban-wire/why-us-cities-are-investing-safer-more-connected-cycling-infrastructure">economic, safety and mobility benefits for cities</a>. And they <a href="https://doi.org/10.1016/j.jth.2017.06.002">boost health by promoting exercise</a>. In our view, cities and states should assess e-bike incentive investments based on this broad range of benefits, rather than focusing solely on a narrow environmental objective.</p>
<h2>Not just a climate tool</h2>
<p>Clean technology incentives tend to be focused on a specific outcome – usually, reducing greenhouse gas emissions. This works well for most energy-related upgrades, such as replacing old air conditioners, improving home insulation and generating electricity from wind and solar power. Consumers want the services that these devices deliver – cool air, comfortable conditions indoors and electricity that’s available and affordable. The new devices simply deliver those familiar goods more sustainably. </p>
<p>E-bike incentives are different. They invite people to adopt a new technology that can fundamentally change recipients’ travel patterns. In fact, while replacing car trips with e-bike trips <a href="https://doi.org/10.1016/j.trd.2020.102482">can provide substantial climate benefits</a>, those benefits may be smaller than other benefits that are less widely measured. Focusing narrowly on reducing greenhouse gas emissions by replacing car trips means providing incentives to people who drive the most, or who drive the biggest gas guzzlers.</p>
<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/p/C3lJZJpp8jH/?utm_source=ig_web_copy_link","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
<p>But what about carless households, transit riders or bicyclists? For them, e-bikes can make it much easier to travel in most North American cities. That increased mobility could provide greater access to jobs, shopping or other important services, such as health care.</p>
<h2>Is investing in e-bike incentives worth it?</h2>
<p>Transportation is the <a href="https://www.epa.gov/ghgemissions/sources-greenhouse-gas-emissions">largest source of U.S. greenhouse gas emissions</a>. Electrifying as much of it as possible is an important strategy for slowing climate change. However, e-bike incentives – and, indeed, electric car incentives – are pretty expensive ways to reduce emissions. </p>
<p>The importance of e-bike incentives is that e-bikes are good at replacing car trips and make daily trips easier for people who rely on other options. These advantages provide two main classes of benefits from increasing ownership of e-bikes.</p>
<p>The first set of benefits comes from substituting car-based trips with e-bike trips. Transportation researchers think about a swap like this in terms of vehicle miles traveled.</p>
<p>If I used to drive to work but now ride an e-bike, many benefits will be proportional to the number of miles that I now cover by bike rather than by car. They include reduced traffic congestion, lower fuel and parking costs, increased physical activity and improved health, cleaner air and reduced greenhouse gas emissions. In North America, <a href="https://nitc.trec.pdx.edu/research/project/1041">about 60% of e-bike trips replace car trips</a>. </p>
<p>A second class of benefits comes from improvements in mobility. These effects are more complex to measure. For many people in U.S. cities who don’t own cars, the basic options for getting around are walking, public transit, ride-hailing services like Uber and Lyft, or riding a conventional bicycle. In almost all cases, e-bikes would get them to their destinations faster. </p>
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<figcaption><span class="caption">A father explains how his family used electric cargo bikes to replace a car in Toronto and the Netherlands.</span></figcaption>
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<p>Carless households <a href="https://rosap.ntl.bts.gov/view/dot/63059">tend to have lower income</a> and lack mobility options. E-bike incentives can make travel more affordable and give people better access to jobs, health care, child care, shopping and other destinations. Such benefits likely far exceed any nominal greenhouse gas accounting from these transportation users. </p>
<p>E-bike purchase incentives are an investment in the broad benefits that e-bikes can provide. We believe they should be measured against the collective goals of the agency providing the incentives, whether its mission is transportation, equitable mobility, public health, economic development or environmental protection. </p>
<h2>Putting more people on two wheels</h2>
<p>Once there’s agreement that e-bikes are worth supporting for many reasons, the challenge is how to induce more e-bike use and realize those benefits.</p>
<p>Point-of-purchase discounts or vouchers are the most popular strategy, because they mimic other clean energy incentives, such as those for high-efficiency appliances or electric cars. Our study found that they are also the most efficient way to influence consumer behavior compared with other purchase incentives, such as rebates. </p>
<p>Other strategies could be more effective but need further research. For example, <a href="https://nextcity.org/urbanist-news/bike-libraries-are-increasing-access-to-bikes-across-america">e-bike lending libraries</a> let people test-ride e-bikes without ownership. And employers can <a href="https://transweb.sjsu.edu/sites/default/files/2051-Fitch-Ebike-Employer.pdf">provide e-bikes to employees</a> to help encourage more sustainable and affordable ways to get to work. </p>
<p>Partnering with community organizations or local mobility-oriented programs could be an effective way to get e-bikes into the hands of people who need them and couldn’t afford them otherwise. And giving e-bike owners more reason to use them, such as <a href="https://momentummag.com/is-it-time-governments-start-paying-people-to-bike-to-work/">payments for biking to work</a>, could increase e-bike use and subsequent benefits. </p>
<p>E-bike purchase incentives may be an expensive climate solution, but they also offer other important benefits. Carefully designed incentive programs could help many urban and suburban residents access a faster, healthier and cleaner way to get where they need to go.</p><img src="https://counter.theconversation.com/content/224312/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christopher R. Cherry receives research funding from State and Federal Departments of Transportation and the National Science Foundation. He has consulted for micromobility operators and bicycling advocacy organizations.</span></em></p><p class="fine-print"><em><span>John MacArthur has received research support and funding from state and federal agencies, the National Science Foundation, micromobility operators and bicycling advocacy organizations.</span></em></p><p class="fine-print"><em><span>Luke Jones does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Many incentive programs promote e-bike use, but they aren’t necessarily targeting the right people for the right reasons.Christopher R. Cherry, Professor of Civil and Environmental Engineering, University of TennesseeJohn MacArthur, Sustainable Transportation Program Manager, Transportation Research and Education Center, Portland State UniversityLuke Jones, Professor of Economics, Valdosta State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2239952024-02-23T17:16:46Z2024-02-23T17:16:46ZYour smart watch isn’t a medical device – but it is tracking all your health data<figure><img src="https://images.theconversation.com/files/577550/original/file-20240223-16-alopfu.jpg?ixlib=rb-1.1.0&rect=26%2C0%2C8648%2C5774&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fit-female-runner-using-smart-watch-1037615245">Jacob Lund / Shutterstock</a></span></figcaption></figure><p>For millions of people, smartwatches aren’t just a piece of technology. They can use them to take control of their health in ways never thought possible.</p>
<p>As you go on your morning run, a smartwatch can monitor the rhythmic pounding of your feet and your heart’s steady beat. The watch can record the <a href="https://www.which.co.uk/news/article/can-you-trust-fitness-tracking-stats-ajJf85J6C42l">distance covered and the intensity of your workout</a>, guiding you towards your fitness goals.</p>
<p>During lunch, you can use it to <a href="https://blog.fitbit.com/fitbit-calories-in-vs-out/">log calories for a BLT sandwich</a>. As deadlines loom, they can offer gentle reminders to take a moment for yourself. And as you doze off, they <a href="https://www.zdnet.com/article/samsung-galaxy-watch-gets-first-ever-fda-clearance-for-sleep-apnea-detection/">might pick up instances of apnoea</a> or other sleep disturbances.</p>
<p>But some users could also conflate health tips with medical advice. Device and app developers have <a href="https://www.cnet.com/tech/mobile/features/fitbit-apple-know-smartwatches-arent-medical-devices-but-do-you/">consistently made it clear</a> that their products cannot replace a professional medical doctor’s advice or treatment. </p>
<p>A smartwatch is not a medical device as defined by law. In the UK, medical devices are strictly regulated in a way that other devices such as smartwatches are not. These regulations provide users with better legal protections and clarity as well as providing for resolution in the event of a mishap.</p>
<h2>What qualifies</h2>
<p>The key legal framework in the UK is <a href="https://www.legislation.gov.uk/uksi/2002/618/regulation/2/made">the Medical Devices Regulations 2002 (UK MDR)</a>. Once a product has been identified as a medical device under UK MDR, further classification of it takes place, ranging from low risk (stethoscopes and wheelchairs) to high risk (pacemakers, heart valves, implanted cerebral simulators).</p>
<p>If a device is designed to go inside the body, or if it contains medicinal substances, it is more likely it is treated as high risk. Depending on the risk classification, the law then imposes stringent standards to protect users from harm. These include obligations on the manufacturers and developers to ensure their devices are safe, through conducting risk impact assessments, periodic audits and other actions.</p>
<p>All matters relating to medical devices in the UK <a href="https://www.gov.uk/government/organisations/medicines-and-healthcare-products-regulatory-agency">fall under the responsibility</a> of the Medicines and Healthcare Products Regulatory Agency (MHRA). The MHRA conducts surveillance of medical devices available in the UK and has the authority to make decisions regarding their marketing and distribution. It is also the MHRA’s duty to ensure that manufacturers and developers are complying with the regulations. </p>
<h2>Pursuit of wellness?</h2>
<p>An important question is how one distinguishes a device, digital tool or app as one used for a medical purpose – which is how the UK MDR defines a medical device – versus one that is used for general health and wellness. The latter would include, for example, meditation apps or step counters. </p>
<p>Traditionally, smart watches have been <a href="https://www.insiderintelligence.com/insights/wearable-technology-healthcare-medical-devices/">treated as smart, wearable technology</a>. On the face of it, they offer users insight into their general health and wellness, helping them make necessary lifestyle adjustments to improve their health or fitness goals. </p>
<p>In recent years, however, such technologies have become increasingly advanced. Tens of thousands of digital tools and applications have flooded app stores. These include monitoring apps for mental health, symptom checkers based on information entered by patient users, or medical calculators for drug dosing.</p>
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<img alt="ECG" src="https://images.theconversation.com/files/577593/original/file-20240223-28-zkojeb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577593/original/file-20240223-28-zkojeb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577593/original/file-20240223-28-zkojeb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577593/original/file-20240223-28-zkojeb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577593/original/file-20240223-28-zkojeb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577593/original/file-20240223-28-zkojeb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577593/original/file-20240223-28-zkojeb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Electrocardiogram functions can now be incorporated into smartwatches.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/ekg-monitor-intra-aortic-balloon-pump-1936321450">Pitchyfoto/Shutterstock</a></span>
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<p>Smartwatches may have <a href="https://support.apple.com/en-us/HT208955">electrocardiogram (ECG) functions</a>. An ECG is a test used to check a person’s heart’s rhythm and electrical activity. Medical professionals have traditionally used ECGs to look for signs of coronary heart disease or other cardiovascular conditions. The same functions on a watch may not have the right sensitivity to pick up on medical conditions.</p>
<p>The latest version of the <a href="https://www.apple.com/healthcare/docs/site/Apple_Watch_Arrhythmia_Detection.pdf">Apple watch has embedded sensors</a> that may be able to <a href="https://www.nhs.uk/conditions/atrial-fibrillation/">detect atrial fibrillation</a>, a type of irregular heart rhythm. In the US, <a href="https://www.apple.com/newsroom/2022/06/watchos-9-delivers-new-ways-to-stay-connected-active-and-healthy/">Apple has obtained clearance</a> from the Food and Drug Administration (FDA) <a href="https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K213971">allowing it to be used</a> for this purpose, marking a bold move into the regulated medicine and healthcare space.</p>
<p>Biosensors, previously thought of as devices that were <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4986445/">administered only in clinical settings</a> have now evolved by design into slim patches for consumer use. Take the <a href="https://nixbiosensors.com/">Nix Biosensor device</a>. When paired with Apple Watches, it is designed to measure a user’s optimal <a href="https://www.theverge.com/23582865/nix-hydration-biosensor-review-wearables-hydration">hydration level</a> in real time by identifying molecular markers in sweat and determining the loss of fluid and electrolytes (substances that maintain a balance of fluids inside and outside cells). </p>
<p>Finally, emerging trends also indicate that more and more women are relying on fertility and cycle trackers in smartwatches and sophisticated apps. However, there have been concerns that users might use the information <a href="https://www.wired.com/story/apple-watch-fertility-features-not-birth-control/">in place of actual birth control</a>.</p>
<p>Hence, as smartwatches and trackers evolve, it’s possible that they may approach the threshold for what authorities could consider a medical device.</p>
<h2>Privacy protections</h2>
<p>There’s something else to consider too. Users of devices and digital tools regularly hand over their personal data. Businesses must ensure compliance with the <a href="https://ico.org.uk/for-organisations/data-protection-and-the-eu/data-protection-and-the-eu-in-detail/the-uk-gdpr/">UK General Data Protection Regulation (UK GDPR)</a> and the <a href="https://www.legislation.gov.uk/ukpga/2018/12/contents/enacted">Data Protection Act 2018 (DPA)</a>.</p>
<p>Personal health data is a “special category of data”. This would fall under the application of Articles 6 and 9 of the UK GDPR and Schedule 1 of the DPA. This means that more stringent standards are imposed for the collection and use of such data (in its processing), including potentially an obligation to conduct an extensive data impact assessment. </p>
<p>Indeed, the UK’s privacy watchdog, the Information Commissioner’s Office (ICO) <a href="https://ico.org.uk/about-the-ico/media-centre/news-and-blogs/2024/02/ico-urges-all-app-developers-to-prioritise-privacy/">issued a statement</a> on February 8 2024 reminding all app developers to ensure they protect users’ privacy following the regulator’s review of period and fertility apps. </p>
<p>Other potential safeguards for users’ privacy could come from the <a href="https://www.legislation.gov.uk/ukpga/2021/3/contents">Medicines and Medical Devices Act 2021 (MMDA)</a>, from the appointment of the <a href="https://www.patientsafetycommissioner.org.uk/">Patient Safety Commissioner</a> and from the National Health Service (NHS), which can now evaluate digital tools using the <a href="https://transform.england.nhs.uk/key-tools-and-info/digital-technology-assessment-criteria-dtac/">digital technology assessment criteria (DTAC)</a>.</p>
<p>Clear guidelines in this area are not just necessary, they’re imperative. Without them, we potentially risk both stifling innovation and compromising user care.</p><img src="https://counter.theconversation.com/content/223995/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Pin Lean Lau does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Medical devices have a legal definition, but the lines might become blurred in future.Pin Lean Lau, Senior Lecturer (Associate Professor) in Bio-Law, Brunel University LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2161252024-02-21T13:19:09Z2024-02-21T13:19:09ZYour heart changes in size and shape with exercise – this can lead to heart problems for some athletes and gym rats<p>Exercise has long been recognized by clinicians, scientists and public health officials as an <a href="https://www.nhlbi.nih.gov/health/heart/physical-activity/benefits">important way to maintain health</a> throughout a person’s lifespan. It improves overall fitness, helps build strong muscles and bones, reduces the risk of chronic disease, improves mood and slows physical decline. </p>
<p>Exercise can also significantly reduce the risk of developing conditions that negatively affect heart heath, such as high blood pressure, high cholesterol and obesity. But large amounts of exercise throughout life may also harm the heart, leading to the development of a condition called <a href="https://www.merckmanuals.com/professional/cardiovascular-disorders/sports-and-the-heart/athlete%E2%80%99s-heart">athletic heart</a>.</p>
<p>As the <a href="https://medschool.cuanschutz.edu/cardiology/clinical-programs/multidisciplinary-programs/sports-cardiology">sports cardiology director</a> at the University of Colorado Anschutz Medical Campus, I’m often asked how much and what kind of exercise is necessary to get the benefits of exercise. Many people also wonder about the risks of exercise, and what happens if you exercise too much. </p>
<p>The <a href="https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults">American Heart Association generally recommends</a> 150 minutes of moderate-intensity exercise, such as brisk walking, or 75 minutes of vigorous-intensity exercise, such as running, each week. It also recommends muscle strengthening exercises at least twice per week.</p>
<p>When people exceed these guidelines, the heart may remodel itself in response – that is, it begins to change its size and shape. As a result, heart function may also change. These changes in heart structure and function among people who engage in high levels of exercise are referred to as the athletic heart, or athlete’s heart. Athletic heart doesn’t necessarily cause problems, but in some people it can increase the risk of certain heart issues.</p>
<h2>What is athletic heart?</h2>
<p>To understand how exercise affects the heart, it’s important to consider what kind of exercise you’re participating in. </p>
<p>Exercise is generally divided into <a href="https://doi.org/10.1016/j.jacc.2015.09.033">two broad categories</a>: dynamic and static. </p>
<p>Dynamic exercises, like running, cross-country skiing and soccer, require the heart to pump an increased amount of blood, compared to the amount delivered to the body at rest, in order to sustain the activity. For example, when running, the amount of blood the heart pumps to the body may increase by threefold to fivefold compared to at rest.</p>
<p>Static exercises, like weightlifting, gymnastics or rock climbing, require the body to use skeletal muscle in order to push or pull heavy amounts of weight. While the heart does pump more blood to skeletal muscles that are working during these activities, these kinds of exercises depend on a muscle’s ability to move the weight. For example, in order to do curls with dumbbells, the biceps must be strong enough to lift the desired weight. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/576223/original/file-20240216-28-rwjbi1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Close-up of lower half of the back of a person cycling, one hand outstretched towards the vegetation on the side of the road" src="https://images.theconversation.com/files/576223/original/file-20240216-28-rwjbi1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/576223/original/file-20240216-28-rwjbi1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/576223/original/file-20240216-28-rwjbi1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/576223/original/file-20240216-28-rwjbi1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/576223/original/file-20240216-28-rwjbi1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/576223/original/file-20240216-28-rwjbi1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/576223/original/file-20240216-28-rwjbi1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Cycling involves both dynamic and static exercise.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/man-in-black-shorts-riding-bicycle-on-road-during-daytime-vRuoDd-Qnq8">Judit Murcia/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Some exercises, like rowing or cycling, are both highly dynamic and highly static because they require the heart to pump large amounts of blood while simultaneously requiring a large amount of muscle strength to sustain effort.</p>
<p>It is important to distinguish between dynamic and static exercise because the heart adapts differently according to the type of exercise you engage in over time. Dynamic exercise increases the volume of blood pumping through the heart and can cause the heart to become enlarged, or dilated, over time. Static exercise increases the amount of pressure on the heart and can also cause it to become enlarged over time but with thickened walls.</p>
<h2>Who develops athletic heart?</h2>
<p>Exercise that exceeds guidelines, such as exercising more than an hour most days of the week, may lead to development of athletic heart. Athletic heart commonly occurs <a href="https://doi.org/10.1161/01.CIR.101.3.336">among endurance athletes</a>, who regularly compete in activities like marathons or other long-duration events. Many exercise several hours per day and more than 12 to 15 hours per week.</p>
<p>Among runners, for example, the heart remodels itself in response to having to pump a high volume of blood. As a result, the chambers of the heart enlarge to hold and pump more blood. Among weightlifters, the heart remodels itself by thickening in response to the increase in pressure applied on the heart.</p>
<p>Exercise is good for the body, and athletic heart results from a lifelong commitment to an activity that promotes good health. But there may be some issues that arise from an athletic heart.</p>
<p>First, athletes with markedly enlarged hearts may be at risk of developing <a href="https://www.acc.org/Latest-in-Cardiology/Articles/2019/08/16/08/20/Atrial-Fibrillation-in-Competitive-Athletes">atrial fibrillation</a>, which is abnormal heart rhythms that typically occur among older adults or people with high blood pressure or heart failure. Abnormal heart rhythms are worrisome because they may lead to a stroke. </p>
<p>There are many potential reasons atrial fibrillation occurs in athletes. A dilated atrium – the top chamber in the heart – may become inflamed and develop scar tissue, increasing the risk of atrial fibrillation. <a href="https://doi.org/10.1161/01.CIR.0000031733.51374.C1">Stress and environmental factors</a> may also work together to increase the risk of arrhythmia.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/576219/original/file-20240216-28-p2nrzu.gif?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Clip of an ultrasound reading of an enlarged heart beating" src="https://images.theconversation.com/files/576219/original/file-20240216-28-p2nrzu.gif?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/576219/original/file-20240216-28-p2nrzu.gif?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=537&fit=crop&dpr=1 600w, https://images.theconversation.com/files/576219/original/file-20240216-28-p2nrzu.gif?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=537&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/576219/original/file-20240216-28-p2nrzu.gif?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=537&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/576219/original/file-20240216-28-p2nrzu.gif?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=675&fit=crop&dpr=1 754w, https://images.theconversation.com/files/576219/original/file-20240216-28-p2nrzu.gif?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=675&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/576219/original/file-20240216-28-p2nrzu.gif?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=675&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">This is an echocardiogram of a 30-year-old athlete with an enlarged heart.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:4_chamber_(1).gif">Runandbike/Wikimedia Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p><a href="https://doi.org/10.1161/CIRCULATIONAHA.117.027834">Coronary artery calcification, or CAC</a>, is another concern among elite athletes. Coronary artery calcification, which commonly occurs in older adults or those with risk factors for coronary artery disease, increases the risk of having a heart attack or stroke. In recent years, doctors have been using imaging tests to monitor calcium buildup in the arteries of their patients to try to determine their risk of heart attack or stroke over time.</p>
<p>It is not entirely clear why elite athletes develop coronary artery calcification. Fortunately, it does not appear that athletes have an increased risk of heart attack, even among those with very high levels of CAC. For example, a large study of almost 22,000 participants found that even athletes who engaged in high amounts of exercise and had elevated levels of CAC <a href="https://doi.org/10.1001/jamacardio.2018.4628">did not have an increased risk</a> of death from cardiovascular disease over a decade of follow-up.</p>
<p>Some athletes are appropriately concerned about having calcium buildup in their heart arteries and may wonder whether or not they should be taking medications like aspirin or statins. But risks <a href="https://doi.org/10.1016/j.mayocpiqo.2019.03.007">vary from person to person</a>, so anyone concerned about CAC should talk to their doctor</p>
<h2>Putting exercise in its place</h2>
<p>Though elite athletes may have an increased risk of developing athletic heart, exercise undoubtedly remains one of, if not the best, methods to maintain a healthy lifestyle.</p>
<p>For example, if someone does not exercise routinely, their heart <a href="https://doi.org/10.1161/circulationaha.105.541078">will become stiff</a> and not pump blood as well as it once did. Routine exercise – especially dynamic exercise like running – maintains a compliant heart and prevents stiffening. A compliant heart will expand a lot more as it fills with blood and, in turn, pump out more blood with each heartbeat. A stiff heart has difficulty filling up with blood and has difficulty pumping blood through the body.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/576226/original/file-20240216-24-i1u421.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Two people running on a road lined with trees -- the younger person is trailing behind the older person who has leaped into the air with arms raised" src="https://images.theconversation.com/files/576226/original/file-20240216-24-i1u421.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/576226/original/file-20240216-24-i1u421.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=440&fit=crop&dpr=1 600w, https://images.theconversation.com/files/576226/original/file-20240216-24-i1u421.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=440&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/576226/original/file-20240216-24-i1u421.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=440&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/576226/original/file-20240216-24-i1u421.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=553&fit=crop&dpr=1 754w, https://images.theconversation.com/files/576226/original/file-20240216-24-i1u421.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=553&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/576226/original/file-20240216-24-i1u421.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=553&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Regular exercise can help keep your heart young.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/the-old-and-young-sportsmen-running-on-the-road-royalty-free-image/1086683052">Viacheslav Peretiatko/iStock via Getty Images Plus</a></span>
</figcaption>
</figure>
<p>Generally, routine exercise throughout adulthood encourages the heart to <a href="https://doi.org/10.1016/j.jacc.2014.03.062">remain strong and flexible</a> even in old age. Even if someone were only to begin regularly exercising in their 40s to 50s, it is possible to <a href="https://doi.org/10.1161/circulationaha.117.030617">reverse some of the effects</a> of sedentary aging.</p>
<p>For example, a 2018 study of 53 sedentary people mostly in their early 50s found that those who participated in a two-year exercise training program using a combination of running, cycling and elliptical exercise had hearts that <a href="https://doi.org/10.1161/circulationaha.117.030617">became more compliant</a> compared to the hearts of those who did not exercise.</p>
<p>It is never too late to start exercising. Routinely following exercise guidelines can help promote physical and mental health and help your heart stay young throughout your life.</p><img src="https://counter.theconversation.com/content/216125/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>William Cornwell does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>People who regularly engage in significant amounts of exercise, as endurance athletes do, may develop enlarged hearts. While athletic heart is adapted for performance, it can be cause for concern.William Cornwell, Associate Professor of Cardiology, University of Colorado Anschutz Medical CampusLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2234412024-02-15T02:57:24Z2024-02-15T02:57:24ZRunning or yoga can help beat depression, research shows – even if exercise is the last thing you feel like<figure><img src="https://images.theconversation.com/files/575486/original/file-20240213-16-fi0ivc.jpg?ixlib=rb-1.1.0&rect=0%2C1%2C1000%2C664&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/exercise-healthy-concept-fat-woman-feeling-1095177362">SKT Studio/Shutterstock</a></span></figcaption></figure><p>At least <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.665019/full">one in ten people</a> have depression at some point in their lives, with some estimates <a href="https://www.sciencedirect.com/science/article/pii/S0749379720301793">closer to one in four</a>. It’s one of the worst things for someone’s wellbeing – worse than <a href="https://www.happinessresearchinstitute.com/_files/ugd/928487_4a99b6e23f014f85b38495b7ab1ac24b.pdf">debt, divorce or diabetes</a>.</p>
<p><a href="https://theconversation.com/why-are-so-many-australians-taking-antidepressants-221857">One in seven</a> Australians take antidepressants. Psychologists are in <a href="https://theconversation.com/we-cant-solve-australias-mental-health-emergency-if-we-dont-train-enough-psychologists-here-are-5-fixes-190135">high demand</a>. Still, only <a href="http://dx.doi.org/10.1371/journal.pmed.1003901">half</a> of people with depression in high-income countries get treatment. </p>
<p>Our <a href="https://www.bmj.com/content/384/bmj-2023-075847">new research</a> shows that exercise should be considered alongside therapy and antidepressants. It can be just as impactful in treating depression as therapy, but it matters what type of exercise you do and how you do it.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-are-so-many-australians-taking-antidepressants-221857">Why are so many Australians taking antidepressants?</a>
</strong>
</em>
</p>
<hr>
<h2>Walk, run, lift, or dance away depression</h2>
<p>We found 218 randomised trials on exercise for depression, with 14,170 participants. We analysed them using a method called a network meta-analysis. This allowed us to see how different types of exercise compared, instead of lumping all types together. </p>
<p>We found walking, running, strength training, yoga and mixed aerobic exercise were about as effective as <a href="https://theconversation.com/explainer-what-is-cognitive-behaviour-therapy-37351">cognitive behaviour therapy</a> – one of the <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2018.00004/full">gold-standard treatments</a> for depression. The effects of dancing were also powerful. However, this came from analysing just five studies, mostly involving young women. Other exercise types had more evidence to back them.</p>
<p>Walking, running, strength training, yoga and mixed aerobic exercise seemed more effective than antidepressant medication alone, and were about as effective as exercise alongside antidepressants.</p>
<p>But of these exercises, people were most likely to stick with strength training and yoga.</p>
<p><iframe id="cZaWb" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/cZaWb/2/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>Antidepressants certainly help <a href="https://www.thelancet.com/article/S0140-6736(17)32802-7/fulltext">some people</a>. And of course, anyone getting treatment for depression should talk to their doctor <a href="https://australia.cochrane.org/news/new-cochrane-review-explores-latest-evidence-approaches-stopping-long-term-antidepressants">before changing</a> what they are doing. </p>
<p>Still, our evidence shows that if you have depression, you should get a psychologist <em>and</em> an exercise plan, whether or not you’re taking antidepressants.</p>
<h2>Join a program and go hard (with support)</h2>
<p>Before we analysed the data, we thought people with depression might need to “ease into it” with generic advice, <a href="https://www.who.int/initiatives/behealthy/physical-activity">such as</a> “some physical activity is better than doing none.”</p>
<p>But we found it was far better to have a clear program that aimed to push you, at least a little. Programs with clear structure worked better, compared with those that gave people lots of freedom. Exercising by yourself might also make it hard to set the bar at the right level, given low self-esteem is a symptom of depression.</p>
<p>We also found it didn’t matter how much people exercised, in terms of sessions or minutes a week. It also didn’t really matter how long the exercise program lasted. What mattered was the intensity of the exercise: the higher the intensity, the better the results.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1618986138118803457"}"></div></p>
<h2>Yes, it’s hard to keep motivated</h2>
<p>We should exercise caution in interpreting the findings. Unlike drug trials, participants in exercise trials know which “treatment” they’ve been randomised to receive, so this may skew the results.</p>
<p>Many people with depression have physical, psychological or social barriers to participating in formal exercise programs. And getting support to exercise isn’t free. </p>
<p>We also still don’t know the best way to stay motivated to exercise, which can be even harder if you have depression.</p>
<p>Our study tried to find out whether things like setting exercise goals helped, but we couldn’t get a clear result.</p>
<p>Other reviews found it’s important to have a <a href="https://pubmed.ncbi.nlm.nih.gov/31923898/">clear action plan</a> (for example, putting exercise in your calendar) and to <a href="https://pubmed.ncbi.nlm.nih.gov/19916637/">track your progress</a> (for example, using an app or smartwatch). But predicting which of these interventions work is notoriously difficult. </p>
<p>A <a href="https://www.nature.com/articles/s41586-021-04128-4">2021 mega-study</a> of more than 60,000 gym-goers <a href="https://www.nature.com/articles/s41586-021-04128-4/figures/1">found</a> experts struggled to predict which strategies might get people into the gym more often. Even making workouts fun didn’t seem to motivate people. However, listening to audiobooks while exercising helped a lot, which no experts predicted.</p>
<p>Still, we can be confident that people benefit from personalised support and accountability. The support helps overcome the hurdles they’re sure to hit. The accountability keeps people going even when their brains are telling them to avoid it. </p>
<p>So, when starting out, it seems wise to avoid going it alone. Instead:</p>
<ul>
<li><p>join a fitness group or yoga studio</p></li>
<li><p>get a trainer or an exercise physiologist</p></li>
<li><p>ask a friend or family member to go for a walk with you. </p></li>
</ul>
<p>Taking a few steps towards getting that support makes it more likely you’ll keep exercising.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/exercise-is-even-more-effective-than-counselling-or-medication-for-depression-but-how-much-do-you-need-200717">Exercise is even more effective than counselling or medication for depression. But how much do you need?</a>
</strong>
</em>
</p>
<hr>
<h2>Let’s make this official</h2>
<p>Some countries see exercise as a backup plan for treating depression. For example, the American Psychological Association only <a href="https://www.apa.org/depression-guideline/">conditionally recommends</a> exercise as a “complementary and alternative treatment” when “psychotherapy or pharmacotherapy is either ineffective or unacceptable”.</p>
<p>Based on our research, this recommendation is withholding a potent treatment from many people who need it.</p>
<p>In contrast, The Royal Australian and New Zealand College of Psychiatrists <a href="https://www.ranzcp.org/getmedia/a4678cf4-91f5-4746-99d4-03dc7379ae51/mood-disorders-clinical-practice-guideline-2020.pdf">recommends</a> vigorous aerobic activity at least two to three times a week for all people with depression.</p>
<p>Given how common depression is, and the number failing to receive care, other countries should follow suit and recommend exercise alongside front-line treatments for depression.</p>
<p><em>I would like to acknowledge my colleagues Taren Sanders, Chris Lonsdale and the rest of the coauthors of the paper on which this article is based.</em></p>
<p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.</em></p><img src="https://counter.theconversation.com/content/223441/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Noetel receives funding from the Australian Research Council, the Medical Research Future Fund, Sport Australia, and the National Health and Medical Research Council. He is a director of Effective Altruism Australia.</span></em></p>Our new study shows you may be able to walk, run, lift or dance away depression. And the more intense your exercise program, the better.Michael Noetel, Senior Lecturer in Psychology, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2201432024-01-17T04:33:05Z2024-01-17T04:33:05ZA new year means new fitness goals. But options for people with disability are few and far between<figure><img src="https://images.theconversation.com/files/569758/original/file-20240117-19-y64dwz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/african-american-senior-using-resistance-band-2263427617">Drazen Zigic/Shutterstock</a></span></figcaption></figure><p>Around <a href="https://www.aihw.gov.au/australias-disability-strategy/technical-resources/data-sources/australian-bureau-of-statistics-sdac">4.4 million Australians</a>, or 18% of our population, live with disability. This number is likely to rise as our population ages. </p>
<p>Adults living with disability can experience a range of benefits from participating in community-based physical activities such as dance, Tai Chi and yoga, our recently published <a href="https://bjsm.bmj.com/content/early/2023/12/21/bjsports-2023-107123">review</a> found. </p>
<p>Yet adults with disability are <a href="https://bmjopensem.bmj.com/content/7/1/e000991">less physically active</a> than those without disability, with inclusive community-based physical activities few and far between. This puts people with disability at increased risk of further disability. </p>
<p>People with disability should be able to join a local club or group to participate in physical activity they enjoy, just like the rest of us. So how can we provide more physical activity options?</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/thinking-of-using-an-activity-tracker-to-achieve-your-exercise-goals-heres-where-it-can-help-and-where-it-probably-wont-219235">Thinking of using an activity tracker to achieve your exercise goals? Here's where it can help – and where it probably won't</a>
</strong>
</em>
</p>
<hr>
<h2>Benefits of physical activity</h2>
<p>Our <a href="https://bjsm.bmj.com/content/early/2023/12/21/bjsports-2023-107123">systematic review</a> included 74 trials with 2,954 men and women living with mild-to-moderate physical and intellectual disability.</p>
<p>We looked at studies of Tai Chi, Qigong (which is similar to Tai Chi but more straightforward, using more repetitive movements), yoga, dance, water exercise, gym training, boxing, horse riding, Nordic walking and running. All but one of these physical activities were delivered in condition-specific groups (for example, a group for people with Parkinson’s disease). </p>
<figure class="align-center ">
<img alt="People doing Tai Chi in a park" src="https://images.theconversation.com/files/569742/original/file-20240117-15-l075wi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/569742/original/file-20240117-15-l075wi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/569742/original/file-20240117-15-l075wi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/569742/original/file-20240117-15-l075wi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/569742/original/file-20240117-15-l075wi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/569742/original/file-20240117-15-l075wi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/569742/original/file-20240117-15-l075wi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Poses in Tai Chi can be modified to suit people with a range of abilities.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/elderly-asian-people-practicing-tai-chi-381172381">Dragon Images/Shutterstock</a></span>
</figcaption>
</figure>
<p>People found benefits from participating in these recreation activities. Benefits included improvements in walking, balance and quality of life, and reductions in fatigue, depression and anxiety. </p>
<p>Dance was particularly beneficial for improving walking. Tai Chi, yoga, dance and water exercise were beneficial for balance. Yoga and water exercise were beneficial for fatigue and Tai Chi for depression. </p>
<h2>Considerations for physical recreation in the community</h2>
<p>Some people with disabilities prefer to be active with others who have similar conditions and abilities. Others prefer to be active locally with family and friends. </p>
<p>Travel to a disability-specific activity may increase the cost and time involved. The lack of choice puts people with a disability at a disadvantage compared to non-disabled people. </p>
<p>Some physical recreation activities included in the review used adjustments and extra equipment to be suitable for people with disability. These adjustments were usually only small (for example, seated options or spending a shorter time in a certain pose or position) and equipment was low cost (for chairs, exercise bands, and so on). </p>
<p>Most local community-based recreation groups should be able make simple adjustments to meet the needs of people living with mild to moderate disability. However this doesn’t routinely happen. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/sport-and-physical-activity-play-important-roles-for-aboriginal-and-torres-strait-islander-communities-but-there-are-barriers-to-participation-168263">Sport and physical activity play important roles for Aboriginal and Torres Strait Islander communities, but there are barriers to participation</a>
</strong>
</em>
</p>
<hr>
<p>In the review, few activity leaders (37%) had experience and/or training working with people with disability. This may limit the confidence of the activity leader to include a person with disability in the class. It may also limit the confidence of the person with disability to join a local class. </p>
<h2>Access to services is a basic right</h2>
<p>Australia is a signatory on the <a href="https://humanrights.gov.au/our-work/disability-rights/united-nations-convention-rights-persons-disabilities-uncrpd">Convention on the Rights of Persons with Disabilities</a>. Australia also has a <a href="https://humanrights.gov.au/our-work/disability-rights/disability-discrimination#:%7E:text=The%20Disability%20Discrimination%20Act%201992,places%2C%20because%20of%20their%20disability.">Disability Discrimination Act</a> (1992). But this seems to provide little incentive for services to take active measures to prevent disability discrimination. </p>
<p>The <a href="https://disability.royalcommission.gov.au/">Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability</a> confirmed people with disability were still excluded from many areas of society because of their disability. </p>
<figure class="align-center ">
<img alt="Woman dances in a class" src="https://images.theconversation.com/files/569745/original/file-20240117-27-8fb39c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/569745/original/file-20240117-27-8fb39c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/569745/original/file-20240117-27-8fb39c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/569745/original/file-20240117-27-8fb39c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/569745/original/file-20240117-27-8fb39c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/569745/original/file-20240117-27-8fb39c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/569745/original/file-20240117-27-8fb39c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">People with disability often face greater costs, more travel and fewer choices for physical activity.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/old-lady-dancing-other-women-during-2059280225">BearFotos/Shutterstock</a></span>
</figcaption>
</figure>
<p>The commission’s <a href="https://disability.royalcommission.gov.au/publications/final-report">final report</a> recommended strengthening laws to protect people with disability, prevent discrimination, and build a more inclusive society. </p>
<p>Momentum and expectation is growing in Australian society for better inclusion for people living with disability. </p>
<h2>So what can we do for better physical activity inclusion?</h2>
<p>First, more physical activity options suitable for people with disability are needed in the community. Guided by the <a href="https://www.inclusivesportdesign.com/blog-posts/the-inclusion-spectrum-planning-sport-activities-for-everyone">inclusion spectrum</a>, there should be options for both disability-specific and inclusive mainstream activities. People with disability will then be able to choose an activity that suits their needs and preference. </p>
<p>A handful of <a href="https://coablefitness.com.au/story/">organisations</a> are leading the way, often led by a person with disability or disability advocate, but more are needed.</p>
<p>Second, community-based physical activities need to enable the person with disability to access the setting safely and have equipment suitable to use. Community organisations can audit their service using online tools, such as <a href="https://doi.org/10.1080/09638280410001711432">AIMFREE</a> (Accessibility Instruments Measuring Fitness and Recreation Environments), to evaluate and improve their accessibility. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/we-need-beach-access-for-everyone-and-that-includes-people-with-a-disability-154158">We need beach access for everyone, and that includes people with a disability</a>
</strong>
</em>
</p>
<hr>
<p>A welcoming environment can help ensure a positive experience for the person with disability. Disability Sports Australia offers a free online <a href="https://www.sports.org.au/accessibility-champion">Accessibility Champion course</a> for sporting clubs and recreation providers. This aims to improve staff and volunteer knowledge and confidence to welcome people with disability. All clubs and service providers should commit to completing this type of training.</p>
<p>Finally, we can all do better to ensure we are accepting and welcoming of people of all abilities in the community, especially in recreation or sporting activities we’re involved in. When this happens, Australia will take an important step to being a more inclusive society.</p><img src="https://counter.theconversation.com/content/220143/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Leanne Hassett receives funding from the National Health and Medical Research Council of Australia and Medical Research Future Fund. </span></em></p><p class="fine-print"><em><span>Anne Tiedemann has received funding from the National Health and Medical Research Council and the Medical Research Future Fund. She is an Executive Committee Member of the Australia and New Zealand Falls Prevention Society and the World Falls Prevention Society. </span></em></p><p class="fine-print"><em><span>Cathie Sherrington has received funding from the National Health and Medical Research Council and the Medical Research Future Fund. She is the voluntary secretary of the Cerebral Palsy Sport and Recreation Association of NSW and she is an executive member of the Australian and NZ Falls Prevention Society. </span></em></p>People with disability gain many benefits from being physically active, from greater movement to improved mental health. But options for community-based physical activity are limited.Leanne Hassett, Associate Professor in Physiotherapy, University of SydneyAnne Tiedemann, Professor of Physical Activity and Health, University of SydneyCathie Sherrington, Professor, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2192352024-01-15T19:02:49Z2024-01-15T19:02:49ZThinking of using an activity tracker to achieve your exercise goals? Here’s where it can help – and where it probably won’t<figure><img src="https://images.theconversation.com/files/568548/original/file-20240110-16-1b9rum.jpeg?ixlib=rb-1.1.0&rect=0%2C0%2C4500%2C2943&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sporty-man-running-jogging-park-active-2293505867">MalikNalik/Shutterstock</a></span></figcaption></figure><p>It’s that time of year when many people are getting started on their resolutions for the year ahead. Doing more physical activity is a popular and <a href="https://link.springer.com/article/10.1007/s13668-016-0175-5">worthwhile</a> goal. </p>
<p>If you’re hoping to be more active in 2024, perhaps you’ve invested in an activity tracker, or you’re considering buying one.</p>
<p>But what are the benefits of activity trackers? And will a basic tracker do the trick, or do you need a fancy one with lots of features? Let’s take a look.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-do-i-improve-my-motivation-to-exercise-when-i-really-hate-it-10-science-backed-tips-179761">How do I improve my motivation to exercise when I really hate it? 10 science-backed tips</a>
</strong>
</em>
</p>
<hr>
<h2>Why use an activity tracker?</h2>
<p>One of the <a href="https://doi.org/10.1186/s12966-020-01001-x">most powerful predictors</a> for being active is whether or not <a href="https://www.sciencedirect.com/science/article/abs/pii/S0140673621026301">you are monitoring</a> how active you are. </p>
<p>Most people have a vague idea of how active they are, but this is inaccurate a lot of the time. Once people consciously start to keep track of how much activity they do, they often realise it’s less than what they thought, and this motivates them to be more active. </p>
<p>You can self-monitor without an activity tracker (just by writing down what you do), but this method is hard to keep up in the long run and it’s also a lot less accurate compared to devices that track your every move 24/7. </p>
<figure class="align-center ">
<img alt="A female runner in the bush looking at a watch." src="https://images.theconversation.com/files/568549/original/file-20240110-15-9fx99i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568549/original/file-20240110-15-9fx99i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568549/original/file-20240110-15-9fx99i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568549/original/file-20240110-15-9fx99i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568549/original/file-20240110-15-9fx99i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568549/original/file-20240110-15-9fx99i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568549/original/file-20240110-15-9fx99i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">There are significant health benefits to being active.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/active-fit-retired-female-runner-taking-1784166416">Anatoliy Karlyuk/Shutterstock</a></span>
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</figure>
<p>By tracking steps or “activity minutes” you can ascertain whether or not you are meeting the <a href="https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years">physical activity guidelines</a> (150 minutes of moderate to vigorous physical activity per week).</p>
<p>It also allows you to track how you’re progressing with any personal activity goals, and view your progress over time. All this would be difficult without an activity tracker. </p>
<p>Research has shown the most popular brands of activity trackers are generally reliable when it comes to tracking basic measures such as <a href="https://doi.org/10.2196/18694">steps</a> and <a href="https://doi.org/10.1123/jmpb.2019-0072">activity minutes</a>.</p>
<h2>But wait, there’s more</h2>
<p>Many activity trackers on the market nowadays track a range of other measures which their manufacturers promote as important in monitoring health and fitness. But is this really the case? Let’s look at some of these. </p>
<p><strong>Resting heart rate</strong></p>
<p>This is your heart rate at rest, which is normally somewhere <a href="https://www.healthdirect.gov.au/resting-heart-rate">between 60 and 100 beats per minute</a>. Your resting heart rate will gradually go down as you become fitter, especially if you’re doing a lot of high-intensity exercise. Your risk of dying of any cause (all-cause mortality) is much lower when you have a <a href="https://pubmed.ncbi.nlm.nih.gov/28552551/">low resting heart rate</a>. </p>
<p>So, it is useful to keep an eye on your resting heart rate. Activity trackers are pretty good at tracking it, but you can also easily measure your heart rate by monitoring your pulse and using a stopwatch.</p>
<p><strong>Heart rate during exercise</strong></p>
<p>Activity trackers will also measure your heart rate when you’re active. To improve fitness efficiently, professional athletes focus on having their heart rate in certain “<a href="https://chhs.source.colostate.edu/how-to-target-heart-rate-training-zones-effectively/">zones</a>” when they’re exercising – so knowing their heart rate during exercise is important.</p>
<p>But if you just want to be more active and healthier, without a specific training goal in mind, you can exercise at a level that feels good to you and not worry about your heart rate during activity. The <a href="https://doi.org/10.1097/HCO.0000000000000437">most important thing</a> is that you’re being active. </p>
<p>Also, a dedicated heart rate monitor with a strap around your chest will do a much better job at measuring your actual heart rate <a href="https://doi.org/10.1038/s41746-020-0226-6">compared</a> to an activity tracker worn around your wrist. </p>
<p><strong>Maximal heart rate</strong></p>
<p>This is the hardest your heart could beat when you’re active, not something you could sustain very long. Your maximal heart rate is not influenced by how much exercise you do, or your fitness level. </p>
<p>Most activity trackers <a href="https://jamanetwork.com/journals/jamacardiology/article-abstract/2566167">don’t measure it accurately</a> anyway, so you might as well forget about this one.</p>
<figure class="align-center ">
<img alt="A hand with a smartwatch around the wrist stretching." src="https://images.theconversation.com/files/568551/original/file-20240110-29-8bym1o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568551/original/file-20240110-29-8bym1o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568551/original/file-20240110-29-8bym1o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568551/original/file-20240110-29-8bym1o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568551/original/file-20240110-29-8bym1o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568551/original/file-20240110-29-8bym1o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568551/original/file-20240110-29-8bym1o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Many activity trackers measure heart rate.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/runner-stretching-leg-before-run-closeup-283094750">Maridav/Shutterstock</a></span>
</figcaption>
</figure>
<p><strong>VO₂max</strong></p>
<p>Your muscles need oxygen to work. The more oxygen your body can process, the harder you can work, and therefore the fitter you are. </p>
<p>VO₂max is the volume (V) of oxygen (O₂) we could breathe maximally (max) over a one minute interval, expressed as millilitres of oxygen per kilogram of body weight per minute (ml/kg/min). Inactive women and men would have a VO₂max lower than 30 and 40 ml/kg/min, respectively. A reasonably good VO₂max would be mid thirties and higher for women and mid forties and higher for men. </p>
<p>VO₂max is another measure of fitness that <a href="https://doi.org/10.1001/jamanetworkopen.2018.3605">correlates well</a> with all-cause mortality: the higher it is, the lower your risk of dying. </p>
<p>For athletes, VO₂max is usually measured in a lab on a treadmill while wearing a mask that measures oxygen consumption. Activity trackers instead look at your running speed (using a GPS chip) and your heart rate and compare these measures to values from other people. </p>
<p>If you can run fast with a low heart rate your tracker will assume you are relatively fit, resulting in a higher VO₂max. These estimates are <a href="https://doi.org/10.1007/s40279-021-01639-y">not very accurate</a> as they are based on lots of assumptions. However, the error of the measurement is reasonably consistent. This means if your VO₂max is gradually increasing, you are likely to be getting fitter. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-do-we-really-need-to-take-10-000-steps-a-day-109079">Health Check: do we really need to take 10,000 steps a day?</a>
</strong>
</em>
</p>
<hr>
<p>So what’s the take-home message? Focus on how many steps you take every day or the number of activity minutes you achieve. Even a basic activity tracker will measure these factors relatively accurately. There is no real need to track other measures and pay more for an activity tracker that records them, unless you are getting really serious about exercise.</p><img src="https://counter.theconversation.com/content/219235/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Corneel Vandelanotte receives research funding from the National Health and Medical Research Council, the Australian Research Council, the National Heart Foundation of Australia, and the Medical Research Future Fund. He also receives funding from Health and Wellbeing Queensland and Wellbeing SA for delivering the 10,000 Steps program. </span></em></p>Activity trackers come with a variety of functionalities. While some are important, others you can pay less attention to.Corneel Vandelanotte, Professorial Research Fellow: Physical Activity and Health, CQUniversity AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2208212024-01-11T17:16:05Z2024-01-11T17:16:05ZLong COVID: damaged mitochondria in muscles might be linked to some of the symptoms<figure><img src="https://images.theconversation.com/files/568825/original/file-20240111-27-danv4a.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5375%2C3524&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Many long COVID sufferers find their symptoms worsen after exercise.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/tired-man-wipes-sweat-his-face-1959349945">Miridda/ Shutterstock</a></span></figcaption></figure><p>It’s estimated <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/30march2023">around 3% of people</a> in the UK experience long COVID – persistent, long-lasting symptoms after a COVID-19 infection.</p>
<p>Long COVID encompasses a <a href="https://pubmed.ncbi.nlm.nih.gov/36639608/">range of health problems</a> that can begin after even a mild COVID infection. Some of these symptoms include extreme fatigue, shortness of breath, muscle aches and loss of smell. </p>
<p>For around 50% of long COVID sufferers, their symptoms also fit criteria for a diagnosis of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844405/">myalgic encephalomyelitis</a> (ME), a neuro-immune disease characterised by depleted energy, muscle weakness and pain, cognitive dysfunction and dysautonomia (which affects blood pressure and heart rate). </p>
<p>A cardinal feature of ME is “<a href="https://journals.sagepub.com/doi/10.1177/1359105318784161">post-exertional malaise</a>” (PEM). This refers to a <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0197811">worsening of symptoms</a> that takes place around 24-48 hours after any form of exertion – whether that’s physical, cognitive or emotional. PEM may take days or weeks to subside.</p>
<p>PEM remains one of the most debilitating yet least understood features of both <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844405/">ME and long COVID</a>. But <a href="https://www.nature.com/articles/s41467-023-44432-3">new research</a> may point to a probable explanation for why physical activity in particular worsens long COVID symptoms. The study found that people with long COVID exhibit alterations in their muscle structure. </p>
<p>To conduct their study, the researchers analysed muscle biopsies and blood plasma samples taken from 25 people with long COVID and 21 people who had had COVID but didn’t have long COVID. Participants in both groups were around 41 years old, on average. There was a 48% to 52% split between men and women. </p>
<p>The blood and muscle samples were taken before and after a controlled cycling test. Participants cycled for approximately 15 minutes, starting slowly and gradually increasing in intensity.</p>
<p>During the cycling test, those with long COVID exhibited poorer muscular strength and had lower oxygen uptake compared with the healthy participants – despite putting in the same amount of effort. These results echo the findings of <a href="https://pubmed.ncbi.nlm.nih.gov/34389297/">previous studies</a>, suggesting people with long COVID have significantly reduced exercise capacity. </p>
<p>When the researchers analysed the muscle samples of the participants, they found that those with long COVID had a higher proportion of fast-twitch glycolytic muscle fibres. These muscle fibres can work at high intensity in short bursts, but are <a href="https://journals.physiology.org/doi/epdf/10.1152/ajpcell.00368.2011">highly fatiguable</a> because they have fewer mitochondria (organelles which provide cells with the energy they need to function properly).</p>
<p>The researchers then conducted further tests on the mitochondria in these fibres. They found that exercise lowered mitochondrial function in the long COVID sufferers – indicating that as well as having a reduced capacity for exercise, their muscle tissue had acquired damage during the exercise test.</p>
<figure class="align-center ">
<img alt="A digital drawing of the mitochondria of a cell." src="https://images.theconversation.com/files/568826/original/file-20240111-23-n1134f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568826/original/file-20240111-23-n1134f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=375&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568826/original/file-20240111-23-n1134f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=375&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568826/original/file-20240111-23-n1134f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=375&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568826/original/file-20240111-23-n1134f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=471&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568826/original/file-20240111-23-n1134f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=471&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568826/original/file-20240111-23-n1134f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=471&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Mitochondria provide our cells with energy.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/mitochondrion-235472659">Yurii Andreichyn/ Shutterstock</a></span>
</figcaption>
</figure>
<p>Tests on molecules in muscle and plasma also revealed that people with long COVID had lower levels of vital molecules required for the process mitochondria use to provide cells with energy.</p>
<p>This is not the first time that mitochondrial dysfunction has been implicated in an illness featuring PEM. In fact, this was first proposed as the underlying mechanism in ME more than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2425703/pdf/postmedj00252-0008.pdf">40 years ago</a>. </p>
<p>If the mitochondria in muscles are dysfunctional, this means the muscle cells don’t produce enough energy to meet the body’s demands. This may explain why people with long COVID experience worse symptoms after exercise.</p>
<h2>Muscle ‘microclots’</h2>
<p>Next, the authors studied whether there were clumps of mis-folded proteins present in the muscle samples. </p>
<p>Previous studies have shown these clumps, termed “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8380922/">microclots</a>”, are found at <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8381139/pdf/12933_2021_Article_1359.pdf">raised levels</a> in the plasma of people with long COVID. It’s been proposed that microclots may <a href="https://pubmed.ncbi.nlm.nih.gov/36043493/">block capillaries</a>, causing damage as blood re-enters tissues. This may also cause damage to the mitochondria. </p>
<p>The authors showed that people with long COVID did indeed have more microclots in their muscles compared with the control samples. The number of microclots also increased after exercise in all participants. However, they did not find evidence that they were blocking capillaries.</p>
<p>Finally, they looked at which immune cells were present in muscle tissue. They found increased numbers of macrophages and T-cells, which both <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019499/">help with tissue repair</a>, in the samples of those with long COVID – even before they exercised. This indicates that long COVID sufferers have locally activated immune cells in their muscle tissue as a response to tissue damage.</p>
<p>It’s known that mitochondria can <a href="https://www.mdpi.com/1422-0067/22/21/11338">cause and also be damaged by inflammation</a> (which can be caused by an over-active immune system). This may be another reason why the mitochondria of long COVID sufferers are dysfunctional.</p>
<h2>Targeting mitochondria</h2>
<p>This study supports a growing body of research that has identified considerable abnormalities in the <a href="https://www.nature.com/articles/s41577-023-00904-7">metabolic, muscular and immune function</a> of people with long COVID (and, by extension, people with ME). It also suggests that targeting the mitochondria could help to improve symptoms.</p>
<p>Promisingly, many compounds have already been shown to positively affect mitochondrial function. Some of these are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604531/">available without prescription</a>, such as coenzyme Q10 (which our body naturally produces). But placebo-controlled trials will need to be carried out to see if these compounds have any effect on long COVID symptoms.</p>
<p>These findings also highlight how important it is to exercise caution when designing rehabilitation strategies for people with long COVID.</p>
<p>Traditional programmes work on the basis that gradual increases in effort and difficulty <a href="https://www.nhs.uk/live-well/exercise/">build resilience and exercise capacity</a>. But for people with long COVID, the opposite is true. </p>
<p>This recent paper has now found why this may be the case, showing that for those with long COVID, pushing beyond their capabilities will provoke mitochondrial damage, reducing resilience and provoking a relapse of their condition. These findings are key when considering recommendations for rehabilitation or return to work strategies for long COVID sufferers.</p><img src="https://counter.theconversation.com/content/220821/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Caroline Dalton receives funding from the Patient-Led Research Collaborative. </span></em></p>These findings may provide insights into better ways of managing long COVID.Caroline Dalton, Associate Professor of Neuroscience and Genetics, Sheffield Hallam UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2203422024-01-08T16:56:38Z2024-01-08T16:56:38ZWhy you shouldn’t let guilt motivate you to exercise<figure><img src="https://images.theconversation.com/files/568181/original/file-20240108-17-rohiaz.jpg?ixlib=rb-1.1.0&rect=17%2C17%2C5934%2C3944&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Using guilt and self-pressure may make you less likely to work out overall.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/frustrated-female-runner-sitting-down-hand-1065048539">KieferPix/ Shutterstock</a></span></figcaption></figure><p>The hardest part of consistently exercising is finding the motivation to do it. But using the wrong type of motivation for your workouts could militate against you – and could even have consequences for your mental health. </p>
<p>Our research, which <a href="https://www.tandfonline.com/doi/full/10.1080/02640414.2022.2042124">investigated the motivations</a> of 650 frequent exercisers, found that people who believed things like “I am a loser if I do not succeed in things that matter to me” and “I have to be viewed favourably by people that matter to me” were more likely to use self-pressure and wanting to avoid guilt as motivation to exercise. </p>
<p>Not only was this group more likely to not want to exercise at all, we also found that those who used guilt and self-pressure as motivation were at greater risk of experiencing poor mental health.</p>
<p>The tendency to hold dogmatic beliefs like “I must” or “I have to”, and harmful beliefs about yourself creates a negative and <a href="https://www.tandfonline.com/doi/full/10.1080/10413200.2018.1446472?casa_token=ObBghnn3ab4AAAAA%3ATpiEvunYBqKbIqI2_kuC5fM2zMvhhYLP72TVplW3Noc4PYhQUaMBkq1pEabaXXid0hwnE3R5kNYvnA">unhealthy approach to exercise</a>. </p>
<p>But the darker side of this mindset is that people who held these beliefs reported higher symptoms of anxiety, depression and stress compared with exercisers who didn’t use self-pressure and guilt as motivation. </p>
<p>While it’s possible that people already experiencing poor mental health would be more likely to have negative beliefs about themselves, there’s a deeply reciprocal relationship between mental health and how we think and act.</p>
<p>Research shows that extreme, rigid, negative ways of thinking are <a href="https://pubmed.ncbi.nlm.nih.gov/26609889/">risk factors for mental health problems</a>. Repeating negative thoughts many times, over many years, can lead to deep self-loathing which can corrode your <a href="https://psycnet.apa.org/record/2019-59628-001">mental health</a> and leave you in a continuous state of <a href="https://www.tandfonline.com/doi/pdf/10.1080/02640414.2022.2042124">stress and depression</a>. It can also make you even less likely to positively change your thinking and <a href="https://journals.humankinetics.com/view/journals/tsp/8/3/article-p248.xml">exercise habits</a>.</p>
<p>On the other hand, our study found that people who reported lower symptoms of depression, anxiety and stress had significantly less extreme, rigid and negative ways of thinking. These participants were less likely to endorse ways of thinking that involved self-demands (“I must”), magnification (“things are awful”), and self-condemnation (“I am a failure”). </p>
<p>These exercisers reported using more useful forms of motivation to workout, such as exercising because they loved the activity and recognised the value and importance of exercise as a part of their identity. </p>
<figure class="align-center ">
<img alt="A group of two men and two women run together in a park." src="https://images.theconversation.com/files/568182/original/file-20240108-21-8fuupt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568182/original/file-20240108-21-8fuupt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568182/original/file-20240108-21-8fuupt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568182/original/file-20240108-21-8fuupt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568182/original/file-20240108-21-8fuupt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568182/original/file-20240108-21-8fuupt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568182/original/file-20240108-21-8fuupt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The right mindset is key.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/healthy-group-multiethnic-middle-aged-men-1999270208">Ground Picture/ Shutterstock</a></span>
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</figure>
<p>These findings show us just how important the thoughts you use to motivate your workouts can be, especially when it comes to your mental health. </p>
<p>One solution to these ways of thinking is a psychological approach called <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2016.01423/full">rational emotive behaviour therapy</a> (REBT). REBT aims to understand and challenge deeply held beliefs and develop helpful alternatives. This approach may help an exerciser go from “I have to exercise” and “I’d be worthless if I didn’t exercise” to thinking “I really want to exercise, but if I didn’t exercise, I would be disappointed, but I would not be worthless.” </p>
<p>Improving a person’s beliefs about exercise can change their motivation from being centred on self-pressure and guilt to seeing the value and potential enjoyment in working out.</p>
<p>There are many <a href="https://www.amazon.co.uk/Rational-Practitioner-Performance-Psychologists-Practicing/dp/1032060409">ideas and tools</a> we can apply from REBT even without having to step foot inside a psychologist’s office. So if you find yourself falling into this cycle of self-loathing and losing motivation to exercise, here’s what you can do.</p>
<h2>Think critically about your thinking</h2>
<p>When you think about exercising, are your thoughts negative, unhelpful and self-pressuring? Be more critical of your thoughts about exercise, and ask yourself whether they make sense – and if they’re helping you. </p>
<p>If the answer is no, try to work on adopting thoughts that do make sense and help you achieve your exercise goals, such as seeing exercise as something to enjoy, instead of something you have to do out of guilt. Being able to challenge your own unhelpful beliefs, and learning to harness more helpful ones, can help you <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/sms.12926?casa_token=fbVymZ3SxrAAAAAA:SiNRAlz0Xh11xbeWDUtxjwlP40gDfurptgas5SSHYLtLD9v06uLm8ztlTvi1AnwTSvTReT_u-fdgiJ0h">achieve your goals</a>.</p>
<h2>Realise you’re not what you do</h2>
<p>As human beings, we’re imperfect. We mess up – but we also do great things. When things don’t go to plan, it’s important to try and accept this. And remember that failing doesn’t mean you’re a failure. </p>
<p>Realise that you aren’t <a href="https://www.sciencedirect.com/science/article/pii/S1469029222001662">defined by your shortcomings</a>. Recognising that failing does not make you a failure may help you better bounce back from times when you fall short of your goals and expectations and keep on track with reaching your goals and finding solutions.</p>
<h2>Harness the power of want</h2>
<p>You’re far more likely to stick to your exercise goals if you <a href="https://selfdeterminationtheory.org/SDT/documents/1997_RyanFrederickLepesRubioSheldon.pdf">want to do them</a>. Find an activity that offers you something more than just exercise. Perhaps join an exercise group where you can make new friends or rekindle your passion for something you used to do. </p>
<p>If you’re only exercising because you believe you have to or to avoid guilt, then you probably won’t stick with it. Nobody likes to be pressured into doing difficult things. Finding an activity you don’t have to force yourself to do may help you move from seeing exercise as something you have to do to something you love to do.</p>
<p>Exercise is, of course, important, but guilting yourself into doing it will probably do more harm than good. The best way is by finding things you enjoy, accepting yourself unconditionally if your motivation does wane, and removing “have to” from your thoughts about exercise.</p><img src="https://counter.theconversation.com/content/220342/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Using “I must” or “I have to” to motivate your workouts could be bad for your mental health.Martin J Turner, Reader in Psychology, Manchester Metropolitan UniversityAnthony Miller, Senior Lecturer in Sport and Exercise Psychology, Staffordshire UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2146382024-01-08T00:43:25Z2024-01-08T00:43:25ZWhy are my muscles sore after exercise? Hint: it’s nothing to do with lactic acid<figure><img src="https://images.theconversation.com/files/551088/original/file-20230929-29-ua1o1p.jpg?ixlib=rb-1.1.0&rect=0%2C41%2C6989%2C4610&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>As many of us hit the gym or go for a run to recover from the silly season, you might notice a bit of extra muscle soreness. </p>
<p>This is especially true if it has been a while between workouts. </p>
<p>A common misunderstanding is that such soreness is due to lactic acid build-up in the muscles. </p>
<p>Research, however, shows lactic acid has <a href="https://journals.physiology.org/doi/full/10.1152/physiol.00033.2017">nothing to do with it</a>. The truth is far more interesting, but also a bit more complex.</p>
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Read more:
<a href="https://theconversation.com/cant-afford-a-gym-membership-or-fitness-class-3-things-to-include-in-a-diy-exercise-program-206204">Can't afford a gym membership or fitness class? 3 things to include in a DIY exercise program</a>
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<h2>It’s not lactic acid</h2>
<p>We’ve known for decades that lactic acid has <a href="https://pubmed.ncbi.nlm.nih.gov/27409551/">nothing to do with</a> muscle soreness after exercise.</p>
<p>In fact, as one of us (Robert Andrew Robergs) has long <a href="https://journals.physiology.org/doi/full/10.1152/ajpregu.00114.2004">argued</a>, cells produce lactate, not lactic acid. This process actually <a href="https://journals.physiology.org/doi/full/10.1152/physiol.00033.2017">opposes</a> not causes the build-up of acid in the muscles and bloodstream.</p>
<p>Unfortunately, historical inertia means people still use the term “lactic acid” in relation to exercise. </p>
<p>Lactate <a href="https://www.science.org/doi/10.1126/science.1101141">doesn’t cause major problems</a> for the muscles you use when you exercise. You’d probably be <a href="https://journals.physiology.org/doi/full/10.1152/ajpregu.00114.2004?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&">worse off</a> without it due to other benefits to your working muscles. </p>
<p>Lactate isn’t the reason you’re sore a few days after upping your weights or exercising after a long break.</p>
<p>So, if it’s not lactic acid and it’s not lactate, what is causing all that muscle soreness?</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/551620/original/file-20231003-27-586dxa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A woman clasps her lug in pain." src="https://images.theconversation.com/files/551620/original/file-20231003-27-586dxa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/551620/original/file-20231003-27-586dxa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/551620/original/file-20231003-27-586dxa.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/551620/original/file-20231003-27-586dxa.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/551620/original/file-20231003-27-586dxa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/551620/original/file-20231003-27-586dxa.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/551620/original/file-20231003-27-586dxa.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Regular training will gradually build the muscle adaptations necessary to prevent delayed onset muscle soreness.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>Muscle pain during and after exercise</h2>
<p>When you exercise, a lot of chemical reactions occur in your muscle cells. All these chemical reactions accumulate products and by-products which cause water to enter into the cells.</p>
<p>That causes the pressure inside and between muscle cells to increase.</p>
<p>This pressure, combined with the movement of molecules from the muscle cells can stimulate nerve endings and cause <a href="https://www.sportsmed.theclinics.com/article/S0278-5919(11)00099-8/fulltext">discomfort</a> during exercise.</p>
<p>The pain and discomfort you sometimes feel hours to days after an unfamiliar type or amount of exercise has a different list of causes. </p>
<p>If you exercise beyond your usual level or routine, you can cause microscopic damage to your muscles and their connections to tendons. </p>
<p>Such damage causes the release of ions and other molecules from the muscles, causing localised swelling and stimulation of nerve endings.</p>
<p>This is sometimes known as “<a href="https://www.sportsmed.theclinics.com/article/S0278-5919(11)00099-8/fulltext">delayed onset muscle soreness</a>” or DOMS.</p>
<p>While the damage occurs during the exercise, the resulting response to the injury builds over the next one to two days (longer if the damage is severe). This can sometimes cause pain and difficulty with normal movement.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/551621/original/file-20231003-15-dx0b7m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A woman does lunges in the gym." src="https://images.theconversation.com/files/551621/original/file-20231003-15-dx0b7m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/551621/original/file-20231003-15-dx0b7m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/551621/original/file-20231003-15-dx0b7m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/551621/original/file-20231003-15-dx0b7m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/551621/original/file-20231003-15-dx0b7m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/551621/original/file-20231003-15-dx0b7m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/551621/original/file-20231003-15-dx0b7m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Being less wrecked by exercise makes it more enjoyable.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
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</figure>
<h2>The upshot</h2>
<p>Research is clear; the discomfort from delayed onset muscle soreness has nothing to do with <a href="https://scholar.google.com/citations?user=UVjRNSUAAAAJ&view_op=view_citation&citation_for_view=UVjRNSUAAAAJ:J_g5lzvAfSwC">lactate</a> or <a href="https://journals.physiology.org/doi/full/10.1152/physiol.00033.2017">lactic acid</a>.</p>
<p>The good news, though, is that your muscles adapt rapidly to the activity that would initially cause delayed onset muscle soreness. </p>
<p>So, assuming you don’t wait too long (more than roughly two weeks) before being active again, the next time you do the same activity there will be much less damage and discomfort.</p>
<p>If you have an exercise goal (such as doing a particular hike or completing a half-marathon), ensure it is realistic and that you can work up to it by training over several months.</p>
<p>Such training will gradually build the muscle adaptations necessary to prevent delayed onset muscle soreness. And being less wrecked by exercise makes it more enjoyable and more easy to stick to a routine or habit.</p>
<p>Finally, remove “lactic acid” from your exercise vocabulary. Its supposed role in muscle soreness is a myth that’s hung around far too long already.</p>
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Read more:
<a href="https://theconversation.com/climb-the-stairs-lug-the-shopping-chase-the-kids-incidental-vigorous-activity-linked-to-lower-cancer-risks-210288">Climb the stairs, lug the shopping, chase the kids. Incidental vigorous activity linked to lower cancer risks</a>
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<img src="https://counter.theconversation.com/content/214638/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>For a long time many people believed intense exercise caused your body to produce lactic acid and that this, in turn, caused muscle soreness. This is not correct.Robert Andrew Robergs, Associate Professor - Exercise Physiology, Queensland University of TechnologySamuel L. Torrens, PhD Candidate, Queensland University of TechnologyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2168702024-01-04T13:45:55Z2024-01-04T13:45:55ZFocus on right now, not the distant future, to stay motivated and on track to your long-term health goals<figure><img src="https://images.theconversation.com/files/564976/original/file-20231211-26-io2vdz.jpg?ixlib=rb-1.1.0&rect=342%2C201%2C6367%2C4265&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The fresh flavors taste good now – a here-and-now reward that's more motivating than potentially avoiding health problems in the future.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/fresh-fruit-salad-royalty-free-image/811628388">kajakiki/E+ via Getty Images</a></span></figcaption></figure><p>It’s a familiar start-of-the-year scene. You’ve committed to a healthier lifestyle and are determined that this time is going to be different. Your refrigerator is stocked with fruits and veggies, you’ve tossed out processed foods, and your workout routine is written in pen in your daily planner.</p>
<p>Yet, as you head out one morning, the tantalizing aroma of fresh doughnuts wafts through the air. How can you resist the call of this sugary treat and stick with your healthy choices?</p>
<p>Conventional wisdom, <a href="https://doi.org/10.1037/0033-295X.106.1.3">grounded in years of research</a>, suggests that the best way to resist unhealthy choices is to think about the long-term consequences. For example, you could consider how the added sugar from eating too many doughnuts can lead to <a href="https://www.cdc.gov/nutrition/data-statistics/added-sugars.html">diabetes and obesity</a>. Thinking about these long-term consequences, the argument goes, should help you avoid indulging right now and better stick to your goals. </p>
<p>However, in our <a href="https://scholar.google.com/citations?user=axoPTvwAAAAJ&hl=en&oi=ao">combined 25 years of experience investigating</a> <a href="https://scholar.google.com/citations?user=ZJA5R0QAAAAJ&hl=en&oi=ao">people’s self-control behavior and motivation</a>, we have learned that, in the heat of the moment, people often overlook distant outcomes, diminishing the effectiveness of strategies focused on the long term. </p>
<p>In response, we propose three approaches, backed by recent research, to help you stick to healthier habits.</p>
<h2>To resist temptation, think short term</h2>
<p>One strategy to avoid indulging is to consider the short-term consequences of unhealthy behavior. We tested this approach in <a href="https://doi.org/10.1093/jcr/ucad004">seven studies</a> with over 4,000 participants. </p>
<p>In one study, we invited university students to view one of two <a href="https://www.indeed.com/career-advice/career-development/what-is-a-public-service-announcement">public service announcements</a> detailing reasons to avoid energy drinks. One message emphasized long-term costs of drinking high-sugar energy drinks, such as diabetes and obesity. The other stressed short-term costs, such as anxiety and a sugar and caffeine crash.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/561685/original/file-20231126-23-8s8mzp.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="two PSAs with similar graphic of a drink but different effects highlighted" src="https://images.theconversation.com/files/561685/original/file-20231126-23-8s8mzp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/561685/original/file-20231126-23-8s8mzp.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=362&fit=crop&dpr=1 600w, https://images.theconversation.com/files/561685/original/file-20231126-23-8s8mzp.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=362&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/561685/original/file-20231126-23-8s8mzp.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=362&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/561685/original/file-20231126-23-8s8mzp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=455&fit=crop&dpr=1 754w, https://images.theconversation.com/files/561685/original/file-20231126-23-8s8mzp.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=455&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/561685/original/file-20231126-23-8s8mzp.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=455&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">PSAs about unhealthy energy drinks: One highlights the long-term health costs, and the other highlights the short-term costs – 61.7% of participants chose the energy drink over another prize if they only saw the long-term PSA vs. 46.4% of participants who saw the short-term PSA.</span>
<span class="attribution"><span class="source">Lilia Fromm</span></span>
</figcaption>
</figure>
<p>Students then had a choice between receiving an energy drink or another attractive prize. Those who read about the short-term costs were 25% less likely to choose the energy drink than those who read about the long-term costs.</p>
<p>In another study with a similar setup, participants read about either the short-term costs of eating sugar, the long-term costs of eating sugar, or they did not read about any downsides. Everyone then had to choose a delivery of cookies or a tote bag. Those who read about the short-term costs were 30% less likely to choose the cookies than those who read about the long-term costs and 45% less likely than those who didn’t read about any detriments to sugar.</p>
<p>We found that emphasizing short-term costs can also help you avoid other temptations. For alcohol, think about how excessive drinking can lead to poor sleep and hangovers. For fast food, think about how it can make you feel bloated or give you indigestion.</p>
<p>In our studies, immediate effects were a stronger motivator than long-term consequences that could take decades to occur. The takeaway is simple: To avoid indulging, think short term.</p>
<h2>Focus on the fun of healthy options</h2>
<p>Avoiding unhealthy foods is one thing. On the flip side, can you nudge yourself toward consuming more healthy foods? </p>
<p>Research that one of us (Kaitlin) conducted with behavioral scientist <a href="https://scholar.google.com/citations?user=-vIQsasAAAAJ&hl=en&oi=ao">Ayelet Fishbach</a> found that <a href="https://doi.org/10.1093/jcr/ucv098">prompting people to focus on the good taste</a> – rather than the health benefits – of foods such as apples and carrots increased consumption in the lab and the real world. These findings were independently replicated in an intervention at <a href="https://doi.org/10.1177/0956797619872191">five university dining halls</a> that used food labels focused on either tastiness or healthfulness.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/564978/original/file-20231211-15-fr0nd4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="smiling man outside in jacket with small hand weights" src="https://images.theconversation.com/files/564978/original/file-20231211-15-fr0nd4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564978/original/file-20231211-15-fr0nd4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=374&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564978/original/file-20231211-15-fr0nd4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=374&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564978/original/file-20231211-15-fr0nd4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=374&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564978/original/file-20231211-15-fr0nd4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=469&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564978/original/file-20231211-15-fr0nd4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=469&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564978/original/file-20231211-15-fr0nd4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=469&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Picking a more enjoyable exercise routine can mean sticking with it longer.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/mature-african-american-man-exercising-royalty-free-image/991036038">kali9/E+ via Getty Images</a></span>
</figcaption>
</figure>
<p>This strategy can also promote other healthy behaviors, such as exercise. In one study, Kaitlin asked gymgoers to choose a weightlifting workout from a list of similarly difficult routines. The participants who were instructed to select a <a href="https://doi.org/10.1093/jcr/ucv098">fun exercise completed more reps</a> than those told to pick an exercise most useful for their long-term fitness goals. </p>
<p>Immediate rewards that result from pursuing long-term goals improve your experience right now, although they often go unnoticed. For this reason, focusing on the immediate versus delayed benefits of behaviors such as healthy eating and exercise can increase <a href="https://doi.org/10.1037/rev0000095">intrinsic motivation</a>, making a behavior feel like its own reward and resulting in the immersed-in-an-activity feeling called “<a href="https://doi.org/10.1038/s41467-022-29742-2">flow</a>.”</p>
<h2>Timing the reward sweet spot</h2>
<p>Starting healthy behaviors is one important piece of the puzzle; another is sticking with these behaviors over time. One strategy for persistence is to use rewards to stay committed.</p>
<p>Research led by marketing professor <a href="https://scholar.google.com/citations?user=VNKNZfMAAAAJ&hl=en&oi=ao">Marissa Sharif</a>, along with Kaitlin, involving over 5,000 people across eight experiments found that <a href="https://doi.org/10.1093/jcr/ucac007">small, regular rewards were more effective</a> for cultivating long-term commitment to healthy behavior such as exercising and flossing than were large, occasional rewards. Think watching 20 minutes of a guilty pleasure TV show each day you work out, rather than waiting to the end of the week to watch 80 minutes of TV to reward yourself for those four workouts.</p>
<p>But there’s a twist: Rewarding yourself too early may backfire. It seems rewards are most effective when people have to work to unlock them, after which they become regular. In other words, putting in initial effort while not being rewarded, followed by small, continual perks, is the most effective way to structure rewards.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/564981/original/file-20231211-25-3gd4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="calendar with red X's crossing off days and one date circled" src="https://images.theconversation.com/files/564981/original/file-20231211-25-3gd4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564981/original/file-20231211-25-3gd4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564981/original/file-20231211-25-3gd4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564981/original/file-20231211-25-3gd4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564981/original/file-20231211-25-3gd4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564981/original/file-20231211-25-3gd4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564981/original/file-20231211-25-3gd4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Rewards are less effective when they’re set too far off in the future.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/deadline-royalty-free-image/172704039">JLGutierrez/E+ via Getty Images</a></span>
</figcaption>
</figure>
<p>In a study on exercise, Marissa and Kaitlin followed exercisers as they engaged in <a href="https://doi.org/10.1093/jcr/ucac007">four initial workouts that came with no rewards</a>. Then a work-to-unlock-rewards group began to receive small, continual rewards for each subsequent workout. They ended up persisting longer and completing more workouts than people in a lump-sum group who received a larger, occasional reward for every four workouts they finished.</p>
<p>A similar effect was evident in a <a href="https://doi.org/10.1093/jcr/ucac007">12-day study on tooth flossing</a>. People in the work-to-unlock-rewards group – three days of flossing without rewards followed by daily rewards – flossed for more days than those who received continual rewards right way. Those who had to commit extra effort to unlock the rewards flossed 15% more days.</p>
<p>These studies suggest people can strategically incorporate rewards – with a short initial period without any rewards – into their routine to help them stick with healthy behaviors over time.</p>
<h2>Resistance, enjoyment and persistence</h2>
<p>Our research highlights three effective strategies to help you achieve your goals: prioritizing short-term consequences to resist temptation, finding enjoyment in long-term choices, and continually rewarding yourself for sustained persistence.</p>
<p>What’s great about these strategies is that you can adapt them to any personal goal you hold. For instance, if you’re finding it hard to swap social media for a book, consider reflecting on negative short-term consequences of endless scrolling. Or if carving out time for relaxation feels like a challenge, focus on the immediate benefits of engaging in meditative exercises.</p>
<p>By incorporating these evidence-based approaches, you can empower yourself to follow through on your long-term goals.</p><img src="https://counter.theconversation.com/content/216870/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Long-term goals can be hard to stick to if the benefits are only way off in the future. Research suggests ways to focus on the here and now to help you ultimately achieve your more far-off targets.Kaitlin Woolley, Associate Professor of Marketing, Cornell UniversityPaul Stillman, Assistant Professor of Marketing, San Diego State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2088132024-01-04T12:51:28Z2024-01-04T12:51:28ZHow living like a hunter-gatherer could improve your health<figure><img src="https://images.theconversation.com/files/567858/original/file-20240104-27-obn36.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/camping-time-mixed-race-group-friends-1536037751">Prostock-studio/Shutterstock</a></span></figcaption></figure><p>Many of us want to live long, happy and healthy lives. Yet it’s often confusing to know the best way to achieve this, and many aspects of modern, westernised living conspire to keep us from achieving this goal.</p>
<p>The solution may be to step back in time. For the bulk of our existence, we evolved following a <a href="https://www.history.com/topics/pre-history/hunter-gatherers">hunter-gatherer lifestyle</a> of foraging for food and hunting animals. Today, only a few hunter-gatherer communities still exist, such as <a href="https://www.bbc.co.uk/sounds/play/b08x4s4v">the Hadza</a> of Tanzania. </p>
<p>Research shows that many of the health problems that plague modern society, such as <a href="https://pubmed.ncbi.nlm.nih.gov/27723159/">cardiovascular disease</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3330161/#:%7E:text=A%2520correlation%2520between%2520depression%2520and,needed%2520to%2520assess%2520this%2520possibility">poor mental health</a>, have very low prevalence among hunter-gatherer societies of both past and present day. This suggests there’s much we can learn from hunter-gatherers to improve our lives.</p>
<h2>Building connections</h2>
<p>Hunter-gatherers knew the best strategy for survival was connecting and staying together. </p>
<p>With finite resources, they are <a href="https://www.jstor.org/stable/2801707?casa_token=pcjIHZdOAnsAAAAA%3AnpywT8hkOd3IVhmsJpWZP382NK1SQPJVw7JGFTSJhRktDBsxM7I1Z_Vc6qLFON8hcr1pUOL3DyvpFo1i9SzHM1h69mQKimkbkJWbFiTObEv9YnOPR1gO">egalitarian by nature</a>. Each member contributes, shares equally and belongs to a collective greater than themselves. Life has meaning and purpose. </p>
<p>According to James Woodburn, an anthropologist who studied the Hadza, tribe members “value their life as hunter-gatherers, they regard it as a wonderful life. They have a <a href="https://www.bbc.co.uk/programmes/b08x4s4v">living which makes sense</a>.” </p>
<p>The Japanese call this <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2734064">fundamental reason for being</a> “ikigai”, which can add quality years to your life. Living in small communities of around 20-30 people creates close relationships and a strong social support network.</p>
<p><a href="https://www.liebertpub.com/doi/abs/10.1089/ict.2023.29074.jha">Close meaningful relationships</a> are key drivers of <a href="https://www.simonandschuster.com/books/The-Good-Life/Robert-Waldinger/9781982166694">health and happiness</a> across our lifespan. In fact, our brains are so wired to connect that our <a href="https://psycnet.apa.org/record/2013-09689-000">wellbeing depends on it</a>.</p>
<p>Many aspects of modern society, such as <a href="https://besjournals.onlinelibrary.wiley.com/doi/full/10.1002/pan3.10451">urbanisation</a>, the <a href="https://royalsocietypublishing.org/doi/pdf/10.1098/rstb.2020.0020#:%7E:text=Instead%2C%20the%20%E2%80%98traditional%E2%80%99%20family%20is%20widely%20regarded%20to,are%20solely%20responsible%20for%20%E2%80%98breadwinning%E2%80%99%20and%20women%20%E2%80%98homemaking%E2%80%99">nuclear family</a> and <a href="https://www.sciencedirect.com/science/article/pii/S2352250X22000495">consumerism</a>, mean many of the <a href="https://www.theguardian.com/books/2018/jan/17/lost-connections-johann-hari-review">connections inherent</a> to hunter-gatherer society have been eroded.</p>
<p>But there are many evidence-based ways to reconnect with hunter-gatherer ethos and improve mental wellbeing. </p>
<p>Examples include reconnecting with people and your community (such as through <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10159229/">volunteering</a>) or getting involved in <a href="https://www.tandfonline.com/doi/full/10.1080/10705422.2011.550260">a cooperative</a>. The NHS has even introduced a long-term <a href="https://www.england.nhs.uk/personalisedcare/social-prescribing/">social prescribing strategy</a>, which helps people get involved with these kinds of initiatives and connect with those in their community. </p>
<p>Exercising in <a href="https://extremephysiolmed.biomedcentral.com/articles/10.1186/2046-7648-2-3">green spaces</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679190/">practising mindfulness</a> are also great ways of connecting with the present and boosting mental health.</p>
<h2>Eating well</h2>
<p>Hunter-gatherers eat what nature and the land offer. This at times can be scarce, requiring <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5783752/#:%7E:text=Knowledge%20of%20early%20human%20evolution,with%20little%20or%20no%20food">periods of fasting</a>. Diets primarily consist of <a href="https://pubmed.ncbi.nlm.nih.gov/19350623">plant-based foods</a>, such as tubers, berries and fruit that are readily available. </p>
<p>Many studies have shown that plant-based diets and fasting can have many benefits for health.</p>
<p>For example, research on people living in so-called “<a href="https://pubmed.ncbi.nlm.nih.gov/33391847/">blue zones</a>” – geographic areas that have unusually high life expectancies – suggests their predominantly plant-based diets may contribute to their <a href="https://pubmed.ncbi.nlm.nih.gov/32204974/">long lifespans</a>.</p>
<p>Intermittent fasting helps to <a href="https://pubmed.ncbi.nlm.nih.gov/32673591/">reduce calorie intake</a> and can lower the risk of <a href="https://sa1s3.patientpop.com/assets/docs/151222.pdf">cardiovascular disease and type 2 diabetes</a> by <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5783752/#:%7E:text=Knowledge%20of%20early%20human%20evolution,with%20little%20or%20no%20food">increasing metabolic flexibiltiy</a> – our ability to effectively use both carbs and fat for energy. </p>
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Read more:
<a href="https://theconversation.com/does-it-matter-what-time-of-day-i-eat-and-can-intermittent-fasting-improve-my-health-heres-what-the-science-says-203762">Does it matter what time of day I eat? And can intermittent fasting improve my health? Here's what the science says</a>
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<p>Because hunter-gatherers eat what nature offers, this means their diets consist mainly of whole foods. Yet in the UK and US, <a href="https://pubmed.ncbi.nlm.nih.gov/34647997/">ultra-processed foods</a> (such as ready-made meals) now make up a large proportion of people’s <a href="https://pubmed.ncbi.nlm.nih.gov/29747447/">daily calorie intake</a>.</p>
<p>These foods typically contain lots of sugar, salt, saturated fat and artificial additives. Research has linked these foods with a range of health problems, including <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/obr.13146">obesity</a> and <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00017-2/fulltext">cancer</a>.</p>
<figure class="align-center ">
<img alt="A woman holding a bowl of vegetarian or vegan foods." src="https://images.theconversation.com/files/567543/original/file-20240102-15-i8che2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567543/original/file-20240102-15-i8che2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567543/original/file-20240102-15-i8che2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567543/original/file-20240102-15-i8che2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567543/original/file-20240102-15-i8che2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567543/original/file-20240102-15-i8che2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567543/original/file-20240102-15-i8che2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Try to eat a primarily plant-based diet.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/nutritious-healthy-roasted-veggie-vegan-homemade-1782846293">Cavan-Images/ Shutterstock</a></span>
</figcaption>
</figure>
<p>Limiting intake of ultra-processed foods and <a href="https://www.who.int/news-room/fact-sheets/detail/healthy-diet">adopting a diet</a> more akin to those followed by hunter-gatherers can help improve your health. </p>
<h2>Moving more</h2>
<p>Hunter-gatherers <a href="https://pubmed.ncbi.nlm.nih.gov/20843503/">evolved to move</a>. Their nomadic lifestyle of hunting and foraging meant they consistently covered distances from six to 16km daily. </p>
<p>But modern lifestyles are far more sedentary. Combined with diets high in ultra-processed foods, this means many of us consume more calories each day than we use, leading to weight gain. </p>
<p>To address this imbalance, we need to move more – and move how hunter-gatherers do. </p>
<p>It’s recommended adults get at least 150-300 minutes of moderate-intensity activity (such as brisk walking) or at least 75-150 minutes of vigorous <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">physical activity</a> (such as running or dancing) per week. While this isn’t quite as much movement as hunter-gatherers would get daily, it will still improve cardiorespiratory fitness and muscle strength, which is important for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628304/">better health</a> and longer lifespan. </p>
<p>Being active regularly doesn’t necessarily mean you have to go to the gym. Walking to the shops, climbing stairs and cleaning can all have a <a href="https://pubmed.ncbi.nlm.nih.gov/24167194/#:%7E:text=Conclusions%3A%20A%20generally%20active%20daily,and%20longevity%20in%20older%20adults">positive effect</a> on your cardiovascular health and longevity. </p>
<p>But if you really want to mimic hunter-gatherers’ activity more closely, you might consider trying <a href="https://pubmed.ncbi.nlm.nih.gov/20843503/">interval training</a>. This involves alternating periods of moderate- or high-intensity physical activity with low-intensity activity – such as sprinting for 30 seconds on the treadmill then jogging for a minute in between to catch your breath. This mimics the vigorous kind of physical activity hunter-gatherers would have done when hunting. Interval training is also <a href="https://link.springer.com/article/10.1007/s40279-023-01863-8">beneficial for cardiovascular health</a>.</p>
<p>We can also benefit from moving more like hunter-gatherers. Movements such as <a href="https://pubmed.ncbi.nlm.nih.gov/35034060/">squatting</a> and getting <a href="https://journals.sagepub.com/doi/abs/10.1177/2047487312471759">up and down from the ground</a>, mimic how they’d move when foraging for food. These functional movements help preserve physical independence and may add <a href="https://pubmed.ncbi.nlm.nih.gov/24225329/">years to your life</a>. </p>
<p>While our modern society certainly doesn’t make it easy to live a lifestyle more aligned with how we evolved, that doesn’t mean there aren’t many small, easy changes we can make to be healthier. Making time to socialise, focusing on getting more plants in our diets and moving more often are all things we can do daily to live more like hunter-gatherers – and look after our health.</p><img src="https://counter.theconversation.com/content/208813/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David Clayton has received research funding from the British Nutrition Foundation, the Society for Endocrinology, Innovate UK and the Turmeric Co. </span></em></p><p class="fine-print"><em><span><a href="mailto:m.bertotti@uel.ac.uk">m.bertotti@uel.ac.uk</a> currently receives funding from the National Institute for Health Research, the European Commission and the British Academy. In the past, he has received grants from the Arts and Humanities Research Council, Economic and Social Research Council, UK Research and Innovation, Department for Health and Social Care and the National Health Service. </span></em></p><p class="fine-print"><em><span>Nicholas Bourne does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Making just a few small changes in our daily lives can help improve our health and help us live more aligned with how we evolved.Nicholas Bourne, Senior Lecturer, Applied Sport and Exercise Science, University of East LondonDavid Clayton, Senior Lecturer in Nutrition and Exercise Physiology, Nottingham Trent UniversityMarcello Bertotti, Reader in Community Health, University of East LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2169792024-01-01T14:50:37Z2024-01-01T14:50:37ZWhy some amateur athletes are giving up on smartwatches<p>Measuring the number of steps you take every day; tracking your heart rate, your pace or average ascent while jogging; memorizing the total distance you cycle over the course of a year and sharing it with an online community. These practices have become commonplace in the world of sport, even for amateurs.</p>
<p>This digitization of physical activity is unfolding against the backdrop of a global proliferation of self-quantification tools used to measure productivity at work, track <a href="https://journals.sagepub.com/doi/10.1177/1461444817698478">calorie intake</a>, <a href="https://med.stanford.edu/snyderlab/news/May-24-20211.html">blood sugar levels</a> and weight, monitor <a href="https://pubmed.ncbi.nlm.nih.gov/37461799/">sleep regulation</a> and more.</p>
<p>The market for these tools in sports activities, alone, is both <a href="https://www.wiley.com/en-us/The+Quantified+Self-p-9781509500598">lucrative and competitive</a>. As Finnish researchers <a href="https://www.researchgate.net/publication/373143547_Running_free_recreational_runners%27_reasons_for_non-use_of_digital_sports_technology">Pekka Mertala and Lauri Palsa</a> report, the digital sports technology business is estimated to be worth $12 billion a year, with more than 10,000 portable digital devices for running, alone. Some 90 per cent of amateur runners now use a smartwatch or mobile application.</p>
<p>Tracking your body with numbers is associated with a series of <a href="https://www.sciencedirect.com/science/article/pii/S1110016821002210">promises</a> to become more active, happy and healthy, and with the concept of empowerment. Because of its objectivity and transparency (compared with the approximate nature of bodily sensations), this knowledge is considered to be the foundation of a <a href="https://core.ac.uk/download/pdf/70982364.pdf">personal self-optimization project</a>.</p>
<p>These embedded devices are also used for motivational support, to encourage regularity and assiduity and to put an end to lifestyle habits that are deemed unhealthy. Becoming part of a community of exercisers can also increase motivation by interweaving systems of mutual encouragement and competition.</p>
<p>Yet we are currently seeing a slowdown in this market linked to a <a href="https://www.researchgate.net/publication/360361258_Why_Do_People_Abandon_Activity_Trackers_The_Role_of_User_Diversity_in_Discontinued_Use">massive phenomenon of either discontinuing the use of digital devices</a> or, at the very least, using them for short periods.</p>
<h2>The discontinuation of connected devices</h2>
<p>First of all, we should recall that the adoption of connected devices for sports is <a href="https://www.credoc.fr/publications/barometre-du-numerique-2019">not evenly distributed across the population</a>. It is over-represented among men who are urban, highly educated, socially advantaged and physically active. In addition, the 30-39 age group is the most equipped with <a href="https://www.cairn.info/revue-reseaux-2019-4-page-119.htm">smart bracelets and smartwatches</a>.</p>
<p>While certain population groups have less access to these embedded technologies, others who have acquired them will stop using them, usually after a limited period of use. <a href="https://www.tandfonline.com/doi/abs/10.1080/16138171.2021.1918896">The mechanisms that lead to this are extremely varied</a>, and include logistical overload, the time-consuming dimension of transferring and interpreting data, a lack of accuracy and reliability in data collection, and difficulty in interpreting and using data, among others.</p>
<p>We believe that the rejection of these devices may be the result of a <a href="https://www.implications-philosophiques.org/lauto-quantification-de-son-activite-sportive-altere-t-elle-la-qualite-de-lexperience-vecue-un-scenario-possible-de-labandon-massif-des-pratiques-de-self-tracking/">deterioration in the quality of the experience of a sport</a> when using them. For some participants, putting numbers on an activity actually <a href="https://www.jstor.org/stable/26570266">leads them to experience it more as forced labour than as free, self-determined leisure</a>.</p>
<p>Intrinsic motivation (the pleasure of running for its own sake) then tends to be supplanted by extrinsic motivation (rewards, comparisons, mutual monitoring). The context of a constant call to excel can lead to an anticipated fear of failure, as well as a feeling of shame and guilt in the event of underperformance. Cognitive overload and distracted attention can also lead to a <a href="https://www.cairn.info/revue-corps-2016-1-page-115.htm">disconnect from the here-and-now of one’s activity and the bodily sensations related to it</a>.</p>
<p>Looking at it differently, the withdrawal of the smartwatch could be an act of resistance with strong political, philosophical or even spiritual significance. This may be a desire to break away from what is perceived as a generalized surveillance system, to <a href="https://theconversation.com/sport-comment-les-reseaux-sociaux-transforment-les-pratiques-des-jeunes-207440">emancipate oneself from the pressure of sports social networks</a>, to reject a materialistic race to over equip or even to <a href="https://www.runnersworld.com/runners-stories/a36959570/running-without-any-technology/">put the emphasis back on bodily sensations in sports training</a>.</p>
<p>The attitude of rejection can be linked to <a href="https://aoc.media/analyse/2023/01/23/sobrietes-sportives-choisies/">the emergence of minimalist values</a> such as sobriety, voluntary simplicity and frugality. It’s a question of <a href="https://www.researchgate.net/publication/373143547_Running_free_recreational_runners'_reasons_for_non-use_of_digital_sports_technology">rediscovering a form of lost freedom</a>, of lightness, or even of <a href="https://journals.sagepub.com/pb-assets/cmscontent/ASJ/Acceleration_and_Resonance.pdf">resonance</a>.</p>
<h2>The adherence to quantification tools</h2>
<p>Not all amateur runners who have started using a digital self-quantification tool have stopped using it. While dropping the tools is a significant and explainable phenomenon, the reasons for sticking to them must also be considered. What are the conditions that enable amateur runners to continue practising and quantifying their performance numerically while deriving pleasure and well-being from the activity?</p>
<p>We showed that <a href="https://www.researchgate.net/publication/366028928_Quelles_experiences_intimes_et_pratiques_effectives_de_la_course_a_pied_quantifiee_Etude_des_usages_ordinaires_des_montres_connectees_chez_des_coureurs_et_coureuses_amateures_a_partir_d%27une_auto-expli">the amateur runners who persevered in using digital tools were the ones who had developed a high level of expertise in self-quantification</a>. More specifically, they managed to cobble together and incorporate a series of tactics, or even <a href="https://www.gallimard.fr/Catalogue/GALLIMARD/Folio/Folio-essais/L-invention-du-quotidien">“everyday tricks,”</a> to use Michel de Certeau’s expression, which enabled them to interact with their digital device without altering the quality of their sporting experience.</p>
<p>A first approach in this is to differentiate and alternate the uses of the smartwatch over time. To begin with, they modulate the intensity and types of usage of the tool to adapt to changing life conditions (for example, by suspending the goal to exceed performance levels during a year when family life is demanding). They also learn to let go of certain areas of quantification (sleep, for example) in order to focus their efforts exclusively on running.</p>
<p>When it comes to the training cycle, these runners <a href="https://www.tandfonline.com/doi/full/10.1080/2159676X.2023.2225516">differentiate their modes of interaction with the tool</a> (frequency of consulting the tool, nature of the data collected) according to the type of training session they are engaged in. For example, they reserve intensive use of the smartwatch for interval training sessions but only consult it occasionally during recovery runs, marathon pace workouts or technical sessions. Finally, during a given running session, the runners target certain key moments when they consult their watch. Others never look at the watch during their run but only afterwards, or the other way around.</p>
<p>A second tactic consists of agreeing to adjust, revise or even abandon goals along the way, depending on a runner’s perceived state of fitness and/or environmental conditions. <a href="https://www.consumerreports.org/health/exercise-fitness/do-you-really-need-10000-steps-a-day-a1058474912/#:%7E:text=Perhaps%20you%27ve%20heard%20that,and%20still%20get%20serious%20benefits">This flexibility</a> reflects the development of a relationship of self-care and benevolence towards oneself.</p>
<p>Finally, a third everyday tactic leads amateur runners to take systematic care to put into context what they consider to be counter-performances. Far from considering the figures only in their raw form, they use them to understand the mechanisms underlying the process of producing counter-performance (bad night, professional stress, etc.).</p>
<h2>The nature of the attachment to the device</h2>
<p>We wanted to gain a better understanding of the <a href="https://www.researchgate.net/publication/373196405_Understanding_the_lived_experience_of_self-tracking_among_runners_by_taking_off_their_digital_watch_The_imposed_withdrawal_as_a_methodological_tool_for_approaching_the_embodiment_of_the_digital_techno">connection runners formed with their digital tracking device</a>. To do this, we asked them to take it off for a single running session, while describing in real time, using a Dictaphone, how they felt. This change, which was out of the ordinary for most of them, turned out to be particularly destabilizing and revealed how <a href="https://journals.sagepub.com/doi/full/10.1177/14614448221083992">deeply incorporated their use of, and attachment to the tool was</a>.</p>
<p>All the subjects we studied initially admitted to being very apprehensive about the idea of running without their watch. They tried to deal with it in different ways: by postponing the outing; by running on a course that they had just completed with the watch, so as to use numerical reference points; by using the Dictaphone to estimate the duration and pace of the run; and, finally, by hiding a watch in a backpack to be able to record the amount of running they had done. </p>
<p>Most of the participants then felt a motivational void caused by the absence of the watch, which, when worn, functioned as an incentive to perform and a way to challenge themselves. They felt that the session without the watch was longer, harder, more painful and even pointless: why push yourself if you don’t know the exact result and it’s neither recorded nor stored?</p>
<p>The runners also noted that the simple fact of wearing the watch prompted them to over-focus attention on numbers to the detriment of their running technique, the external environment or their bodily sensations.</p>
<p>The absence of the watch was also seen by some as physically destabilizing. Deprived of their tool, the runners felt naked, unbalanced and asymmetrical and more often than not, they were unable to inhibit the reflex gesture of consulting it – proof that the object and movement associated with using it had been assimilated into the runner’s bodily habits. Lastly, some of them found it extremely difficult to regulate their running and reliably estimate common variables such as length, distance, speed and heart rate.</p>
<p>Ultimately, there’s nothing spontaneous, magical or automatic about interacting with your quantification device in a functional way. It has to be learned and built patiently. <a href="https://journals.openedition.org/ejrieps/7754">Physical and sports education in schools must adopt a training role in this field</a>, as digitalization is becoming unavoidable in the <a href="https://boutique.territorial.fr/sport-et-numerique-option.html">world of sports</a>.</p><img src="https://counter.theconversation.com/content/216979/count.gif" alt="La Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Matthieu Quidu received funding from the University of Lyon 1 for a research project entitled, "In search of sobriety: sociological insights into the emergence of minimalist sporting practices."</span></em></p><p class="fine-print"><em><span>Brice Favier-Ambrosini received funding from the Fonds de recherche du Québec - Société et Culture (FRQSC) for a project entitled "Identifying the essential, eliminating the rest," an analysis of the trend towards minimalism in the consumption of sports leisure activities.
</span></em></p>To better measure their activity and become members of a sports community, many amateur athletes are adopting smartwatches and digital tools. But others are giving them up.Matthieu Quidu, Maître de conférences en sociologie du sport, Université Claude Bernard Lyon 1Brice Favier-Ambrosini, Professor, Educational sciences, Université du Québec à Chicoutimi (UQAC)Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2202692024-01-01T14:45:08Z2024-01-01T14:45:08ZResistance (exercise) is far from futile: The unheralded benefits of weight training<figure><img src="https://images.theconversation.com/files/567305/original/file-20231222-21-ph8fgz.jpg?ixlib=rb-1.1.0&rect=455%2C14%2C8365%2C5662&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Resistance training works about as well as aerobic exercise in all the critical areas, including cardiovascular health.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/resistance-exercise-is-far-from-futile-the-unheralded-benefits-of-weight-training" width="100%" height="400"></iframe>
<p>Everyone can agree that exercise is healthy. Among its many benefits, exercise improves heart and brain function, aids in controlling weight, slows the effects of aging and helps lower the risks of several chronic <a href="https://doi.org/10.1101%2Fcshperspect.a029694">diseases</a>.</p>
<p>For too long, though, one way of keeping fit, aerobic exercise, has been perceived as superior to the other, resistance training, for promoting health when, in fact, they are equally valuable, and both can get us to the same goal of overall physical fitness.</p>
<p>Aerobic exercise such as running, swimming and cycling is popular because it provides great benefits and with ample <a href="https://doi.org/10.1371/journal.pmed.1001335">scientific evidence</a> to back that up.</p>
<p>What has been far less influential to date is that resistance training — whether that’s with dumbbells, weightlifting machines or good old push-ups, lunges and dips — works about as well as aerobic exercise in all the critical areas, including cardiovascular health.</p>
<p>Resistance training provides another benefit: building strength and developing power, which become increasingly important as a <a href="https://doi.org/10.1007/s12603-021-1665-8">person ages</a>.</p>
<figure>
<iframe src="https://player.vimeo.com/video/843867756" width="500" height="281" frameborder="0" webkitallowfullscreen="" mozallowfullscreen="" allowfullscreen=""></iframe>
<figcaption><span class="caption">Video about different forms of resistance training explores how all are effective at building strength.</span></figcaption>
</figure>
<p>Building and maintaining muscle strength keeps us springing out of our chairs, maintaining our balance and posture and firing our metabolism, as my colleagues and I explain in a paper recently <a href="https://doi.org/10.1249/FIT.0000000000000916">published</a> by the American College of Sports Medicine.</p>
<p>So, if aerobic exercise and resistance training offer roughly equal benefits, how did we end up with so many runners and cyclists compared to weightlifters?</p>
<p>It was a combination of timing, marketing and stereotyping.</p>
<h2>The rise of aerobics</h2>
<p>The preference for aerobic exercise dates back to landmark research from the <a href="https://www.cooperinstitute.org/research/ccls">Cooper Centre Longitudinal Study</a>, which played a pivotal role in establishing the effectiveness of aerobics — Dr. Ken Cooper invented or at least popularized the word with his book <a href="https://www.cooperaerobics.com/About/Aerobics.aspx"><em>Aerobics</em></a>, spurring desk-bound Baby Boomers to take up exercise for its own sake.</p>
<p>Meanwhile, resistance training languished, <a href="https://www.cnet.com/health/fitness/does-lifting-weights-make-women-bulky/">especially among women</a>, due to the misguided notion that weightlifting was only for men who aspired to be hyper-muscular. <a href="https://www.britannica.com/biography/Charles-Atlas">Charles Atlas</a>, anyone?</p>
<figure class="align-center ">
<img alt="A smiling man holding small blue dumbbells" src="https://images.theconversation.com/files/567302/original/file-20231222-29-if70n6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567302/original/file-20231222-29-if70n6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567302/original/file-20231222-29-if70n6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567302/original/file-20231222-29-if70n6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567302/original/file-20231222-29-if70n6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567302/original/file-20231222-29-if70n6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567302/original/file-20231222-29-if70n6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Resistance training does not invariably lead to bulking up, nor does it demand lifting heavy weights.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Cultural influences solidified the dominance of aerobic exercise in the fitness landscape. In 1977, Jim Fixx made running and jogging popular with <a href="https://en.wikipedia.org/wiki/The_Complete_Book_of_Running"><em>The Complete Book of Running</em></a>. In the 1980s, Jane Fonda’s <a href="https://www.janefonda.com/shop/fitness-videos/jane-fondas-complete-workout/"><em>Complete Workout</em></a> and exercise shows such as <em><a href="https://www.imdb.com/title/tt0268895/">Aerobicize</a></em> and the <em><a href="https://www.imdb.com/title/tt0299431/">20 Minute Workout</a></em> helped solidify the idea that exercise was about raising one’s heart rate.</p>
<p>The very word “aerobic,” previously confined to the lexicon of science and medicine, entered popular culture about the same time as leg warmers, tracksuits and sweatbands. It made sense to many that breathing hard and sweating from prolonged, vigorous movement was the best way to benefit from exercising.</p>
<p>All the while, resistance training was waiting for its turn in the spotlight.</p>
<h2>Recognizing the value of resistance</h2>
<p>If aerobics has been the hare, resistance training has been the tortoise. Weight training is now coming up alongside and preparing to overtake its speedy rival, as athletes and everyday people alike recognize the value that was always there.</p>
<p>Even in high-level sports training, weightlifting did not become common until the last 20 years. Today, it strengthens the bodies and lengthens the careers of soccer stars, tennis players, golfers <a href="https://doi.org/10.1007/s40279-016-0486-0">and many more</a>. </p>
<p>Rising popular interest in resistance training owes a debt to <a href="https://www.livestrong.com/article/545200-the-fall-of-fitness/">CrossFit</a>, which, despite its controversies, has helped break down stereotypes and introduced more people, particularly women, to the practice of lifting weights.</p>
<p>It’s important to recognize that resistance training does not invariably lead to bulking up, nor does it demand lifting heavy weights. As our team’s research has shown, lifting lighter weights to the point of failure in multiple sets provides <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00154.2016">equal benefits</a>.</p>
<h2>Strength and aging</h2>
<figure class="align-center ">
<img alt="An older couple in sweatshirts using small dumbbells" src="https://images.theconversation.com/files/567293/original/file-20231222-23-reglr3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567293/original/file-20231222-23-reglr3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=452&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567293/original/file-20231222-23-reglr3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=452&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567293/original/file-20231222-23-reglr3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=452&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567293/original/file-20231222-23-reglr3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=568&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567293/original/file-20231222-23-reglr3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=568&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567293/original/file-20231222-23-reglr3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=568&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Resistance training can be vital to maintaining overall functionality and independence.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>The merits of resistance training extend beyond improving muscle strength. It addresses a critical aspect often overlooked in traditional aerobic training: the ability to exert force quickly, or what’s called power. As people age, activities of daily living such as standing up, sitting down and climbing stairs demand <a href="https://doi.org/10.1186/s11556-022-00297-x">strength and power</a> more than cardiovascular endurance.</p>
<p>In this way, resistance training can be vital to maintaining overall functionality and independence.</p>
<h2>Redefining the fitness narrative</h2>
<p>The main idea is not to pit resistance training against aerobic exercise but to recognize that they complement each other. Engaging in both forms of exercise is better than relying on one alone. The <a href="https://doi.org/10.1161/CIR.0000000000001189">American Heart Association</a> recently stated that “…resistance training is a safe and effective approach for improving cardiovascular health in adults with and without cardiovascular disease.”</p>
<p>Adopting a nuanced perspective is essential, especially when we guide <a href="https://doi.org/10.1016/j.arr.2021.101368">older individuals</a> who may associate exercise primarily with walking and not realize the limitations imposed by neglecting strength and power training.</p>
<p>Resistance training is not a one-size-fits-all endeavour. It encompasses a <a href="https://doi.org/10.1016/j.jshs.2023.06.005">spectrum of activities</a> tailored to individual capabilities.</p>
<p>It’s time to redefine the narrative around fitness to make more room for resistance training. It’s not necessary to treat it as a replacement for aerobic exercise but to see it as a vital component of a holistic approach to <a href="https://doi.org/10.1249/ESM.0000000000000001">health and longevity</a>.</p>
<p>By shedding stereotypes, demystifying the process and promoting inclusivity, resistance training can become more accessible and appealing to a broader audience, ultimately leading to a new way to perceive and prioritize the benefits of this form of training for <a href="https://doi.org/10.1136/bjsports-2021-105061">health and fitness</a>.</p><img src="https://counter.theconversation.com/content/220269/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stuart Phillips receives funding from CIHR, NSERC, U.S. NIH, and several industry funders. He is affiliated with Exerkine Corporation. </span></em></p>It’s time for aerobics to share the spotlight with weightlifting as a form of exercise that promotes health and may be de rigueur as we age.Stuart Phillips, Professor, Kinesiology, Tier 1 Canada Research Chair in Skeletal Muscle Health, McMaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2145802023-12-26T20:30:36Z2023-12-26T20:30:36ZYou can’t reverse the ageing process but these 5 things can help you live longer<figure><img src="https://images.theconversation.com/files/565071/original/file-20231212-19-m904rz.jpg?ixlib=rb-1.1.0&rect=0%2C437%2C6500%2C3746&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/seniors-enjoying-breakfast-1105683980">Rawpixel.com/Shutterstock</a></span></figcaption></figure><p>At this time of year many of us resolve to prioritise our health. So it is no surprise there’s a <a href="https://digiday.com/marketing/health-food-brands-ramp-up-marketing-efforts-around-consumers-new-years-resolutions/">roaring trade</a> of products purporting to guarantee you live longer, be healthier and look more youthful. </p>
<p>While an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822264/">estimated</a> 25% of longevity is determined by our genes, the rest is determined by what we do, day to day. </p>
<p>There are no quick fixes or short cuts to living longer and healthier lives, but the science is clear on the key principles. Here are five things you can do to extend your lifespan and improve your health.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/no-you-cant-reverse-ageing-by-injecting-young-blood-and-fasting-but-that-doesnt-stop-people-trying-207038">No, you can't reverse ageing by injecting 'young blood' and fasting. But that doesn't stop people trying</a>
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</p>
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<h2>1. Eat a predominantly plant-based diet</h2>
<p>What you eat has a huge impact on your health. The evidence overwhelmingly <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8210981/#:%7E:text=According%20to%20an%20expansive%20review,13%20Given%20that%20so%20many">shows</a> eating a diet high in plant-based foods is associated with health and longevity. </p>
<p>If you eat more plant-based foods and less meat, processed foods, sugar and salt, you reduce your risk of a range of illnesses that shorten our lives, including heart disease and cancer. </p>
<figure class="align-center ">
<img alt="Delicious Mediterranean serving platter." src="https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=371&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=371&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=371&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=466&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=466&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=466&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The Mediterranean diet is one of the healthiest and most studied eating patterns.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/tray-of-food-on-white-surface-K47107aP8UU">Louis Hansel/Unsplash</a></span>
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</figure>
<p>Plant-based foods <a href="https://www.nature.com/articles/s41398-019-0552-0">are rich</a> in nutrients, phytochemicals, antioxidants and fibre. They’re also anti-inflammatory. All of this protects against damage to our cells as we age, which helps prevent disease. </p>
<p>No particular diet is right for everyone but one of the most studied and <a href="https://www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/mediterranean-diet/#:%7E:text=%5B6%5D%20Those%20who%20had%20the,who%20had%20the%20lowest%20adherence.">healthiest</a> is the <a href="https://www.eatingwell.com/article/291120/mediterranean-diet-for-beginners-everything-you-need-to-get-started/">Mediterranean diet</a>. It’s based on the eating patterns of people who live in countries around the Mediterranean Sea and emphases vegetables, fruits, wholegrains, legumes, nuts and seeds, fish and seafood, and olive oil.</p>
<h2>2. Aim for a healthy weight</h2>
<p>Another important way you can be healthier is to try and achieve a healthy weight, as obesity <a href="https://www.healthline.com/health/obesity/how-obesity-affects-body">increases the risk</a> of a number of health problems that shorten our lives.</p>
<p>Obesity puts strain on all of our body systems and has a whole myriad of physiological effects including causing inflammation and hormonal disturbances. These <a href="https://www.ncbi.nlm.nih.gov/books/NBK572076/">increase your chances</a> of a number of diseases, including heart disease, stroke, high blood pressure, diabetes and a number of cancers.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/the-body-mass-index-cant-tell-us-if-were-healthy-heres-what-we-should-use-instead-211190">The body mass index can't tell us if we're healthy. Here's what we should use instead</a>
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<p>In addition to affecting us physically, obesity is also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052856/">associated with</a> poorer psychological health. It’s linked to depression, low self-esteem and stress.</p>
<p>One of the biggest challenges we face in the developed world is that we live in an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6817492/">environment</a> that promotes obesity. The ubiquitous marketing and the easy availability of high-calorie foods our bodies are hard-wired to crave mean it’s easy to consume too many calories.</p>
<h2>3. Exercise regularly</h2>
<p>We all know that exercise is good for us – the <a href="https://www.insurancebusinessmag.com/au/news/breaking-news/hcf-reveals-australias-most-popular-new-years-resolutions-for-2023-431665.aspx">most common resolution</a> we make this time of year is to do more exercise and to get fitter. Regular exercise <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">protects</a> against chronic illness, lowers your stress and improves your mental health. </p>
<p>While one of the ways exercising helps you is by supporting you to control your weight and lowering your body fat levels, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1402378/#:%7E:text=For%20instance%2C%20routine%20physical%20activity,HDL%5D%20cholesterol%20levels%20and%20decreased">effects</a> are broader and include improving your glucose (blood sugar) use, lowering your blood pressure, reducing inflammation and improving blood flow and heart function.</p>
<figure class="align-center ">
<img alt="Woman with grey hair does yoga outside" src="https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Do the types of exercise you enjoy.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/woman-in-black-tank-top-and-gray-denim-jeans-sitting-on-green-grass-field-during-daytime-FGQQho5XXn4">Kelly Newton/Unsplash</a></span>
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<p>While it’s easy to get caught up in all of the hype about different exercise strategies, the evidence <a href="https://www.medicalnewstoday.com/articles/320760">suggests</a> that any way you can include physical activity in your day has health benefits. You don’t have to run marathons or go to the gym for hours every day. Build movement into your day in any way that you can and do things that you enjoy.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/cant-afford-a-gym-membership-or-fitness-class-3-things-to-include-in-a-diy-exercise-program-206204">Can't afford a gym membership or fitness class? 3 things to include in a DIY exercise program</a>
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<hr>
<h2>4. Don’t smoke</h2>
<p>If you want to be healthier and live longer then don’t smoke or vape. </p>
<p>Smoking cigarettes affects almost every organ in the body and is associated with both a shorter and lower quality of life. There is no safe level of smoking – every cigarette increases your <a href="https://theconthatkills.org.au/?utm_source=googlesearch&utm_medium=search&utm_campaign=theconthatkills23&utm_content=RSA&gclid=Cj0KCQjwqP2pBhDMARIsAJQ0Czrlep6EQHC-8_9xUhpz0h9v2ZglMF-6-k7_65awq8FxVaIL5HRoivwaAqJwEALw_wcB&gclsrc=aw.ds">chances of developing</a> a range of cancers, heart disease and diabetes. </p>
<p>Even if you have been smoking for years, by giving up smoking at any age you can experience <a href="https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/benefits/index.htm">health benefits</a> almost immediately, and you can reverse many of the harmful effects of smoking.</p>
<p>If you’re thinking of switching to vapes as a healthy long term option, <a href="https://theconversation.com/can-vaping-help-people-quit-smoking-its-unlikely-204812">think again</a>. The long term health effects of vaping are not fully understood and they come with their own <a href="https://theconversation.com/no-vapes-arent-95-less-harmful-than-cigarettes-heres-how-this-decade-old-myth-took-off-203039">health risks</a>.</p>
<h2>5. Prioritise social connection</h2>
<figure class="align-center ">
<img alt="Older men play chess outdoors." src="https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Don’t forget about friendship and socialising.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/two-men-playing-chess-ItphH2lGzuI">Vlad Sargu/Unsplash</a></span>
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</figure>
<p>When we talk about living healthier and longer, we tend to focus on what we do to our physical bodies. But one of the most important discoveries over the past decade has been the recognition of the importance of spiritual and psychological health. </p>
<p>People who are lonely and socially isolated have a much higher risk of dying early and are <a href="https://healthnews.com/longevity/healthspan/social-connection-and-longevity/#:%7E:text=One%20of%20the%20biggest%20benefits,the%20following%20factors%20and%20influences.">more likely</a> to suffer from heart disease, stroke, dementia as well as anxiety and depression. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/are-you-part-of-a-social-group-making-sure-you-are-will-improve-your-health-81996">Are you part of a social group? Making sure you are will improve your health</a>
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</em>
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<p>Although we don’t fully understand the mechanisms, it’s likely due to both behavioural and biological factors. While people who are more socially connected are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150158/">more likely</a> to engage in healthy behaviours, there also seems to be a more direct physiological effect of loneliness on the body. </p>
<p>So if you want to be healthier and live longer, build and maintain your connections to others.</p><img src="https://counter.theconversation.com/content/214580/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Hassan Vally does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Don’t believe the hype about products claiming they can help you live longer. Here are five lifestyle changes to prioritise instead.Hassan Vally, Associate Professor, Epidemiology, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2174312023-12-26T19:41:43Z2023-12-26T19:41:43ZCardio or weights first? A kinesiologist explains how to optimize the order of your exercise routine<figure><img src="https://images.theconversation.com/files/566783/original/file-20231220-27-k6tsl.jpg?ixlib=rb-1.1.0&rect=547%2C0%2C4607%2C3013&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Resistance and aerobic training each offer unique benefits.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/group-of-people-exercise-in-a-gym-royalty-free-image/501958013">vgajic/E+ via Getty Images</a></span></figcaption></figure><p>When you enter the gym, which way should you head first? Toward the treadmills and spin studio to get your sweat on with a cardio session? Or toward the free weights and strength-training machines to do some resistance training?</p>
<p>The American College of Sports Medicine <a href="https://doi.org/10.1249/MSS.0b013e318213fefb">suggests doing both types of exercise</a> to take advantage of their unique benefits for improving health and daily functioning and reducing chronic disease risk. But what is the optimal sequence to get the best results?</p>
<p>The answer to this question is … it depends. <a href="https://scholar.google.com/citations?user=fDSCAhgAAAAJ&hl=en">I’m an exercise physiologist</a>. Recently in my lab we have been studying the effects of combinations of aerobic and resistance training on improving health-related fitness, particularly aerobic capacity and muscular strength.</p>
<p>Research suggests that when you’re designing your exercise program, there are a few factors to take into account, including your age, fitness level and exercise history and goals. You’ll also want to consider the volume of your exercise routine – that is, its duration and intensity – and how you’ll schedule your training during the day.</p>
<h2>Benefits of exercise</h2>
<p>First, just about any exercise at all is going to be better for you than doing nothing.</p>
<p><a href="https://my.clevelandclinic.org/health/articles/7050-aerobic-exercise">Aerobic exercise</a> is rhythmic activity that gets your heart pumping. Examples are walking, running, swimming, cycling and using a cardio machine such as an elliptical trainer.</p>
<p>Aerobic exercise can improve cardiorespiratory function – over time, your heart and lungs get better at delivering oxygen to your muscles to make energy for continued muscle contractions. <a href="https://doi.org/10.1161/CIRCOUTCOMES.118.005263">Aerobic exercise can also</a> reduce several chronic disease risk factors, increase how much energy your body uses and how much fat it burns, and improve physical and cognitive function.</p>
<p><a href="https://www.britannica.com/topic/resistance-training">Resistance training</a> involves strengthening your muscles by lifting, pushing or pulling against resistance. This type of exercise can be done using free-weight barbells, dumbbells, kettlebells, weight machines or even elastic bands.</p>
<p><a href="https://doi.org/10.12968/ijtr.2015.22.8.385">Resistance exercise</a> improves muscular strength, endurance and the power and the size of muscles – what exercise physiologists call <a href="https://www.medicalnewstoday.com/articles/muscle-hypertrophy">muscle hypertrophy</a>. Studies show resistance training has health-related benefits, as well, particularly for people who <a href="https://doi.org/10.1249/MSS.0b013e3181eeb61c">have or are at risk of developing Type 2 diabetes</a>. It can improve blood pressure, blood levels of glucose and the ability of muscles to use glucose for energy, and it helps maintain lean body mass and bone health.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/566784/original/file-20231220-17-uaocdf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="smiling woman and man walking outdoors with hand weights" src="https://images.theconversation.com/files/566784/original/file-20231220-17-uaocdf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/566784/original/file-20231220-17-uaocdf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=335&fit=crop&dpr=1 600w, https://images.theconversation.com/files/566784/original/file-20231220-17-uaocdf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=335&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/566784/original/file-20231220-17-uaocdf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=335&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/566784/original/file-20231220-17-uaocdf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=421&fit=crop&dpr=1 754w, https://images.theconversation.com/files/566784/original/file-20231220-17-uaocdf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=421&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/566784/original/file-20231220-17-uaocdf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=421&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Many people work out with the main goal of staying healthy.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/african-american-couple-power-walking-on-waterfront-royalty-free-image/1483170000">kali9/E+ via Getty Images</a></span>
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<h2>Training for health benefits</h2>
<p>With a limited amount of time to devote to working out, many people include both cardio and weights in the same exercise session. This concurrent training comes with plenty of benefits for your health, including lowering your cardiovascular and metabolic risks.</p>
<p>In fact, <a href="https://doi.org/10.1371/journal.pone.0210292">doing both forms of exercise together</a> is better, especially for people with chronic disease risk factors, than exercising for the same amount of time but sticking with just aerobic or resistance exercise.</p>
<p>Studies of concurrent training suggest a generalized training effect – similar improvements in aerobic capacity and muscular strength, regardless of the order of aerobic and resistance exercises in a session. These <a href="https://doi.org/10.1007/s40279-021-01587-7">benefits hold for a wide variety of people</a>, including those who are initially inactive, recreationally active, young people and older women and men.</p>
<p>Resistance exercise done before aerobic exercise results in a small increase in <a href="https://doi.org/10.1007/s40279-017-0784-1">lower-body muscular strength without compromising</a> all the other improvements in health-related physical fitness.</p>
<p>So if your exercise goals are along the lines of staying generally healthy and enjoying the <a href="https://theconversation.com/the-exercise-pill-how-exercise-keeps-your-brain-healthy-and-protects-it-against-depression-and-anxiety-155848">mental benefits of moving your body</a>, resistance training first might provide a little boost. Research suggests that overall, though, you don’t need to worry too much about which order to focus on – cardio versus weights. </p>
<h2>Training with performance goals in mind</h2>
<p>On the other hand, you may want be more thoughtful about the order of your workout if you’re a performance-oriented athlete who is training to get better at a particular sport or prepare for a competition.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/566785/original/file-20231220-29-hurgjv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="women soccer players chase the ball" src="https://images.theconversation.com/files/566785/original/file-20231220-29-hurgjv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/566785/original/file-20231220-29-hurgjv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/566785/original/file-20231220-29-hurgjv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/566785/original/file-20231220-29-hurgjv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/566785/original/file-20231220-29-hurgjv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/566785/original/file-20231220-29-hurgjv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/566785/original/file-20231220-29-hurgjv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Training toward specific performance goals can change the calculus about the order of your workout.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/professional-female-midfielder-expertly-controls-royalty-free-image/1477804764">Lighthouse Films/DigitalVision via Getty Images</a></span>
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<p>Research suggests that for these exercisers, concurrent training may slightly inhibit improvement in aerobic capacity. More likely, it can hinder gains in muscular strength and power development, and to a lesser degree muscle growth. This phenomenon is called the “<a href="https://doi.org/10.1113/JP272270">interference effect</a>.” It shows up most in well-trained athletes undertaking <a href="https://pubmed.ncbi.nlm.nih.gov/27506998/">high volumes of both aerobic and resistance</a> exercise.</p>
<p>Researchers are still investigating what happens on a cellular level to cause the interference effect. Aerobic and resistance training unleash <a href="https://doi.org/10.3390/sports6040127">competing influences at the molecular level</a> that affect genetic signaling and protein synthesis. At the start of an exercise program, the body’s adaptations are more generalized. But with more training, the muscle changes become more and more specific to the kind of work being done, and the likelihood of the interference effect kicking in increases.</p>
<p>Of course, many sports require combinations of aerobic and muscular capabilities. Some elite-level athletes need to improve both. So the question remains: What is the optimal order of the two modes of exercise to get the best performance effects?</p>
<p>Given research findings about <a href="https://doi.org/10.1007/s40279-014-0162-1">concurrent training for high-level athletes</a>, it makes sense to do resistance exercise first or to train first in the type of exercise that is most important to your performance goals. Additionally, if possible, elite athletes should give their bodies a break of at least three hours between resistance and aerobic training sessions.</p>
<h2>Don’t sweat the order</h2>
<p>In my lab, we’re studying what we call “microcycles” of aerobic and resistance exercise. Instead of needing to decide which to do first, you weave the two modalities together in much shorter bursts. For instance, one set of a resistance exercise is immediately followed by three minutes of walking or running; you repeat this cycle for as many times as necessary to include all of the resistance exercises in your routine.</p>
<p>Our preliminary findings suggest this method of concurrent training results in similar gains in aerobic fitness, muscular strength and lean muscle mass – while also feeling less challenging – when compared with the typical concurrent routine where all of the resistance exercise is followed by all of the aerobic exercise.</p>
<p>For most people, my current advice remains to choose the order of exercise based on your personal preferences and what will keep you coming back to the gym. High-level athletes can avoid any significant interference effect by doing their resistance routine before the aerobic routine or by separating their aerobic and resistance workouts within a particular day.</p><img src="https://counter.theconversation.com/content/217431/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Randal Claytor has received funding in the past from NIH, AHA, ADA. </span></em></p>How to structure your workout − resistance then aerobic training or vice versa − depends on your exercise goals.Randal Claytor, Associate Professor of Kinesiology, Nutrition and Health, Miami UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2200272023-12-26T17:16:54Z2023-12-26T17:16:54ZHow to jump-start your New Year with cold weather running<figure><img src="https://images.theconversation.com/files/567208/original/file-20231222-29-cdexst.jpg?ixlib=rb-1.1.0&rect=494%2C8%2C5497%2C3979&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Checking the weather frequently can serve to preemptively avoid injury pitfalls from extreme cold or slippery surfaces.</span> <span class="attribution"><span class="source">(Pexels)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/how-to-jump-start-your-new-year-with-cold-weather-running" width="100%" height="400"></iframe>
<p>As 2024 approaches, many people look to begin the year with resolutions to become more fit. Some people find it challenging to get enthusiastic about outdoor exercise during the winter. However, don’t discount the joys of running in a winter wonderland. It’s accessible, available to all and doesn’t involve gym fees or expensive equipment.</p>
<h2>Health benefits</h2>
<p>First off, exercising has immense physical health benefits such as <a href="https://doi.org/10.1210/jc.2014-2440">increased heart and blood vessel health, increased metabolism</a>, favorable <a href="https://doi.org/10.3390%2Fhealthcare11162348">body composition</a> and enhanced immune function. <a href="https://www.miracle-recreation.com/blog/benefits-of-outdoor-exercise/?lang=can">Regular exercise can also help with mental health including reducing depression, anxiety and improving overall mood</a>. </p>
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<em>
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Read more:
<a href="https://theconversation.com/exercise-can-help-prevent-and-treat-mental-health-problems-and-taking-it-outside-adds-another-boost-to-those-benefits-202343">Exercise can help prevent and treat mental health problems, and taking it outside adds another boost to those benefits</a>
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<p>In fact, there is some recent evidence to show that outdoor exercise may provide <a href="https://doi.org/10.1038/s41598-022-26093-2">additional improvements in well-being</a>. These improvements could also contribute to combating <a href="https://doi.org/10.1080/09291010802067171">seasonal affective disorders</a> during the winter months and help to combat a slew of <a href="https://doi.org/10.1136/bjsports-2022-106644">seasonal illnesses</a>. So, what can we do to jump in and reap these health benefits in winter? </p>
<h2>Motivation 101</h2>
<p>Before you start running, think about what motivates you. <a href="https://theconversation.com/got-health-goals-research-based-tips-for-adopting-and-sticking-to-new-healthy-lifestyle-behaviours-173740">New year’s resolutions</a> are a great start, but there needs to be a consistent motivator — something that won’t <a href="https://www.cbc.ca/news/canada/newfoundland-labrador/new-years-resolution-janine-hubbard-1.5412777">go away by February</a> — to get you out and running when the weather forecast begins with a minus sign. </p>
<p>If you’re looking for motivation, <a href="https://blog.mercy.com/staying-motivated-exercise-during-cold-weather/">start with these tips for pumping yourself up</a>. Once you’ve found your motivation, lacing up and taking the first (and next) steps, consistently, won’t be as tough. Here’s a few helpful hints to make that winter run a bit easier and much more enjoyable. </p>
<h2>Getting started</h2>
<p>The biggest injury concerns to cold weather running are slippery conditions and <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/frostbite">frostbite</a>. With that in mind, make sure you’re set with the right equipment. When out in the winter, think <strong>COLD</strong>. This is not only an assessment of the weather. <a href="https://lowellstrauss.com/stay-warm-with-c-o-l-d">It’s an acronym that stands for</a>: </p>
<ul>
<li><strong>CLEAN:</strong> Keeping your gear (clothing and shoes) clean, allows them to work properly. Mud and slush on your hands and feet can make you lose heat quickly.<br></li>
<li>Avoid <strong>OVERHEATING</strong>: If it’s your first time exercising in the cold, you might think you have to put on a snowsuit. However, with poorly chosen outfits, you run the risk of overheating.<br></li>
<li><strong>LAYERED</strong> clothing: Wearing a fitted and moisture-wicking base layer, a light but insulating middle layer, and a breathable, but wind- and water-repellent jacket will give you the best of all worlds. Cover the parts of your body most likely to be exposed such as your hands, neck, and face with running gloves, a neck gaiter or scarf, and toque to keep these sites warm. Consider running with a waist bag or backpack, to carry these items along with your phone for safety.<br></li>
<li>Keep your clothing <strong>DRY</strong>: Breathable, but wind and water repellant clothing will keep your clothes from becoming too damp with either sweat or the environmental conditions, which could suck your heat away.<br></li>
</ul>
<p>Finally, understand that clothing is a matter of personal preference. As a coach of local, national and international (Olympic) track and field athletes, Kurt Downes, co-author of this story, has coached athletes who run in shorts with mittens and others who can barely move with so many layers on. Experiment with what works for you, and makes you comfortable. </p>
<h2>Tips for success and safety</h2>
<figure class="align-center ">
<img alt="A runner's shoes standing in snow" src="https://images.theconversation.com/files/567214/original/file-20231222-23-bsi02m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567214/original/file-20231222-23-bsi02m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567214/original/file-20231222-23-bsi02m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567214/original/file-20231222-23-bsi02m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567214/original/file-20231222-23-bsi02m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567214/original/file-20231222-23-bsi02m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567214/original/file-20231222-23-bsi02m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Keeping your gear (clothing and shoes) clean allows them to work properly. Mud and slush on your hands and feet can make you lose heat quickly.</span>
<span class="attribution"><span class="source">(Piqsels)</span></span>
</figcaption>
</figure>
<p>Make sure you have a clearly defined goal. Do you want to increase fitness, burn calories, enjoy some fresh air or just move your body? Whatever your goal, make it something that is <a href="https://health.clevelandclinic.org/smart-fitness-goals">short-term, sweet and attainable</a>. Leave room to adjust and scale up as you crush those running goals. </p>
<p><strong>Schedule and plan:</strong> Find a slot of time that works best for you and block it out. In winter, it is especially important to plan your runs. My sound advice is to start slow and follow a gradual progression. </p>
<p>Don’t skip ahead despite how well you may be doing. Think about your current level of fitness: you might set out with the intention of running 10 kilometres, but if you’re five kilometres from home and get tired or twist an ankle, the long walk (or hobble) home increases the risks of cold injuries like <a href="https://www.cdc.gov/disasters/winter/staysafe/hypothermia.html">hypothermia and frostbite</a>, and may also mean you’re returning in the dark. </p>
<p><strong>Connect:</strong> Get to nature. Find a local well-lit and travelled trail, a riverfront, a park or take to your neighbourhood streets. Grab a partner, connect with people in your workplace, download a running app or join a running club. Meet at a local spot or pick a hang out spot after your running session. Make it a weekly social event. </p>
<p><strong>Weather check:</strong> Lastly for those of us who have smartphones connected to our hip, have a solid weather app on your home screen. Checking the weather frequently can serve to preemptively avoid injury pitfalls from extreme cold or slippery surfaces. </p>
<h2>Injury prevention</h2>
<p>Be mindful of the times that you head out for runs; if possible, find a time during sunlight hours. It will add a bit of warmth, <a href="https://doi.org/10.1289%2Fehp.116-a160">positively affect mood and increase vitamin D production</a> for bone health and immune function. Run in well-lit areas and wear bright colours so you’re visible to others, especially if running on the road.</p>
<p><strong>Fix your eyes forward:</strong> Focus on what’s coming ahead. It’s easy to get into the zone and lose yourself in thoughts or your favourite tune, but judging the terrain ahead is important to prevent a misplaced step, a twisted ankle <a href="https://www.youtube.com/watch?v=JKZj2W2YyKY">or a slip</a>. </p>
<p><strong>Stride wise:</strong> First, focus on settling into a rhythm at a fixed tempo. This will allow you to create a stride pattern that’s neither too short nor too long to keep on moving. Shortening your stride length will provide more stability when ice and snow are present (this is not the time to work on an Olympic-level stride pattern). If you can’t avoid a snowy or icy patch, it’s probably best to stop and walk around it. </p>
<p><strong>Breathing:</strong> Check your breath. The effects of cold exposure can often impede normal physiological function. Specifically, inhaling cold dry air during physical activity can have <a href="https://doi.org/10.1136/bjsports-2012-091296">adverse health effects on breathing</a>. Especially true for those with compromised respiratory systems or those predisposed to asthma. </p>
<p><strong>Hydration:</strong> Even though it may not seem like an immediate need, it’s important to be well hydrated before and throughout your workouts. Cold and snow don’t mean the air is wet (much of the arctic is actually <a href="https://www.britannica.com/science/cold-desert">classified as a desert</a> because of the lack of precipitation). Also, your body generates a lot of heat, even more when you’re exercising, causing heat loss from sweat. </p>
<p>If you’re just getting started with winter running, know that there are plenty of others out there too. In cities across North America, runners kick-start their year by hitting the streets to cover five-kilometre and 10-kilometre distances <a href="https://www.newyearsrun.com/">on New Year’s Day</a>, which could be a great inspiration to jump-start your winter exercising. Remember, as you get started, make a plan to do it safely.</p><img src="https://counter.theconversation.com/content/220027/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kurt Michael Downes is affiliated with The Border City Athletics Club, a not-for-profit athletics club.</span></em></p><p class="fine-print"><em><span>Kevin Milne does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Winter running has all the health benefits of aerobic exercise, as well as fresh air. However, be aware of the specific safety and injury-prevention concerns that come with cold weather.Kurt Michael Downes, PhD Student, Kinesiology, University of WindsorKevin Milne, Associate professor, Kinesiology, University of WindsorLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2199462023-12-20T20:29:28Z2023-12-20T20:29:28ZHow to keep your physical and mental health on track during the holidays<figure><img src="https://images.theconversation.com/files/566975/original/file-20231220-15-t8vqeb.jpg?ixlib=rb-1.1.0&rect=67%2C67%2C5178%2C3665&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Many people veer from their healthy lifestyle routines during the holidays.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/how-to-keep-your-physical-and-mental-health-on-track-during-the-holidays" width="100%" height="400"></iframe>
<p>With the festive season upon us, many people will be gathering with family and friends, whether it’s a workplace party, a friend’s get-together or a quiet night at home watching Christmas movies. While enjoyable, these events can disrupt your healthy lifestyle habits. </p>
<p>A <a href="https://www.sciencedaily.com/releases/2023/12/231204135305.htm">recent survey</a> reported nearly 45 per cent of people take a break from exercise during the holidays, more than half say they feel more tired and have less time for themselves, and about one-third report drinking more. </p>
<p>My research looks at the benefits of a <a href="https://drscottlear.com/">healthy lifestyle</a> on <a href="https://open.spotify.com/show/1xsvY0F6qbBKDG8INVvy5T">physical and mental health</a>. And many of these same healthy behaviours can help you navigate the holidays.</p>
<h2>Eating right</h2>
<p>Cakes, chocolates, spiced ham, turkey stuffing, mulled wine and other delights abound during this time of year. Most of these foods are high in fat, sugar and calories. So it’s no surprise the holidays are associated with a greater consumption of food. And one survey even pegged people <a href="https://www.huffingtonpost.co.uk/entry/calories-consumed-on-christmas-day_uk_584abfb4e4b0fccb67997275">eating close to 6,000 calories on Christmas Day</a>. That’s two to three times the daily caloric recommendation for most people.</p>
<figure class="align-right ">
<img alt="A wine bottle and wine glass wearing a santa hat, with holiday wreath in the background" src="https://images.theconversation.com/files/566977/original/file-20231220-19-y85bzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/566977/original/file-20231220-19-y85bzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=745&fit=crop&dpr=1 600w, https://images.theconversation.com/files/566977/original/file-20231220-19-y85bzk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=745&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/566977/original/file-20231220-19-y85bzk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=745&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/566977/original/file-20231220-19-y85bzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=936&fit=crop&dpr=1 754w, https://images.theconversation.com/files/566977/original/file-20231220-19-y85bzk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=936&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/566977/original/file-20231220-19-y85bzk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=936&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In one survey, one-third of people reported drinking more alcohol during the holidays.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>With this amount of eating, there are many claims the holidays result in weight gain. While there is an enduring rumour that <a href="https://www.nytimes.com/2006/10/31/health/nutrition/31real.html">average holiday weight gain is five to 10 pounds</a> (2.25 to 4.5 kilograms), in reality it may be much less. A study published in 2000 reported it to be only <a href="https://doi.org/10.1056/NEJM200003233421206">around one pound</a>, or about half a kilogram. However, as this was an average amount, there were still some people in the study who gained five or more pounds. </p>
<p>While indulging on one or two occasions isn’t going to derail your diet, if you have a holiday circuit of events you do, you may want to develop a strategy on how to manage your diet. First ask yourself if you need (or want) to go to all of them. </p>
<p>For the events you do go to, pick one or two occasions at which you’ll indulge. These might have the best food, or your closest family and friends are present. For the others, try staying on the healthier side of things.</p>
<p>Before you go, make sure you eat well during the day leading up to your event so you’re not going to the event hungry. Also, make sure you get plenty of sleep. A lack of sleep can make you more likely to reach for <a href="https://doi.org/10.1016/j.foodqual.2020.104074">high-energy foods and eat more</a>. </p>
<p>Try to enlist a health buddy, whether a friend or even the host, to keep you on track. And be mindful of alcohol intake, which can impair your self-discipline.</p>
<h2>Staying active</h2>
<figure class="align-center ">
<img alt="Melted snowman cookies against a blue background" src="https://images.theconversation.com/files/566978/original/file-20231220-21-7k59t4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/566978/original/file-20231220-21-7k59t4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/566978/original/file-20231220-21-7k59t4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/566978/original/file-20231220-21-7k59t4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/566978/original/file-20231220-21-7k59t4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/566978/original/file-20231220-21-7k59t4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/566978/original/file-20231220-21-7k59t4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Missing a few exercise sessions isn’t going to affect your fitness and long-term health, but it can affect your mood.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>When it comes to exercise, most of us are creatures of habit. This is a good thing, because having <a href="https://journals.sagepub.com/doi/10.1177/1559827618818044">a routine is the best way to maintain regular exercise</a>. But the holidays are anything but routine. Gyms, pools and community centres may have shortened hours or be closed. Your trainer or aerobics instructor may have taken time off.</p>
<p>Now, missing a few exercise sessions isn’t going to affect your fitness and long-term health, but it can affect your mood. Exercise is known to <a href="https://doi.org/10.1016/j.physbeh.2017.03.013">increase energy levels</a>, <a href="https://doi.org/10.1007/s10902-018-9976-0">improve mood</a> and <a href="https://doi.org/10.1016/j.psyneuen.2014.10.019">reduce stress</a>. All of which can be helpful during the frenetic holidays. And missing an exercise session can be like not having your morning coffee.</p>
<p>But the holidays also present numerous opportunities to get in a lot of activity — from shopping to Christmas markets to walking around your neighbourhood looking at the decorations. </p>
<p>You can also get into the holiday spirit by singing Christmas carols (or any other song). Singing can <a href="https://doi.org/10.1136/bmjopen-2018-026995">reduce anxiety</a>, potentially <a href="https://doi.org/10.1136/bmjresp-2021-000959">increase your lung capacity</a> and <a href="https://doi.org/10.1007/s10865-004-0006-9">increase the number of infection-fighting molecules</a> in your blood. And singing with others is known to build social bonds and <a href="https://doi.org/10.1177/03057356211042668">release oxytocin</a>, which can improve one’s mood. </p>
<p>While the quality of your singing doesn’t matter for most of these benefits, the more you do sing, <a href="https://doi.org/10.1002/hbm.21173">the more you’ll likely benefit</a>.</p>
<h2>Managing stress</h2>
<p>Nearly <a href="https://www.apa.org/news/press/releases/2023/11/holiday-season-stress">90 per cent of adults in the United States associate the holiday season with some form of stress</a>. While the holidays are meant to be a period of joy, it’s not uncommon to feel overwhelmed by the shopping, hosting events, expectations of others and the added financial costs. </p>
<figure class="align-center ">
<img alt="red and white mini candy canes arranged in heart shapes and big candy canes in a heart shape with one side broken into three pieces" src="https://images.theconversation.com/files/566979/original/file-20231220-19-y2x3cx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/566979/original/file-20231220-19-y2x3cx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/566979/original/file-20231220-19-y2x3cx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/566979/original/file-20231220-19-y2x3cx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/566979/original/file-20231220-19-y2x3cx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/566979/original/file-20231220-19-y2x3cx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/566979/original/file-20231220-19-y2x3cx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">While the holidays are meant to be a period of joy, it’s not uncommon to feel overwhelmed by the shopping, hosting events, expectations of others and the added financial costs.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>This may be one of the reasons why the number of <a href="https://doi.org/10.1161/01.CIR.100.15.1630">heart attacks and cardiac-related deaths</a> increase during the holiday period. In addition, it’s believed people delay seeking treatment during the holidays, given that <a href="https://doi.org/10.1161/01.CIR.0000151424.02045.F7">emergency department visits spike after they’re over</a>.</p>
<p>Stress occurs when people feel they don’t have control over what’s going on. Setting up a holiday plan can help. Your plan could include a spending budget, which events you’ll attend and which you’ll say no to. If you’re hosting a dinner, plan the menu ahead of time, enlist help from others or even get take-out. </p>
<p>Other strategies for managing, and preventing, stress include getting regular exercise, ensuring you get enough sleep, avoiding unrealistic expectations and setting aside some quiet time to do something just for yourself.</p>
<p>While we all want things to be perfect, even the best plans may go astray. If that does happen, that’s okay and go easy on yourself. If you do find the holidays challenging, make sure you speak up to the people around you for their support.</p><img src="https://counter.theconversation.com/content/219946/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Scott Lear receives funding from the Canadian Institutes of Health Research and Hamilton Health Sciences, and has received funding from the Heart and Stroke Foundation, Novo Nordisk, and the Robert Wood Johnson Foundation.</span></em></p>The holidays can disrupt healthy lifestyle habits, like nutrition and exercise routines. Here’s how to enjoy the season without derailing your physical or mental health.Scott Lear, Professor of Health Sciences, Simon Fraser UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2172032023-12-14T13:48:45Z2023-12-14T13:48:45ZHow much could the NHS save if people had healthier lifestyles? Hundreds of millions according to research<figure><img src="https://images.theconversation.com/files/565332/original/file-20231212-19-rf91na.jpg?ixlib=rb-1.1.0&rect=77%2C132%2C5106%2C3292&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-backpack-hiking-on-footpath-autumn-2377721871">encierro/Shutterstock</a></span></figcaption></figure><p>The NHS spends a lot of time and money looking after people who smoke, or drink too much or don’t do enough exercise. Hospital admissions and treatments are an expensive business. </p>
<p>So what would happen if these people were able to change their lifestyles, for example by switching to vaping, moderating alcohol intake and being more physically active? My research suggests that costs to the NHS could be significantly reduced. </p>
<p>One of <a href="https://www.magonlinelibrary.com/doi/abs/10.12968/bjhc.2023.0046">my studies</a> indicates that if half of England’s <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/adultsmokinghabitsingreatbritain/2022#smoking-prevalence-in-the-uk-by-sex-age-and-region">5 million smokers</a> switched to e-cigarettes or heated tobacco, the NHS would save more than £500 million a year. The shift away from cigarettes would lead to a decrease in cases of lung cancer, mouth cancer and heart disease. While the risks of vaping are still <a href="https://theconversation.com/how-bad-is-vaping-and-should-it-be-banned-197913">not entirely clear</a>, the damage caused by smoking has been firmly established.</p>
<p><a href="https://www.sciencedirect.com/science/article/abs/pii/S1090944323000613">Another study</a> I carried out in Italy reinforces this conclusion. It suggests that if half of Italy’s smoking population transitioned to alternative products, that country’s public health service could save over €700 million (£600 million) a year.</p>
<p>The larger figure comes from a slightly different cost structure for Italy’s health service, and the fact that more people smoke in Italy than in England. That study also delves into potential savings related to reducing excessive alcohol consumption and promoting increased physical activity.</p>
<p>My research <a href="http://dati.istat.it/Index.aspx?QueryId=16778&lang=en">used statistics</a> which suggest that just under 3% of Italians are currently considered heavy drinkers. Overindulging in alcohol can lead to many <a href="https://www.thelancet.com/pdfs/journals/lanrhe/PIIS2665-9913(23)00073-5.pdf">health problems</a>, including liver damage, heart defects, increased blood pressure, and a heightened risk of certain types of cancer.</p>
<p>I found that if a single heavy drinker (someone who consumes over four units of alcohol a day) out of every 1,000 Italians reduced their consumption to the recommended guidelines (two units a day for men, one a day for women), this would result in an annual saving to the health service of €60 million (£52 million). </p>
<p>Another finding was that if one physically inactive person out of every 100 Italians started to take the recommended level of at least 150 minutes of moderate physical activity, the gain would be €223 million (£193 million) per year. </p>
<p>Almost 40% of Italians do no exercise, which increases the risk of cardiovascular diseases, type 2 diabetes and obesity. It also <a href="https://www.who.int/news/item/04-04-2002-physical-inactivity-a-leading-cause-of-disease-and-disability-warns-who">elevates the risk</a> of colon cancer, high blood pressure, osteoporosis, depression and anxiety. </p>
<p>So overall, as the Italian government – in common with many wealthy countries – struggles with healthcare funding, close to €1 billion could be saved every year in direct costs if a relatively small number of people made fairly straightforward changes. </p>
<h2>Save lives, save money</h2>
<p>A similar impact could be had on the NHS (which has an annual budget of £182 billion) by targeting smokers, heavy drinkers and those who take no exercise. </p>
<p>The economic impact could in fact be far greater than my calculations suggest. For the savings predicted by my research do not account for the loss in productivity due to time off work connected to illness, treatment and recovery. </p>
<figure class="align-center ">
<img alt="Bottles of water held up in celebration." src="https://images.theconversation.com/files/565334/original/file-20231212-19-lbgug.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565334/original/file-20231212-19-lbgug.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565334/original/file-20231212-19-lbgug.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565334/original/file-20231212-19-lbgug.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565334/original/file-20231212-19-lbgug.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565334/original/file-20231212-19-lbgug.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565334/original/file-20231212-19-lbgug.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Contains no alcohol.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/cheers-healthy-couple-cheering-fresh-water-1134634340">AePatt Journey/Shutterstock</a></span>
</figcaption>
</figure>
<p>Some may argue that given the risky nature of cigarettes and alcohol, a more straightforward – and economically beneficial – approach would be to implement an outright ban. After all, if successful, it could potentially result in even greater savings of lives and resources. </p>
<p>But banning people from doing things they like, even if those things are harmful, <a href="https://theconversation.com/history-not-harm-dictates-why-some-drugs-are-legal-and-others-arent-110564">rarely works out well</a>. The idea of taking away the right to smoke or drink, or enforcing physical exercise would be a tough political sell. </p>
<p>Recognising that people are often inclined to engage in risky behaviour, the objective should be to reduce the excessive harm they cause themselves. A push towards encouraging and enabling people to smoke less, drink less and do more exercise would benefit them and significantly decrease the financial pressure on our healthcare systems.</p><img src="https://counter.theconversation.com/content/217203/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Francesco Moscone is affiliated with University of Ca' Foscari Venice </span></em></p>Small changes, big savings.Francesco Moscone, Professor of Business Economics, Ca' Foscari University of Venice, Brunel University LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2193442023-12-08T14:53:05Z2023-12-08T14:53:05ZDoes exercise really do nothing for longevity, as a Finnish twins study suggests?<figure><img src="https://images.theconversation.com/files/564483/original/file-20231208-25-jfdagi.jpg?ixlib=rb-1.1.0&rect=8%2C0%2C5742%2C3828&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fitness-woman-jumping-outdoor-urban-environment-1080117269">BGStock72/Shutterstock</a></span></figcaption></figure><p>Surveys on lifestyle and longevity consistently find that people who do more exercise live longer. So it is surprising to see a report from the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10274991/">Finnish Twins Cohort Study</a> that there is little direct effect of “leisure time physical activity” on lifespan. What makes this study different from others – and is it right?</p>
<p>Human behaviour and biology are complex and interact with wider society and the environment. How much exercise a person gets could be linked to their genetics, diet, disabilities, education, wealth, or just whether they have enough leisure time and a safe green space. Each of these factors could also be linked to lifespan in different ways. </p>
<p>You can probably think of a dozen other things that might be associated both with a person’s health and the amount of exercise that they do. The direction of the causation will not always be clear. Although it is certainly true that people who exercise more will, on average, live longer, it is far more difficult to know how much is caused by the exercise itself, versus these other factors. </p>
<p>How can we hope to isolate this single causal effect from the complexity of people’s lives?</p>
<p>Studies of twins can help us here. Twins have similar or identical genetics and early life experiences, so we can more directly test how differences in their later-life behaviour affect lifespan.</p>
<p>This is precisely the approach taken by researchers at the University of Jyväskylä in Finland. They used exercise questionnaires given to 11,000 pairs of adult same-sex twins in 1975, 1981 and 1990, and linked this to death records up to the year 2020. </p>
<figure class="align-center ">
<img alt="Young identical blond twins." src="https://images.theconversation.com/files/564485/original/file-20231208-25-4vzws2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564485/original/file-20231208-25-4vzws2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564485/original/file-20231208-25-4vzws2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564485/original/file-20231208-25-4vzws2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564485/original/file-20231208-25-4vzws2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564485/original/file-20231208-25-4vzws2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564485/original/file-20231208-25-4vzws2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Studying twins can help scientists determine whether a certain trait, illness or disorder is influenced more heavily by genes or the environment.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-portrait-twin-girls-two-beautiful-2292761521">Andrey Zhernovoy/Shutterstock</a></span>
</figcaption>
</figure>
<h2>Least and most active groups biologically older</h2>
<p>They found that, as expected, the most active had a 24% lower rate of death compared with the least active. This effect is smaller than suggested by previous studies, and most of the excess risk was confined to the least active 10% of the study participants. </p>
<p>They also looked at biological age, measured by the degree of DNA damage (<a href="https://www.nature.com/articles/d41586-022-00077-8">methylation</a>) and, surprisingly, found that both the most and the least active groups appeared biologically older than the others. </p>
<p>Pairing twins deals with genetics and early life differences, but what about other aspects of health behaviour? </p>
<p>When smoking, alcohol consumption and body mass index (BMI) were taken into account in the analysis, the link between exercise and longevity was much reduced, with only a 9% difference in death rate between the least active group and others – and no difference between the highly and moderately active. In other words, for a hypothetical twin pair with very different activity levels but the same smoking history, alcohol use and BMI, there would be very little difference in life expectancy. </p>
<p>But what does it mean to change exercise levels while all other aspects of health remain constant? For example, if the effect of exercise on death was mediated by weight loss, then this analysis would not reveal that link. And if exercise increases but weight does not change, then must something else be compensating? </p>
<p>There was also some evidence that the effect of exercise was stronger in the first 20 years after the assessment compared to the subsequent decade. So it is possible that exercise needs to be maintained to keep its longevity benefits into later life. </p>
<p>This would agree with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1402378/">evidence from clinical trials</a> that show more immediate benefits of exercise interventions on health in people with existing conditions.</p>
<h2>Smaller role than previously thought</h2>
<p>So what can we safely conclude from these new findings – which have won a national sports medicine prize in Finland, but are yet to be peer-reviewed? </p>
<p>Clearly, people who exercise more live longer on average. Genetics, social factors, existing health and other aspects of lifestyle explain some of the association. We should not rule out a direct link between exercise and longevity, but this study suggests that it may have a smaller role than previously thought.</p>
<p>Nevertheless, experimental evidence shows that exercise can prevent illness and disability, <a href="https://bjsm.bmj.com/content/57/18/1203">improve mood</a> and <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/414776">overall quality of life</a>, which many would regard as more meaningful outcomes than lifespan alone. </p>
<p>It can be difficult for people to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4988401/">maintain lifestyle changes</a>, and so social and environmental efforts, such as <a href="https://www.kingsfund.org.uk/projects/improving-publics-health/access-green-and-open-spaces-and-role-leisure-services">maintaining high-quality green spaces</a>, to support healthy lifestyles are important. </p>
<p>Social inequalities in health and lifespan <a href="https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on">exist and are growing</a> so it’s vital that we continue to refine our understanding of the reasons why and what we should do about it.</p><img src="https://counter.theconversation.com/content/219344/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>George M. Savva does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>We should not rule out a direct link between exercise and longevity, but it may have a smaller role than previously thought.George M. Savva, Senior research scientist, Quadram InstituteLicensed as Creative Commons – attribution, no derivatives.