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Tuesday, October 10, 2017
If you exercise a lot, you probably think your heart is in good shape. Maybe not.
By Emily Sohn, Washington Post, October 7, 2017
Jason Lathrop was training for a solo backpacking trip in 2015 when he started to feel a creaking sensation in his knees during morning runs near his home in Portland, Ore.
Expecting to learn that he’d torn his meniscus or strained a ligament, he went to his doctor, who told him his knees were just fine. Instead, he learned, he had a heart murmur. Six weeks later, the 43-year-old father of two was undergoing open-heart surgery to repair a faulty mitral valve.
After a lifetime of active and virtuous living that including frequent exercise, healthy eating and no smoking, Lathrop was stunned to learn that something could be wrong with his heart.
“Your heart is your aerobic engine along with your lungs, and I thought if there were any organs I would not have problems with, it would be those two because I took such good care of them,” says Lathrop, an analyst at Intel. “It was such a shock.”
Exercise does a lot to strengthen the heart and lengthen lives, experts say. But heart problems are still common–and sometimes dramatic–in active people. It’s a point that’s likely to come up during this fall’s marathon season, given the cases of sudden cardiac death and heart attacks that sometimes occur during long races.
Those rare but often highly publicized events offer an opportunity to deliver a nuanced message about heart health to active people: Exercise is good, but nothing is 100 percent protective, says Aaron Baggish, director of the Cardiovascular Performance Program at Massachusetts General Hospital in Boston.
“No amount of exercise confers complete immunity to heart disease,” Baggish says. “You can’t outrun heart problems completely.”
Decades of research on tens of thousands of people have drawn a direct connection between routine exercise and heart health. Among other measures, studies show, getting the recommended 150 minutes of moderate exercise each week can lower rates of blood pressure, heart disease, death and more.
“If you had to pick one pill for the American public to take, exercise is more perfect than any other pill you could come up with,” says Mark Link, a cardiac electrophysiologist at the University of Texas Southwestern Medical Center in Dallas.
But reducing risk isn’t the same as eliminating it. Sometimes exercise can exacerbate heart risks, especially at extreme levels–although scientists are still working out the details of what an athlete’s heart should look like.
In one 2013 study, researchers looked at the health records of more than 52,000 Swedish cross-country skiers who competed in a 56-mile race between 1989 and 1998. They found that male athletes who had skied faster and those who had competed in more races showed higher rates of irregular heart rhythms, called arrhythmias, over a period of 10 years.
Compared with men who had competed just once, those who completed five races were twice as likely to be hospitalized for bradyarrhythmias, or unusually slow heart rates. Atrial fibrillation, an irregular or very fast heart rate, was also more common in the most-serious skiers.
But overall, the athletes reaped plenty of benefits. Rates of death were lower in skiers who did more races compared with those who did fewer. Mortality rates were lower in the skiers compared with the general population.
This is not the only example where evidence is revealing that vigorous training alters hearts in ways that require more research. For example, serious athletes seem to show increased levels of calcium deposits in the arteries of the heart. These plaques are normally a sign of elevated risk for heart attacks, but new studies suggest that they may be less worrisome in otherwise healthy athletes. “To some degree,” Baggish says, “the jury is still out on this.”
A more common risk that active people face is the belief that exercise gives them freedom to indulge in heart-damaging behaviors. And excessive alcohol, junk food and tobacco in early adulthood can catch up to people later in life, Baggish says.
Genetic predispositions also matter, even for people who do everything right. That’s something that Jay Kuo, a 49-year-old Broadway composer and producer in New York, has been struggling with since his blood pressure and triglycerides spiked a couple of years ago, despite his healthy habits.
Already spooked by a family history of heart disease, including the death of his father at age 44, Kuo had stopped smoking, reduced his salt intake, cut out processed meats and started drinking a kale smoothie every morning. He also jogs, does yoga, meditates and takes medications to improve his blood pressure and triglyceride levels. Despite all that, he’s not making as much progress as he’d like.
“It’s frustrating,” he says. “I need to not have what happened to my dad happen to me.”
Screening for heart conditions remains controversial, as researchers continue to debate whether looking for trouble would wind up harming more people than it might help.
See a doctor if you have concerns, Baggish suggests. But don’t let stories of athletes with heart problems scare you away from exercise.
“Our country’s problem is not too much exercise,” he says. “It’s too little exercise.”
And a diagnosis doesn’t have to mean the end of an athletic lifestyle. Two years after his heart surgery, Lathrop is running three days a week, often for 10 miles or more at a time.
“I’m running much farther than I ever did before the surgery,” he says. “I have a new lease on life.”
How to Actually Get Rest
By Brad Stulberg, New York Magazine, Oct. 4, 2017
The thing about scrolling through social media is that it often feels like it should be a restful activity. It even looks like one. You’re barely moving, after all; you might even be lying down. And yet when is the last time you closed Twitter feeling refreshed?
In case you haven’t yet heard, rest is important. It’s when our bodies repair and grow; our brains become smarter and more creative; and our minds replenish willpower and gain emotional control. Rest is so important to working in a happy, healthy, and sustainable manner that we’d be wise to think of it not as something separate from doing good work, but rather, as an integral part of doing good work; sometimes, not working is the work.
But there is a science–and art–to resting well, and not all forms of kicking back are created equal. It turns out that lots of the activities we think are restful may actually leave us feeling more tired and stressed.
Before we get into the best ways to rest, it’s instructive to agree on a common definition of what rest even is. Most researchers agree that rest is a physiological state during which your innate fight-or-flight stress response, or sympathetic nervous system, subsides in favor of a more relaxed condition. Your heart rate and blood pressure come down, and your shoulders usually follow. Psychologically, rest is considered a shift from deliberate and effortful thinking–for example, straining to solve a problem or trying to figure out the best way to communicate a complex topic–to a more passive state, sometimes characterized by mind-wandering or zoning out.
While both “stress” and “rest” are somewhat subjective–a five-mile run might be a restful activity for one person and a stressful one for another–there are a few ingredients that are essential to any truly restful activity.
You aren’t exerting self-control. At first, it might take some willpower to resist worrying about work or other seemingly pressing issues, but once you’re in the midst of a nice bout of rest, it should feel pretty easy. Trying really hard to rest–for example, forcing yourself to listen to music and breathe deeply when all you really want to do is respond to emails–defeats its purpose. Either find an activity that more easily lets your mind drift away (more on that below), or just respond to the emails and try relaxing afterwards.
You aren’t consciously thinking about your work or other issues that may be weighing on you. Perhaps your subconscious mind is still connecting dots and problem solving in the background, but your conscious awareness is not on your work–instead, it’s floating freely. Likewise, a restful activity can’t be one that’s triggering anxiety. (See: cable news or a polarizing Twitter feed.)
You aren’t disrupting your ability to fall and remain asleep, which is the ultimate form of rest. As for two of the developed world’s favorite evening activities: If watching television (though not the news) allows you to check out, and doesn’t interfere with your falling asleep, then by all means go for it. Same goes for a glass of wine. But beware: Studies show that if consumed within a few hours prior to bed, both can interfere with sleep–the culprits being blue light from the former and alcohol from the latter. If you are struggling to fall or stay asleep, it’s probably best to eliminate late-night TV and your nightcap.
Plenty of activities meet the above criteria for rest, but a few in particular come with strong evidence of benefits.
Walking: In a study aptly titled “Give Your Ideas Some Legs,” researchers from Stanford University found that individuals who took a short (6 to 15 minute) walking break increased creative thinking by 40 to 60 percent, as compared to those who remained seated at a desk. At first, they speculated that increased blood flow to the brain was the primary reason for walking’s benefits. But it appears the benefits might also emerge from the interplay between walking and attention: mainly, walking requires just enough coordination to occupy the parts of the brain responsible for effortful thinking, allowing us to more easily zone out and mind-wander, both of which are associated with creativity and insight.
Hanging out with friends. The ratio of the hormones testosterone to cortisol acts as a good indicator of stress and recovery. Testosterone is associated with growth and rejuvenation whereas cortisol is associated with stress and degradation–so the higher the ratio, the better. Studies have found that following stressful periods–like a competitive sporting event, for example–individuals who kick back and relax with friends experience a much quicker rebound in their testosterone to cortisol ratio. Other research shows that social connection helps to shift the nervous system into a restful state and releases hormones that have anti-inflammatory properties, like oxytocin and vasopressin.
Experiencing nature. Time spent in nature is associated with more relaxed physiological and psychological states–even just looking at pictures of natural settings for a few minutes has been shown to increase creative thinking. Writing in her book The Nature Fix, Florence Williams suggests that “nature lulls us with soft fascination, helping to rest our top-down, direct attention faculties.”
Hiking. Combine the above three strategies! Group forest walks have been found to decrease stress hormones and attenuate virtually every part of the fight-or-flight stress response. For the full effect, leave your smartphone behind (or at least keep it turned off if you feel the need to bring it). I’ve never met anyone who regretted a digital-device-free hike with friends.
Sleeping! The obvious one, but still: No form of rest is as powerful. During sleep, your body repairs and grows and your mind retains, consolidates, and connects the information that you were exposed to during the day. Short naps (10 to 30 minutes) can give you a boost in energy and creativity, but nothing can replace the massive importance of sleeping seven to nine hours every night. Put simply: Sleep is one of the most productive things you can do.
When it comes to how much you should rest, though there are no straightforward guidelines, a good rule of thumb is to balance stress with rest. The more stress in your life, the more you should offset it with rest. Another good way to think about rest is to mimic “interval” training throughout your days, by alternating between bursts of intense, deep-focus work and short breaks.
If you want to prioritize rest (and you should!), be careful not to fall for a common trap, one that leaves many well-intentioned people believing they’re resting but never feeling too well-rested. The activities that may seem like rest are often far from it. Trade in couch time and screens for walking, nature, mind-wandering, and hanging out with friends. Doing so may seem hard at first, but once you get going, you’ll feel a lot better.
Wednesday, October 4, 2017
The common mistake that puts runners in danger on the road
By Ben Opipari, Washington Post, September 27, 2017
It’s a showdown that plays out every day: Two runners approach each other on the shoulder, one running with traffic and the other against. Who is running in the correct direction?
If there’s a sidewalk, the law says that’s where they should be. But if the shoulder is the only option, laws in the District, Maryland and Virginia say they must run against traffic. Maryland law, like the others, is clear: “If there is no sidewalk, always walk on the side of the road facing traffic.” Although no federal laws mandate which side you should be on, the Centers for Disease Control and Prevention and the U.S. Transportation Department recommend running against traffic.
One study bears this out. Researchers in Finland looked at data from auto accidents from 2006 to 2010, covering about 2,000 miles and 258 pedestrian accidents. The researchers found that pedestrians walking against traffic have on average a 77 percent lower risk of being struck and injured by a car. “If no pavement or pedestrian lane is available,” they write, “facing traffic substantially improves pedestrian safety.”
The reason is simple–you can’t react to something you can’t see. Facing traffic, you can react quicker to a wayward–or distracted–driver. Jean Knaack, executive director of the Road Runners Club of America, encourages runners to go against traffic. “Running against traffic allows you to see incoming vehicles and to react to them,” she says. “If your back is to incoming traffic, you’re far less likely to react if a car is not giving you an adequate right of way.”
Dennis Barker is the head coach at Team USA Minnesota, where he has coached 24 national track champions and an Olympian. Seeing oncoming traffic is important, he says, so that the runner and the driver know what the other is doing. When he used to run on rural two-lane roads, he noticed that when cars approached and passed one another, they would move away from the center–and closer to the runner. Running against traffic allows you to notice this adjustment.
“As a driver, I appreciated others who walked or ran facing traffic because it helped me see them better when they adjusted their position as I approached,” Barker says. “I, in turn, adjusted my position. We both took responsibility for each other’s safety.”
Runners should practice “defensive running” in the same vein as defensive driving. Defensive runners always look for oncoming distracted drivers encroaching their space. “Staying aware provides crucial time to avoid a distracted driver who may not be taking a straight line,” Barker says. “A runner going with traffic is not aware of what’s coming and is at the mercy of the driver.”
Making eye contact with the oncoming driver allows you to see what’s going on behind the wheel. Unfortunately, you may not like what you see.
The U.S. Transportation Department said that in 2015 there were nearly 3,500 fatalities and 400,000 pedestrian injuries because of distracted driving, primarily from people manipulating handheld devices. “Never assume a driver sees you. Try to make eye contact with drivers as they approach you to make sure you are seen,” the agency recommends.
It’s easier to be seen if you wear clothing that’s a different color from your surroundings. Todd Straka, who publishes the Boulder Running website and is the race director for a popular Boulder 5k race series, says that runners should look more like bikers. “Bikers often have blinking lights, even during the day. I would suggest runners wear something like that so they can be seen from afar,” he says.
Some people who run with traffic believe that if they are hit, the impact will not be as severe since they are moving in the same direction as the car. But physics proves this false. Rebecca Metzler, associate professor of physics at Colgate University, is a runner. Her rural community is two-lane roads, so she always runs against traffic. Metzler says that while the impact might not be as great if you get hit running with traffic, “you’re probably going to get hurt either way. Your reaction time is far more important, and that smaller force is outweighed by the ability to get out of the way in the first place.”
Wade Gordon, a retired Air Force colonel and an orthopedic trauma surgeon with extensive experience in traumatic and high energy injuries, agrees. “The force of being struck by a vehicle is great enough that it will break stuff, whether you’re traveling with or against traffic,” he says.
It’s also not any safer to run in the direction of traffic on neighborhood roads, even though speeds might be slower. Todd Templeman, an emergency physician at Suburban Hospital, says that head injuries are especially common, and can even be fatal, at these low impacts. Templeman says that he runs only on sidewalks or running paths like the Capital Crescent Trail. “I never run on the road. Ever. There are too many safety issues. “
If you do choose the road, however, experts agree that you should never wear headphones because you can’t hear the cars. One study examining pedestrian deaths from 2004 to 2011 noted the dangers of headphones. Headphones also cause inattentional blindness, which is the inability to notice unexpected objects even when they might be right in front of you. The cognitive function that you use to listen to music takes away from the more important cognitive function of seeing cars approach.
There are two instances, however, where running against traffic can be unsafe: as you approach the crest of a steep hill and as you round a sharp turn. The runner and the driver may not see each other until it’s too late. If this happens, it’s best to cross the road far in advance of the hill or the turn and run with traffic until it’s safe to cross back over to the left side of the road.
Wednesday, April 19, 2017
You’re middle-aged—this is the perfect time to work on staying healthy
Choices people make in their 20s and 30s about exercise, eating and handling health issues set the stage for the future, but in your 50s and 60s you still have time to make up for any mistakes and increase your odds of healthful aging. Eating well, spending time with others, getting screened for some health problems and tending to your emotional needs are all important.
Here’s what experts had to say about some simple changes you can make or measures to adopt to maximize your chances of aging well from middle age on.
Joy Bauer, a nutritionist and the author of “From Junk Food to Joy Food”:
Metabolism slows with age, so it’s vital to eat voluminous and tasty meals without bumping up calorie intake. Fruits and vegetables are high in volume and low in calories, so they fill you up without filling you out. They are also loaded with antioxidants to boost memory and brain power. Eat a vegetable with every meal–veggies are packed with potassium, calcium and magnesium, which help lower blood pressure and protect bones and joints.
Andrew Weil, a physician and the director of the Arizona Center for Integrative Medicine at the University of Arizona, and author of “Mind Over Meds”:
To reinforce healthy habits, spend more time with people who have them. To improve eating habits, spend time with people who eat well; if you want to be physically active, associate with active people. Maintain social and intellectual connectedness: They correlate strongly with healthy aging.
Richard A. Friedman, a professor of clinical psychiatry at Weill Cornell Medical College in New York:
At every age, there is strong evidence that you can improve thinking and physical fitness. Baby boomers might be tempted by the lure of brain training, but there are no credible data that practicing brain games transfers to any other cognitive skill other than the game itself. Instead, physical exercise has been shown in numerous studies to enhance memory and performance speed.
Gunnar Peterson, a Los Angeles-based personal trainer:
Focus more on recovery–sleep, water and bodywork–because you are a little more: “seasoned,” but you are by no means limited. Make sure your strength training is comprehensive and “pre-habilitative.” At 65, you should challenge your balance system, keep lifting weights. And have fun–you’ve earned it.
Wednesday, April 5, 2017
Is It Harder to Lose Weight When You’re Older?
By Karen Weintraub, NY Times, March 31, 2017
Q. Is it more difficult for an older person to lose weight?
A. Yes, unfortunately. Although it is possible to lose weight at any age, several factors make it harder to lose weight with age.
Even those who remain active lose muscle mass every decade beginning in their 30s, research suggests, replacing it with fat. Muscles use up more calories than fat, so less muscle means a slower metabolism and the need for fewer calories, said Dr. Medha Munshi, a geriatrician and endocrinologist at Beth Israel Deaconess Medical Center in Boston.
Declining levels of the sex hormones estrogen and testosterone, which typically start around the early 50s for women, with the onset of menopause, and somewhat later for men, compound the effect, said Dr. Munshi, who also directs the Joslin Diabetes Center’s geriatric diabetes programs.
People may also pay in late-middle age for weight they gained and lost in earlier decades, said Dr. Leslie Cho, an interventional cardiologist at the Cleveland Clinic. Weight gain changes metabolism, she said. A 60-year-old who now weighs 200 pounds but once weighed 300, for example, will need far fewer calories per day than someone of the same age and size who was never so overweight. Losing those fat cells, she explained, tricks the body into thinking it is starving and needs to hold on more tightly to calories consumed. “You do have to eat less to maintain that weight if you’ve been heavy,” said Dr. Cho, who also directs the Cleveland Clinic’s Women’s Cardiovascular Center. .
Older people also tend to have more aches and pains and to be more sedentary, engaging in fewer physical activities.
Instead of obsessing about a number on a scale, Dr. Cho suggests that older people focus on general fitness. “It’s not about losing weight,” she said. “It’s about maintaining weight loss, but also about healthy eating and lifestyle.”
Adding muscle through weight training can also help speed up metabolism, or at least compensate somewhat for its decline, Dr. Munshi said. She tells her older patients that “you need it now more than you needed it at 25.” Eating more protein–but not more calories–may also help build or sustain muscle, she said. And she noted that many of her oldest patients end up underweight because they’ve lost their appetite along with their sense of smell, so food doesn’t seem appealing anymore.
Saturday, February 18, 2017
Why Exercise Is Good for the Heart
Even a single workout could be good for the heart. That’s the conclusion of a fascinating new study in mice that found that 30 minutes on a treadmill affects gene activity within cardiac cells in ways that, over the long haul, could slow the aging of the animals’ hearts.
Although the study involved mice, the results may help to explain just how, at a cellular level, exercise improves heart health in people as well.
It turned out that immediately after a single, 30-minute jog, the runners’ heart cells were noticeably different than those of the animals that had not moved. In particular, they showed higher levels of the proteins directly related to telomere length. These increases were slight but consistent. The runners’ cells also had markers of greater activity in the genes that respond to DNA stress than the nonrunners’ cells.
These findings indicate that a single, moderate workout beneficially alters telomere biology in the heart, says Andrew Ludlow, who was a doctoral candidate at the University of Maryland and lead author of the study. He currently is a postdoctoral researcher at the University of Texas Southwestern Medical Center.
Presumably, such changes would accumulate with repeated training, he says, and over time help to keep cardiac telomeres longer than without the exercise.
That process could be slow, though. In this study, many of the effects seen in the animals’ hearts immediately after the run were beginning to dissipate an hour later, with protein levels dropping back almost to those seen in the sedentary mice.
So it may be necessary, Dr. Ludlow says, to stick with an exercise routine for some time in order to realize the cellular benefits for the heart.
It is also worth repeating that this study involved mice, not people.But the implications are encouraging. It looks like getting up and moving may start to immediately change how the heart’s cells work, Dr. Ludlow says, in ways that “seem to make gene expression more youthful and keep the heart young.”
Saturday, January 14, 2017
Weekend Warriors Show Survival Benefits
Working out only on the weekends or otherwise compressing your total physical activity into one or two prolonged runs or a single vigorous basketball or soccer game each week could lessen your risks of dying prematurely almost as effectively as more frequent, shorter workouts spread throughout the week, according to an interesting new study of the so-called weekend warrior phenomenon.
As most of us have heard by now, the standard recommendation about how much exercise we should complete each week for health purposes is 150 minutes of moderate or 75 minutes of vigorous physical activity. Moderate exercise consists of activities like brisk walking or easy cycling that raise heart rates while still allowing us to talk to training partners, and vigorous activities are those like running, fast-paced cycling, and many team sports, including basketball and soccer, that raise heart rates into a zone where speaking is difficult.
Meeting these guidelines is associated with a substantially reduced risk of developing a wide range of diseases and dying too young.
The guidelines also suggest that, for practical purposes, people consider breaking the 150 minutes into five moderate 30-minute sessions each week or a comparable number of shorter, more vigorous workouts.
But many people apparently do not have the time or inclination to exercise five times per week. About a third of American adults engage in zero weekly exercise and others pack their workouts into one or two sessions on Saturday or Sunday, when they have more free time.
There has been little information, though, about whether the weekend warrior pattern of exercise lowers the risk for premature death as effectively as more frequent and generally shorter workouts.
So for the new study, which was published on Monday in JAMA Internal Medicine, researchers at Loughborough University in England and other institutions decided to delve into the exercise routines of tens of thousands of men and women already participating in the Health Survey for England and the Scottish Health Survey.
The researchers zeroed in on data from 63,591 middle-aged men and women who had provided detailed descriptions of their workout patterns when they first entered the study at least 15 years before, telling the survey questioners how many minutes they had exercised each week during the past month, what kinds of exercise they had undertaken, and how many times per week they had worked out.
The researchers used that data to categorize the men and women into a variety of groups. Those who never exercised were defined, unsurprisingly, as inactive, while those who worked out but did not meet the standard guidelines were considered insufficiently active. Those who did exercise for the full 150 gentle or 75 vigorous weekly minutes were labeled sufficiently active.
This last group was then subdivided into those who spread their physical activity over at least three sessions and those who jammed it into one or two workouts, presumably on weekends (although the actual days were not specified).
Interestingly, these weekend warriors were mostly male, almost half exercised only once per week, and an overwhelming majority, almost 90 percent, reported that their exercise occurred during vigorous sports like competitive running and cycling or team sports like soccer.
Finally, the researchers crosschecked their participants against death registries, to determine mortality in the intervening years since each person had joined the original survey.
It turned out that exercise, in any amount, had substantially lessened the risk that someone would die from any cause, including heart disease and cancer. Men and women who exercised, even if they did not meet the guideline recommendations, were about 29 percent less likely to die prematurely than people who never worked out.
Those who met the recommendations gained a slight edge in longevity, being about 30 percent less likely to have died than people who never exercised.
This advantage remained about the same whether people worked out three or more times during the week or jammed all of their activity into a session or two.
“Reductions in risk were similar in the weekend warriors and the regularly active,” says Gary O’Donovan, a research associate at Loughborough University who led the study.
The good news from this study, Dr. O’Donovan says, is that whatever type of activity you can fit into your schedule appears to be better for your longevity than no activity at all.
Sunday, December 18, 2016
Running as the Thinking Person’s Sport
Running seems to require a greater amount of high-level thinking than most of us might imagine. The sport seems to change how the brain works in surprising ways, according to a new report.
The study, published this month in Frontiers in Human Neuroscience, found that the brains of competitive distance runners had different connections in areas known to aid in sophisticated cognition than the brains of healthy but sedentary people. The discovery suggests that there is more to running than mindlessly placing one foot in front of another.
Scientists have known for some time that mastering certain activities demands considerable thought and consequently can alter the workings of the brain. Playing a musical instrument, for instance, requires refining a variety of fine motor skills, while also engaging memory, attention, forward planning and many other executive functions of the brain. So it’s not surprising that past brain-scanning studies have found that expert musicians tend to have greater coordination between areas of the brain associated with different kinds of thinking, as well as sensory processing and motor control, than do people who have never picked up a bassoon or other instrument.
Similarly, in neurological studies of athletes whose sports stress hand-eye coordination, strategizing and mental attention, such as badminton players and gymnasts, the athletes generally displayed greater interplay between parts of the brain devoted to cognition and mental focus than did the nonathletes.
But running is not usually considered to be cerebral. Most of us learned to run as toddlers, perhaps falteringly at first but progressively with more confidence, and afterward mostly stopped thinking about how to run, at least consciously.
So we would probably not, as a rule, expect running to activate parts of the brain that control advanced cognition.
But researchers at the University of Arizona suspected that running might in fact be intellectually demanding and could affect thinking patterns in people who run, even when they are not running.
To test that idea, the scientists recruited 11 competitive, collegiate male runners and another 11 young men who said that they had not exercised in the past year. The researchers used questionnaires and mathematical formulas to quantify the men’s physical activity levels and estimate their aerobic fitness. (They focused on men primarily because it is difficult to control for the effects of the menstrual cycle on the bodies and brains of young women.)
Then they had each volunteer lie quietly for six minutes in an M.R.I. scanner while the machine measured levels of activity in their brains.
The researchers were particularly interested in any coordinated activity between different parts of the brain, as indicated by areas of the brain that were simultaneously lighting up in similar ways. Such synchronized activation is thought to indicate that parts of the brain have developed functional connections, even if they are physically separated from one another.
It turned out that the runners’ brains displayed a number of different connections than did the brains of the sedentary young men, and those connections involved areas of the brain needed for higher-level thought.
In particular, the scientists noted more connectivity in the runners than in the inactive men between parts of the brain that aid in working memory, multitasking, attention, decision-making, and the processing of visual and other sensory information.
There also, interestingly, was less activity among the runners in a part of the brain that tends to indicate lack of focus and mind wandering.
In essence, the runners seemed to have brains in which certain cognitive skills, including multitasking and concentration, were more finely honed than among the inactive men. Earlier studies in older adults have found that similar connections are associated with improved memory and cognition as people age.
“To me, this suggests that running may not be such a simple activity after all,” says Gene E. Alexander, a professor of psychology, neurology and physical sciences at the University of Arizona. He co-led the study in conjunction with David Raichlen, a professor of anthropology at the university.
Instead, running seems to be a kind of mobile math puzzle. “It requires complex navigational skills,” Dr. Alexander says, “plus an ability to plan, monitor and respond to the environment, juggle memories of past runs and current conditions, and also continue with all of the sequential motor activities of running, which are, themselves, very complicated.”
Given running’s mental demands, he was not surprised, he says, that the runners’ brains indicated differing thinking patterns than in the sedentary young men.
Of course, this type of study cannot prove that running actually caused the differences in the men’s thinking, only that runners had certain patterns of thought.
Likewise, it is unclear whether running, alone, has such effects, or if other endurance sports, including cycling and swimming, would be associated with similar brain connections, or whether people who are not college-aged and male would respond in the same ways. The scientists also did not test their volunteers’ cognition, so they could not say whether the differing thinking patterns among the runners were linked with being smarter.
But Dr. Alexander and his colleagues hope to perform experiments in the future that could tell us more about how running and other physical activities actually alter thinking patterns and whether, as we age, we might be able literally to run away from mental decline.
Thursday, November 17, 2016
Genetic Heart Disease Risk Eased by Healthy Habits, Study Finds
Is genetics destiny when it comes to heart disease?
A new analysis of data from more than 55,000 people provides an answer. It finds that by living right–by not smoking, by exercising moderately and by eating a healthy diet heavy in fruits, vegetables and grains–people can tamp down even the worst genetic risk.
“DNA is not destiny; it is not deterministic for this disease,” said Dr. Sekar Kathiresan, the director of the Center for Human Genetic Research at Massachusetts General Hospital. “You do have control over the problem, even if you have been dealt a bad genetic hand.”
The research, by Dr. Kathiresan and his colleagues, is the first attempt to use large data sets to tease apart the effects of genes and lifestyle in heart disease, researchers said. It was published on Sunday in The New England Journal of Medicine to coincide with the presentation of the results at the annual meeting of the American Heart Association.
About 365,000 people die of coronary heart disease–the most common type–annually in the United States, and 17.3 million worldwide, making it one of the biggest killers.
The investigators found that genes can double the risk of heart disease, but a good lifestyle cuts it in half. Just as important, they found, a terrible lifestyle erases about half of the benefits of good genetics.
According to Dr. Lawrence J. Appel, the director of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins Medical Institutions, you do not have to have an exemplary lifestyle to reap a big benefit. It looks as if the biggest protective effect by far came from going from a terrible lifestyle to one that was at least moderately good.
The new study shows a new way to think about genes and lifestyle, researchers say.
“It’s very important,” said Dr. David Maron, the director of preventive cardiology at Stanford, who was not involved in the new study. “If you are dealt a bad hand, there are things you can do to attenuate the risk.”
Dr. Kathiresan is already using the study’s results when he sees patients, he said. The genetic test is not available outside of research studies, he said, but he often gets an idea of who has a worrisome genetic risk when he talks to patients.
“A poor man’s substitute,” he said, “is: ‘My dad died at 45 of a heart attack. I have a strong family history.’”
He now replies, “You have it in your power to change that risk.”
Thursday, October 20, 2016
The 8 Health Habits Experts Say You Need in Your 20s
If you had just one piece of health advice for people in their 20s, what would it be?
That’s the question we posed to a number of experts in nutrition, obesity, cardiology and other health disciplines. While most 20-year-olds don’t worry much about their health, studies show the lifestyle and health decisions we make during our third decade of life have a dramatic effect on how well we age.
Staying healthy in your 20s is strongly associated with a lower risk for heart disease in middle age, according to research from Northwestern University. That study showed that most people who adopted five healthy habits in their 20s–a lean body mass index, moderate alcohol consumption, no smoking, a healthy diet and regular physical activity–stayed healthy well into middle age.
And a disproportionate amount of the weight we gain in life is accumulated in our 20s, according to data from the Centers for Disease Control and Prevention. The average woman in the United States weighs about 150 when she’s 19, but by the time she’s 29, she weighs 162 pounds–that’s a gain of 12 pounds. An average 19-year-old man weighs 175 pounds, but by the time he hits 29 he is nine pounds heavier, weighing in at 184 pounds.
But it can be especially difficult for a young adult to focus on health. Young people often spend long hours at work, which can make it tough to exercise and eat well. They face job pressure, romantic challenges, money problems and family stress. Who has time to think about long-term health?
To make it easier, we asked our panel of experts for just one simple piece of health advice. We skipped the obvious choices like no smoking or illegal drug use–you know that already. Instead we asked them for simple strategies to help a 20-something get on the path to better health. Here’s what they had to say.
Weigh yourself often.–Susan Roberts, professor of nutrition at Tufts University and co-founder of the iDiet weight management program.
Buy a bathroom scale or use one at the gym and weigh yourself regularly. There is nothing more harmful to long-term health than carrying excess pounds, and weight tends to creep up starting in the 20s. It is pretty easy for most people to get rid of three to five pounds and much harder to get rid of 20. If you keep an eye on your weight you can catch it quickly.
Learn to cook.–Barbara J. Rolls, professor and Guthrie Chair of Nutritional Sciences at Penn State
Learning to cook will save you money and help you to eat healthy. Your focus should be on tasty ways to add variety to your diet and to boost intake of veggies and fruits and other nutrient-rich ingredients. As you experiment with herbs and spices and new cooking techniques, you will find that you can cut down on the unhealthy fats, sugar and salt, as well as the excess calories found in many prepared convenience foods. Your goal should be to develop a nutritious and enjoyable eating pattern that is sustainable and that will help you not only to be well, but also to manage your weight.
Cut back on sugar.–Steven E. Nissen, chairman of cardiovascular medicine at the Cleveland Clinic Foundation
I suggest that young people try to avoid excessive simple sugar by eliminating the most common sources of consumption: 1) sugared soft drinks 2) breakfast cereals with added sugar and 3) adding table sugar to foods. Excessive sugar intake has been linked to obesity and diabetes, both of which contribute to heart disease. Sugar represents “empty calories” with none of the important nutrients needed in a balanced diet. Conversely, the traditional dietary villains, fat, particularly saturated fat, and salt, have undergone re-examination by many thoughtful nutrition experts. In both cases, the available scientific evidence does not clearly show a link to heart disease.
Live an active life.–Walter Willett, chairman of the nutrition department at the Harvard School for Public Health
While many people can’t find time for a scheduled exercise routine, that doesn’t mean you can’t find time to be active. Build physical activity into your daily life. Find a way to get 20 or 30 minutes of activity each day, including riding a bike or briskly walking to work.
Eat your veggies.–Marion Nestle, professor of nutrition, food studies and public health at New York University
Nutrition science is complicated and debated endlessly, but the basics are well established: Eat plenty of plant foods, go easy on junk foods, and stay active. The trick is to enjoy your meals, but not to eat too much or too often.
Practice portion control.–Lisa R. Young, adjunct professor of nutrition at New York University
My tip would be to not to ban entire food groups but to practice portion control. Portion control doesn’t mean tiny portions of all foods–quite the opposite. It’s okay to eat larger portions of healthy foods like vegetables and fruit. No one got fat from eating carrots or bananas. Choose smaller portions of unhealthy foods such as sweets, alcohol and processed foods. When eating out, let your hand be your guide. A serving of protein like chicken or fish should be the size of your palm. (Think 1-2 palms of protein.) A serving of starch, preferably a whole grain such as brown rice or quinoa should be the size of your fist. Limit high-fat condiments like salad dressing to a few tablespoons–a tablespoon is about the size of your thumb tip.
Adopt a post-party exercise routine.–Barry Popkin, professor of global nutrition at the University of North Carolina at Chapel Hill
If you engage in a lot of drinking and snacking, ensure you exercise a lot to offset all those extra calories from Friday to Sunday that come with extra drinking and eating. We found in a study that on Friday through Sunday young adults consumed about 115 more calories than on other days, mainly from fat and alcohol.
Find a job you love.–Hui Zheng, associate sociology professor, population health, Ohio State University
Ohio State University research found that work life in your 20s can affect your midlife mental health. People who are less happy in their jobs are more likely to report depression, stress and sleep problems and have lower overall mental health scores. If I can give just one piece of health advice for 20-year-olds, I would suggest finding a job they feel passionate about. This passion can keep them motivated, help them find meaning in life, and increase expectations about their future. That in turn will make them more engaged in life and healthier behaviors, which will have long term benefits for their well-being.
Thursday, September 29, 2016
Walking Fends Off Disability, And It’s Not Too Late To Start
People who have reached their later years may think it’s primarily a time to relax, not to increase their physical activity. Not so. Previous research has suggested that exercise can improve memory and reverse muscle loss in older adults, among other benefits. And a study out Monday finds that a regular program of physical activity reduces the time spent with mobility-limiting disability.
Researchers took more than 1,600 sedentary people between 70 and 89 years old who had some functional limitations, but who could walk about a quarter of a mile in 15 minutes or less, unassisted by another person or a walker. (Canes were OK.)
Half of the participants got a health education program involving regular in-person sessions and some stretching exercises, while the other group was told to aim for 150 minutes of aerobic activity as well as strength, flexibility and balance training both at the study’s facilities and at home. “Walking was the cornerstone of the program,” says Thomas Gill, a professor of geriatrics at the Yale School of Medicine and an author of the study, which appears in Annals of Internal Medicine.
The study followed participants for about 2.7 years, and found that the physical activity program cut the amount of time that people spent with a “major mobility disability”–defined as being unable to walk a quarter mile–by 25 percent compared to the education program. Previous findings from the same study showed that the exercise program lowered the risk of becoming disabled in the first place; this one showed that it sped recovery from an episode of disability and lowered the risk of subsequent episodes.
“They’ve done a really nice job of showing the incredible power of physical activity,” says Bradley Cardinal, a professor of kinesiology at Oregon State University who wasn’t involved with the study. “It’s the secret ingredient to successful aging in terms of quality of life.” An editorial accompanying the study, by the University of California, San Francisco’s Patricia Katz and the University of South Carolina’s Russell Pate, also noted that people who engage in physical activity have a lower risk for heart disease, diabetes, certain cancers, depression, cognitive impairment and functional decline.
The exercise program pretty closely followed the government’s recommendations for all adults, including older ones: 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity exercise per week, plus two strength sessions that hit all the major muscle groups.
But most Americans don’t get that much exercise, and that becomes increasingly true as people age. According to statistics from the Centers for Disease Control and Prevention, just 28 percent of those 75 and up meet the recommendation for aerobic activity, and only 8 percent also did the suggested amount of strength training.
Cardinal says older adults need to realize that exercise can greatly improve their quality of life by maximizing function as long as possible. But he says that many believe that older age is for relaxing and that physical activity is somehow dangerous or unnatural. That belief “is pervasive among older adults,” he says, even though for many of them, meeting the minimum requirements “is doable.”
Semantics can help. “We try to frame this as more physical activity than exercise,” says Gill. “We talk with older folks and many say, ‘I can’t exercise, but maybe I can become more physically active.’” Study participants were advised to “start low and go slow,” and some were even able to get rid of their canes after six months of exercise, which Gill says they found particularly rewarding.
There are some basic behavioral strategies for getting yourself to get moving, no matter your age, including giving yourself an incentive to change and engineering your environment to encourage the activity.
Monday, August 8, 2016
Monday, August 1, 2016
To Boost Memory: Study, Wait, Then Exercise
Learning requires more than the acquisition of unfamiliar knowledge; that new information or know-how, if it’s to be more than ephemeral, must be consolidated and securely stored in long-term memory.
Mental repetition is one way to do that, of course. But mounting scientific evidence suggests that what we do physically also plays an important role in this process. Sleep, for instance, reinforces memory. And recent experiments show that when mice and rats jog on running wheels after acquiring a new skill, they learn much better than sedentary rodents do. Exercise seems to increase the production of biochemicals in the body and brain related to mental function.
Researchers at the Donders Institute for Brain, Cognition and Behavior at Radboud University in the Netherlands and the University of Edinburgh have begun to explore this connection. For a study published this month in Current Biology, 72 healthy adult men and women spent about 40 minutes undergoing a standard test of visual and spatial learning. They observed pictures on a computer screen and then were asked to remember their locations.
Afterward, the subjects all watched nature documentaries. Two-thirds of them also exercised: Half were first put through interval training on exercise bicycles for 35 minutes immediately after completing the test; the others did the same workout four hours after the test.
Two days later, everyone returned to the lab and repeated the original computerized test while an M.R.I. machine scanned their brain activity.
Those who exercised four hours after the test recognized and recreated the picture locations most accurately. Their brain activity was subtly different, too, showing a more consistent pattern of neural activity. The study’s authors suggest that their brains might have been functioning more efficiently because they had learned the patterns so fully. But why delaying exercise for four hours was more effective than an immediate workout remains mysterious. By contrast, rodents do better in many experiments if they work out right after learning.
Eelco van Dongen, the study’s lead author and a former researcher at Radboud University (he is now a policy officer at the Netherlands Organization for Scientific Research), hopes that future studies will help determine both the optimal time to exercise and the ideal activity to reinforce learning. Workouts that are too strenuous “could be less positive or even detrimental” to acquiring knowledge, Dr. van Dongen says, while gentle exertions–“a short, slow walk,” he adds–might not prompt enough of an increase in the biochemicals needed to influence how the brain learns.
For now, he says, if you are trying to memorize a PowerPoint narrative or teach yourself macroeconomics, it could be beneficial to exercise a few hours after a study session. “Long-term memory is not only influenced by what happens when you learn new things,” he says, “but also by the processes that take place in the hours and days afterward, when new information is stabilized and integrated in your brain.”
Monday, July 18, 2016
Can Running Make You Smarter?
To strengthen your mind, you may first want to exert your leg muscles, according to a sophisticated new experiment involving people, mice and monkeys. The study’s results suggest that long-term endurance exercise such as running can alter muscles in ways that then jump-start changes in the brain, helping to fortify learning and memory.
I often have written about the benefits of exercise for the brain and, in particular, how, when lab rodents or other animals exercise, they create extra neurons in their brains, a process known as neurogenesis. These new cells then cluster in portions of the brain critical for thinking and recollection.
Even more telling, other experiments have found that animals living in cages enlivened with colored toys, flavored varieties of water and other enrichments wind up showing greater neurogenesis than animals in drab, standard cages. But animals given access to running wheels, even if they don’t also have all of the toys and other party-cage extras, develop the most new brain cells of all.
These experiments strongly suggest that while mental stimulation is important for brain health, physical stimulation is even more potent.
But so far scientists have not teased out precisely how physical movement remakes the brain, although all agree that the process is bogglingly complex.
Fascinated by that complexity, researchers at the National Institutes of Health recently began to wonder whether some of the necessary steps might be taking place far from the brain itself, and specifically, in the muscles, which are the body part most affected by exercise. Working muscles contract, burn fuel and pump out a wide variety of proteins and other substances.
The N.I.H. researchers suspected that some of those substances migrated from the muscles into the bloodstream and then to the brain, where they most likely contributed to brain health.
But which substances were involved was largely a mystery.
So for the new study, which was published last month in Cell Metabolism, the N.I.H. researchers first isolated muscle cells from mice in petri dishes and doused them with a peptide that affects cell metabolism in ways that mimic aerobic exercise. In effect, they made the cells think that they were running.
Then, using a technique called mass spectrometry, the scientists analyzed the many chemicals that the muscle cells released after their pseudo-workouts, focusing on those few that can cross the blood-brain barrier.
They zeroed in on one substance in particular, a protein called cathepsin B. The protein is known to help sore muscles recover, in part by helping to clear away cellular debris, but it had not previously been considered part of the chain linking exercise to brain health.
To determine whether cathepsin B might, in fact, be involved in brain health, the researchers added a little of the protein to living neurons in other petri dishes. They found that those brain cells started making more proteins related to neurogenesis.
Cathepsin B also proved to be abundant in the bloodstreams of mice, monkeys and people who took up running, the scientists found. In experiments undertaken in collaboration with colleagues in Germany, the researchers had mice run for several weeks, while rhesus monkeys and young men and women took to treadmills for four months, exercising vigorously about three times a week for approximately an hour or sometimes longer.
During that time, the concentrations of cathepsin B in the jogging animals and people steadily rose, the researchers found, and all of the runners began to perform better on various tests of memory and thinking.
Finally, because there’s nothing like removing something from the body to underscore how important it may be, the scientists bred mice without the ability to create cathepsin B, including after exercise. The researchers had those mice and other, normal animals run for a week, then taxed their ability to learn and retain information.
After running, the normal mice learned more rapidly than they had before and also held on to those new memories well. But the animals that could not produce cathepsin B learned haltingly and soon forgot their new skills. Running had not helped them to become smarter.
The lesson of these experiments is that our brains appear to function better when they are awash in cathepsin B and we make more cathepsin B when we exercise, says Henriette van Praag, an investigator at the National Institute on Aging at the N.I.H. who oversaw this study.
Of course, increases in cathepsin B explain only part of the benefits of exercise for the brain, she said. She and her colleagues plan to continue looking for other mechanisms in future studies.
They also hope to learn more about how much exercise is necessary to gain brain benefits. The regimen that the human runners followed in this study was “fairly intensive,” she said, but it’s possible that lighter workouts would be almost as effective.
“There is good reason to think,” she said, “that any amount of exercise is going to be better than none” for brain health.
Friday, July 8, 2016
Walking for a Better Brain
Edward Payson Weston started off on foot from New York to San Francisco in March 1909. He was 70 years old, and would eventually arrive 105 days later, averaging about 40 miles per day. Not surprisingly, his walk triggered a lot of talk about aging and the abilities of the elderly.
Coincidentally, that same year, several men gathered at the house of G. Stanley Hall, president of the American Psychological Association, in Worcester, Massachusetts. Present were three well-known psychologists: William James, Sigmund Freud, and Carl Jung.
While the science of psychology had been around for some time–the first laboratory of experimental psychology had been founded in Leipzig in 1879, and James was considered a pioneer in the field–gerontology, the study of aging, had only recently arisen, with the term itself coined in 1903. Harvard historian Jill Lepore has referred to Hall as the founder of gerontology, among the first to understand that senescence–the opposite of adolescence–was a period worth studying on its own. “Old age takes everyone by surprise, and no one ever really comes to terms with it,” Lepore wrote. “Hall thought this was because old age is the only stage of life we never grow out of, and can never look back on, not on this earth, anyway.”
Others had given thought to aging, of course–ancient Arabs had various special treatments just for the elderly–but no one person had drawn as much attention to theories of aging at the time as the McGill University-trained doctor Sir William Osler. Osler was the chief physician at Johns Hopkins Hospital in Baltimore for 14 years, and he found unwitting global fame in 1905 after making an offhand comment during his Johns Hopkins valedictory address before repairing to England to teach at Oxford. Osler spoke of the “comparative uselessness of men above 40 years of age,” and made an apparently jocular reference to the Anthony Trollope novel The Fixed Period, which averred that man’s work was done by age 40, and that he ought to be “chloroformed at 60.”
Ironic comments sometimes fail to travel with their quotation marks. Osler spent much of his remaining years on the earth insisting that, no, really, it was all in jest, and that he actually didn’t believe people over 60 should be done in. (He was 55 when he made the speech. His Times obituary pointed out that “he reached the age of 70 himself, and his last 10 years formed a period of great activity and of his greatest influence.”)
During Weston’s 1909 walk, Osler’s accidental controversy was far from extinguished, and Weston–never averse to publicity–was happy to see his walk prompt the debate to flare anew. Discussion took place in newspapers and drawing rooms and among knots of people gathered along the roads to watch Weston pass by. Most had to agree that he looked healthy and active. With his pluck and dauntless walking style, he demonstrated what those of advanced years can accomplish if they put their minds to it.
“Many physicians, of this city at least,” reported the New York Times, were watching his trip closely. “Their interest is not excited alone by the nature of the feat, though all hold it marvelous that a man of Weston’s age is capable of even attempting it; they are looking deeper, watching for the effect which this example will have in renewing the lost interest in walking as a pastime and an exercise, and for the effect they believe it will have in counteracting the theory they condemn–the theory that at the age of 50 or thereabouts a man is ‘down and out.’”
A column in the Dallas Morning News admitted that many considered Weston’s walk from ocean to ocean “foolishness” and “an idle waste of time.” But, the writer asked, was it “preferred to the needless senility into which far too many men begin to drift at the period of three score years and 10?” The writer chastised those who chose inertness when their working days were over, “lounging about in the sort of aimless apathy which benumbs the soul and closes up all the channels of sensation.” He went on: “Remember that there is mighty little excitement of divertissement in shuffling to town twice a day ‘for the mail,’” and that lapsing into indolence was “far more foolish and ill-advised than it was for Edward Payson Weston to start on his 70th birthday, to walk from New York to San Francisco.”
Around the time of Weston’s walk, exercise at an advanced age was often regarded in poor favor, as if practitioners were involved in a zero-sum game: If you exercised too much, you sacrificed mental agility. A “nerve specialist” from New York named J. Leonard Corning said in 1909 that he was opposed to “excessive exercise,” which was what he believed Weston’s attempt to be. He thought that with the “over-cultivation of the physique the mentality suffered.”
Corning wrote during a period when experts widely believed that brain cells didn’t regenerate. As a result, graceful aging was in large part a matter of learning to cope with gradually diminishing brain capacity. Modern science has shown that’s not the case; we generate new brain cells throughout our lives, although the process can become increasingly imperfect and less efficient with age, as it does with much cellular activity.
But staying active helps. One study of older rats suggested that running for a total of just 11 to 15 minutes four times a week for four weeks led to healthy developments in the parts of the brain associated with memory; these rats then performed better than sedentary rats did on spatial memory tests. That’s proving true in human testing as well. One of the largest studies ever conducted was on a group of 121,000 nurses, who were surveyed on a wide range of their health and lifestyle habits starting in 1976. The survey was repeated every two years. The results, published in The Journal of the American Medical Association, suggested that those who exercised the most–the group that maintained a median level of walking for six hours a week–were 20 percent less likely to show cognitive impairment than those who exercised the least.
Other long-term studies also show that even modest exercise can serve as a bulwark against dementia.
Peter Snyder of Brown University’s Alpert Medical School, who studies the effects of aging on the brain, recently told National Public Radio that “what we’re finding is that of all of these noninvasive ways of intervening, it is exercise that seems to have the most efficacy at this point–more so than nutritional supplements, vitamins and cognitive interventions … The literature on exercise is just tremendous,” he said.
Indeed, a 20-year-long study in 2010 found that walking just five miles per week “protects the brain structure” over a 10-year period in people with Alzheimer’s disease and in those who exhibit signs of mild cognitive impairment. Another study, from 2012, supported those findings, also concluding that even moderate walking helped stave off further deterioration among elderly people in the early stages of Alzheimer’s disease.
While different studies arrive at moderately different conclusions via various routes, the recent research of dozens of scientists more often than not converges at a single intersection. And that consistently suggests that if you exercise, your brain will be fitter than if you don’t. This applies to the young, those in the prime of their days, and especially to the elderly.
Weston certainly didn’t know the details, but he understood the contours of the benefits of walking. And others noticed. “Edward Payson Weston is a living example of what open air, temperance, exercise, and healthy-mindedness will do for the human race,” one newspaper trumpeted just days after the walking septuagenarian departed New York for San Francisco. “His example is worth a hundred sermons.”
Weston went on not only to walk from New York to San Francisco, but the following year from Los Angeles to New York. With more cooperative weather on a southern route and tail winds pushing him on, he made it in 77 days. At age 74 he walked from New York to Minneapolis, and then at 83 from Buffalo to New York.
But eventually, the car won. At 88 he stepped off a curb in Manhattan and was struck by a cab. It didn’t kill him, but he wouldn’t walk again. Bedridden, he lived to 90 and died shortly thereafter.
In his nine decades, he’d not only rebuffed Osler, but was emerged as a prescient advocate for the benefits of walking–as a way to quietly collaborate with body, brain and even society at large to build something better.
“Anyone can walk,” Weston said in 1910. “It’s free, like the sun by day and the stars by night. All we have to do is get on our legs, and the roads will take us everywhere.”
