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.”

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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.

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Why Exercise Is Good for the Heart

By Gretchen Reynolds, NY Times, Feb. 15, 2017

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.”

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Weekend Warriors Show Survival Benefits

By Gretchen Reynolds, NY Times, Jan. 11, 2017

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.

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Running as the Thinking Person’s Sport

By Gretchen Reynolds, NY Times, Dec. 14, 2016

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.

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Can Running Make You Smarter?

By Gretchen Reynolds, NY Times, July 13, 2016

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.

Most striking, in the human volunteers, the men and women whose fitness had increased the most–suggesting that they had run particularly intensely–not only had the highest levels of cathepsin B in their blood but also the most-improved test scores.

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.

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Closest Thing to a Wonder Drug? Try Exercise

Aaron E. Carroll, NY Times, June 20, 2016

After I wrote last year that diet, not exercise, was the key to weight loss, I was troubled by how some readers took this to mean that exercise therefore had no value.

Nothing could be further from the truth. Of all the things we as physicians can recommend for health, few provide as much benefit as physical activity.

In 2015, the Academy of Medical Royal Colleges put out a report calling exercise a “miracle cure.” This isn’t a conclusion based simply on some cohort or case-control studies. There are many, many randomized controlled trials. A huge meta-analysis examined the effect of exercise therapy on outcomes in people with chronic diseases.

Let’s start with musculoskeletal diseases. Researchers found 32 trials looking specifically at the effect of exercise on pain and function of patients with osteoarthritis of the knee alone. That’s incredibly specific, and it’s impressive that so much research has focused on one topic.

Exercise improved those outcomes. Ten more studies showed, over all, that exercise therapy increases aerobic capacity and muscle strength in patients with rheumatoid arthritis. Other studies proved its benefits in other musculoskeletal conditions, like ankylosing spondylitis, and even some types of back pain.

For people (mostly middle-aged men) who had had a heart attack, exercise therapy reduced all causes of mortality by 27 percent and cardiac mortality by 31 percent. Fourteen additional controlled trials showed physiological benefits in those with heart failure. Exercise has also been shown to lower blood pressure in patients with hypertension, and improve cholesterol and triglyceride levels.

People with diabetes who exercise have lower HbA1c values, which is the marker of blood sugar control, low enough to probably reduce the risk of complications from the disease. Twenty randomized controlled trials have showed that patients with chronic obstructive pulmonary disease can walk farther and function better if they exercise.

Multiple studies have found that exercise improves physical function and health-related quality of life in people who have Parkinson’s disease. Six more studies showed that exercise improves muscle power and mobility-related activities in people with multiple sclerosis. It also appeared to improve those patients’ moods.

The overall results of 23 randomized controlled trials showed that exercise most likely improves the symptoms of depression. Five others appear to show that it improves symptoms in patients with chronic fatigue syndrome. In trials, exercise even lessened fatigue in patients who were having therapy for cancer.

What other intervention can claim results like these?

Even studies of older, hospitalized patients show a beneficial effect from multidisciplinary interventions that include exercise. Those randomized to such interventions in the hospital were more likely to be discharged to go home, and to spend less time in the hospital over all–and at a lower cost.

Although we don’t think of it this way, you can make a pretty good argument that exercise is as good as drugs for many conditions. A 2013 meta-analysis of meta-analyses (that’s how much data we have) combined and analyzed the results from 16 reviews of randomized controlled trials of drug and exercise interventions in reducing mortality. Collectively, these included 305 trials with almost 340,000 participants.

Diuretic drugs (but not all drugs) were shown to be superior to exercise in preventing death from heart failure. But exercise was found to be equally good as drugs in preventing mortality from coronary heart disease. Exercise was better than drugs in preventing death among patients from strokes.

Many people will be surprised at how little you need to do to achieve these results. Years ago, in an effort to get in shape, I tried the P90X routine. It proved too hard for me. Later, when I tried the Insanity workout, it beat me so badly that people at work kept asking me if I was ill. Two years ago, I tried P90X3. It was a bit more manageable, but I still couldn’t keep it up.

I have not been alone in thinking that physical activity to improve health should be hard. When I hear friends talk about exercising, they discuss running marathons, participating in cross-fit classes or sacrificing themselves on the altar of SoulCycle. That misses the point, unfortunately. All of these are much more than you need to do to get the benefits I’ve described.

The recommendations for exercise are 150 minutes per week of moderate intensity physical activity for adults, or about 30 minutes each weekday.

Moderate intensity is probably much less than you think. Walking briskly, at 3 to 4 miles per hour or so, qualifies. So does bicycling slower than 10 miles an hour. Anything that gets your heart rate somewhere between 110 and 140 beats per minute is enough. Even vacuuming, mowing the lawn or walking your dog might qualify.

Today, my goals are much more modest. Trekking from my office to the clinic and back again gives me 30 minutes of exercise. Or, I walk to the supermarket from my office to grab lunch, at a mile each way. In colder weather, I spend half an hour on the elliptical machine. Doing this five days a week gets me the activity I need.

Although it feels as if there’s nothing we can do to change people’s behavior, there is evidence to the contrary. A systematic review and meta-analysis of advice and counseling by health professionals found that promotion of physical activity works.

Doctors and clinics that made efforts to promote exercise to patients needed to engage 12 adults on the subject to get one additional adult to meet recommended levels of activity one year later. That might not sound impressive, but it’s one of the better such results.

After the Academy of Medical Royal Colleges wrote its report, an editorial in the BMJ, a prominent medical journal, countered that exercise wasn’t a “miracle cure.” Instead, the authors argued it was “the best buy for public health.”

If that’s the best “counterpoint,” then physical activity seems like a no-brainer.

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At 100, Still Running for Her Life

By Noah Remnick, NY Times, April 22, 2016.

On a cloudless Sunday afternoon in April, a 100-year-old woman named Ida Keeling laced up her mustard yellow sneakers and took to the track at the Fieldston School in the Bronx. Her arrival was met without fanfare. In fact, no one in the stands seemed to notice her at all.

It is possible the spectators were distracted by the girls’ soccer game taking place on the field. Or perhaps they were simply unaware that Ms. Keeling is a reigning national champion.

When she runs, Ms. Keeling occupies a lane all her own. She has held several track-and-field records since she began racing in her late 60s, and she still has the fastest time for American women ages 95 to 99 in the 60-meter dash: 29.86 seconds. In the week to come, she plans to compete in a 100-meter event at the Penn Relays in Philadelphia, where she hopes to establish a new standard for women over 100 years old.

“You see so many older people just sitting around–well, that’s not me,” said Ms. Keeling, who is barely 4-foot-6 and weighs 83 pounds. “Time marches on, but I keep going.”

Ms. Keeling was not always such an accomplished runner. As a child growing up in Harlem, she preferred riding bikes or jumping rope. With Title IX half a century away, there were few opportunities for girls, let alone black girls, to play organized sports. When she did run, it was always to race, never to exercise.

“I was pretty fast as a girl,” she said. “What makes me faster now is that everyone else slowed down.”

When the Depression hit, Ms. Keeling’s athletic inclinations receded into memory, supplanted by a series of jobs washing windows and babysitting for neighbors. Her family, who for years lived in cramped quarters in the back of her father’s grocery, was forced into even more humbling circumstances when the store went out of business and her father began peddling fruits and vegetables from a pushcart for a living.

“I learned to stand on my own two feet during the Depression,” she said. “It taught you to do what you had to do without anyone doing it for you.”

Ms. Keeling’s resilience only deepened with time. After her husband died of a heart attack at 42, she was left to raise their four children on her own. She moved the family into a one-bedroom apartment in a Harlem housing project and took up work sewing in a factory, all the while contending with the abuses and indignities endured by black women in mid-20th-century America. As the civil rights movement took shape, Ms. Keeling became an active demonstrator, shuttling her children to Malcolm X speeches and boarding a predawn bus for the 1963 March on Washington.

“I always understood from mother that you die on your feet rather than live on your knees,” said her daughter Shelley Keeling.

Over time, that resolve was gravely tested. While serving overseas in the Navy, Ms. Keeling’s older son, Donald, developed a crippling drug addiction that he struggled to shed even after returning home to Harlem. His habit ensnared his younger brother, Charles, who had served in the Army. Ms. Keeling watched in horror as both boys, barrel-chested charmers who friends joked looked like superheroes, withdrew into the world of drugs.

In 1978, Ms. Keeling received a call from the police informing her that Donald had been hanged. Around two years later, the phone rang again: Charles was dead–beaten in the street with a baseball bat. Both killings were suspected to be drug-related; neither was ever solved.

“I’ve never felt a pain so deep,” Ms. Keeling recalled, her voice lowering to a whisper. “I couldn’t make sense of any of it and things began to fall apart.”

As Ms. Keeling fell into a deep depression, her health began to falter. Her blood pressure shot up, along with her heart rate. The image of her once-vital mother in such despair shook the younger Ms. Keeling. A lifelong track-and-field athlete whose trophies fill an entire room of her apartment, she intervened with the means of healing most familiar to her: running.

“It was trial by fire,” recalled Shelley Keeling, 64, who has coached track and field at Fieldston for 21 years. “Based on where she was emotionally, it just had to be.”

After some coaxing from her daughter, Ms. Keeling, then 67, registered for a five-kilometer race through Brooklyn. It had been decades since she had last gone running. The two women took off together, but the younger Ms. Keeling soon darted to the front of the pack as her mother drifted far behind. After a suspenseful respite, she was relieved to see her mother scamper across the finish line, barely out of breath.

“Good Lord, I thought that race was never going to end, but afterwards I felt free,” Ms. Keeling recalled. “I just threw off all of the bad memories, the aggravation, the stress.”

So began the sunset career of Ida Keeling, at a time when most of her peers were settling in for a future of seated yoga or abandoning athletics altogether. In the decades since, she has traveled across the world for competitions. She often races alone, the only contestant in her age group.

“Now I’m just chasing myself–there’s no one else to compete with,” she said. “It’s wonderful, but it feels a little crazy.”

Running gives Ms. Keeling a sense of serenity, she said. Her sinewy arms urge her body forward, each stride stronger than the last as she picks up momentum. Though she has developed arthritis and occasionally relies on a cane while walking, Ms. Keeling betrays none of her ailments as she runs.

To maintain her health, Ms. Keeling adheres to a stringent regimen of diet (“I eat for nutrition, not for taste”) and exercise (“I’ve got to get my hour in every day”). On a recent afternoon, Shelley Keeling led her mother through a routine that included push-ups, wall sits, shoulder presses and sprints back and forth on the balcony of her apartment in the Riverdale section of the Bronx. Ms. Keeling lives alone and says that self-sufficiency is a key to her longevity.

Ms. Keeling eschews food products with preservatives, favoring fresh grains and produce, along with limited portions of meat. Desserts are rarities, and a tablespoon of cod-liver oil supplements breakfast most mornings. Despite her exceptional discipline, Ms. Keeling allows herself one indulgence. “This is putting gas in the car,” she said before downing a tall shot of Hennessy.

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Walk, Jog or Dance: It’s All Good for the Aging Brain

By Gretchen Reynolds, NY Times, April 7, 2016:

More people are living longer these days, but the good news comes shadowed by the possible increase in cases of age-related mental decline. By some estimates, the global incidence of dementia will more than triple in the next 35 years. That grim prospect is what makes a study published in March in The Journal of Alzheimer’s Disease so encouraging: It turns out that regular walking, cycling, swimming, dancing and even gardening may substantially reduce the risk of Alzheimer’s.

Exercise has long been linked to better mental capacity in older people. Little research, however, has tracked individuals over years, while also including actual brain scans. So for the new study, researchers at the University of California, Los Angeles, and other institutions analyzed data produced by the Cardiovascular Health Study, begun in 1989, which has evaluated almost 6,000 older men and women. The subjects complete medical and cognitive tests, fill out questionnaires about their lives and physical activities and receive M.R.I. scans of their brains. Looking at 10 years of data from nearly 900 participants who were at least 65 upon entering the study, the researchers first determined who was cognitively impaired, based on their cognitive assessments. Next they estimated the number of calories burned through weekly exercise, based on the participants’ questionnaires.

The scans showed that the top quartile of active individuals proved to have substantially more gray matter, compared with their peers, in those parts of the brain related to memory and higher-­level thinking. More gray matter, which consists mostly of neurons, is generally equated with greater brain health. At the same time, those whose physical activity increased over a five-year period–though these cases were few–showed notable increases in gray-matter volume in those same parts of their brains. And, perhaps most meaningful, people who had more gray matter correlated with physical activity also had 50 percent less risk five years later of having experienced memory decline or of having developed Alzheimer’s.

“For the purposes of brain health, it looks like it’s a very good idea to stay as physically active as possible,” says Cyrus Raji, a senior radiology resident at U.C.L.A., who led the study. He points out that “physical activity” is an elastic term in this study: It includes walking, jogging and moderate cycling as well as gardening, ballroom dancing and other calorie-burning recreational pursuits. Dr. Raji said he hopes that further research might show whether this caloric expenditure is remodeling the brain, perhaps by reducing inflammation or vascular diseases.

The ideal amount and type of activity for staving off memory loss is unknown, he says, although even the most avid exercisers in this group were generally cycling or dancing only a few times a week. Still, the takeaway is that physical activity might change aging’s arc. “If we want to live a long time but also keep our memories, our basic selves, intact, keep moving,” Dr. Raji says.

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How Exercise May Lower Cancer Risk

By Gretchen Reynolds, NY Times, February 24, 2016:

The relationship between exercise and cancer has long both intrigued and puzzled oncologists and exercise physiologists.

Exercise is strongly associated with lowered risks for many types of cancer. In epidemiological studies, people who regularly exercise generally prove to be much less likely to develop or die from the disease than people who do not. At the same time, exercise involves biological stress, which typically leads to a short-term increase in inflammation throughout the body. Inflammation can contribute to elevated risks for many cancers.

Now, a new study in mice may offer some clues into the exercise-cancer paradox. It suggests that exercise may change how the immune system deals with cancer by boosting adrenaline, certain immune cells and other chemicals that, together, can reduce the severity of cancer or fight it off altogether.

But mice, obviously, are not people, and it is impossible to know from this study whether a similar process occurs in humans, although exercise, particularly moderately intense exercise such as jogging, has been shown to increase adrenaline and the production of natural killer immune cells in people, Dr. Hojman said.

“So the mechanisms,” she said, that seemed to partially protect the running mice in this study from malignancies, “can also happen in people,” perhaps providing one more incentive, if we still need it, to get up and move.

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Running gives your brain a workout, say scientists

Daily Telegraph, 09 Feb 2016

Running is not only good for your body, but also boosts your brainpower, according to a new study.

Researchers found that aerobic exercise increases the neuron reserves in the hippocampus area of the brain, responsible for learning.

And importantly, exercise such as running boosted these reserves far more than high intensity training (HIT) or resistance training.

The study, published in the Journal of Physiology: London, was carried out by Department of Psychology and the Department of Biology of Physical Activity at the University of Jyväskylä in Finland.

Lead researcher Professor Heikki Kainulainen said: “Aerobic exercise, such as running, has positive effects on brain structure and function, for example, the generation of neurons in the hippocampus, a brain structure important in learning.

“It has been unclear whether high-intensity interval training, referring to alternating short bouts of very intense anaerobic exercise with recovery periods, or anaerobic resistance training has similar effects on hippocampal neurogenesis in adulthood. “

The team studied rats who underwent sustained running, HIT and resistance training

Prof Kainulainen added: “The results indicate that the highest number of new hippocampal neurons was observed in rats that ran long distances and that also had a genetic predisposition to benefit from aerobic exercise.

“Compared to sedentary animals, HRT rats that ran voluntarily on a running wheel had 2-3 times more new hippocampal neurons at the end of the experiment.

“Resistance training had no such effect. Also the effects of HIT were minor. To conclude, only sustained aerobic exercise improved hippocampal neurogenesis in adult animals.”

Prof Kainulainen added: “The result is important because, according to previous research, the new hippocampal neurons produced as a result of neurogenesis are needed among other things for learning temporally and spatially complex tasks.

“It is possible that by promoting neurogenesis via sustained aerobic exercise, the neuron reserve of the hippocampus can be increased and thus also the preconditions for learning improved also in humans.”

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The Steve Fountaine Story!

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Steve Prefontaine, a Man of Passion!

By Aron Taylor, XCNation Founder | email

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The man, Steve Prefontaine has been described by so many in one word, Passion. He was considered for three decades the greatest long distance runner in American History and by far one of the most popular Track and Field athlete's of all time. At the time of his death at a young age of 24, Pre held 14 American Track and Field Records from 2,000 meters to 10,000 meters and was ranked the #3 most popular athlete in America competing with the likes of Wilt Chamberlain and Joe Namath. That Passion of Steve Prefontaine has defined the sport of American distance running for more than 40 years. From the streets of Coos Bay, Oregon to the legacy of excellence established while competing for the University of Oregon he was always defined by one word, Passion.

Steve Prefontaine inspired an entire generation of distance runners, coaches, and running enthusiasts. It wasn't that he was the best role model or that he was perfect it was how he performed when he stepped on the line to test himself against another human being. I think those who knew him best admired his loyalty, his dedication, his committment to his cause of justice, and to his unwavering loyalty to his friends. I admire Pre because of his commitment to prove to himself he was not a quitter. All those that watched him compete and all those who would remember always walked away with the feeling they had witnessed a masterpiece summarized by this statement, "that you can expect the best, more than the best from yourself each and every moment you compete". In the movie "Prefontaine" Bill Bowerman used the analogy that this mindset in running would directly correlate to winning in the game called life. 

Since the tragic and untimely death of Steve Prefontaine there have been many runners who have gone faster. All of his records have been broken. Runners from Galen Rupp, Matt Centrowitz, Leonel Manzano, to Nick Symmonds have won World Championship and Olympic Games medals. There are moments we see Pre's Passion in them. There are moments we do not. The reason we are continually inspired by one imperfect man was not in the number of trinckets that he accumulated, we do not remember him for the times of the distances he raced, or that he was some mythical role model who did not experience the struggles of life, we remember him for how much he expected from himself inspite of his challenges. It was the Passion Pre had to expect excellence from himself that inspired runners like Galen Rupp, and millions more that have never won state titles, or medals, or set records, to individual excellence in their moment, their game of life. From the 11-minute 3200 meter runner who aspires to run 10:59 and looks for that extra bit of juice or the junior varsity runner who just wishes to make the varsity team 1-time, we can look to the Passion that Pre had for the expectation of himself to push 1-more second, to give one more last ditch effort, to not give up when you have reached your limitation, to be ruggedly determined to push against that wall.

I have thought long and hard about why Steve Prefontaine should matter to runners today and why coaches today should consider one man, still relevant in a world where the expectation is winning and nothing else. Pre never won his Olympic Gold medal, but every one of us can run in a way, can live in a way, that with the finish line just ahead we can finish the race his death never allowed him to complete. We do not have to be defined by our failures, from the first place runner to the last place runner the expectation can be set to run without limits for yourself, to choose to finish Steve Prefontaines last race. To finish knowing how it feels to expect more. I believe only then will a runner, a person, understand what it feels like to hit the finish line knowing you had nothing left with 30 feet to go and somehow willed your way through to the end. This applies not to running but life. Always looking forward, never looking back. (Photo Art by Aron Taylor)

Prefontaine abhorred what he deemed corruption, injustice or unfairness and was not afraid to call a spade a spade. He was the first to speak out when he saw unfairness. The world of track and field gave him a big target, hypocrisy bother him the most. He did not pull punches or look away, he was not politically correct. His personality was a distinction of his running style, he was not afraid to say what others were too timid or afraid. Everything he lived for, breathed, dreamed of, hoped for was running and lived according to his unspoken code of right and wrong. This is a quality that I admire in Prefontaine.

The 1972 Olympics were said to be a precursor of things to come for the man known simply as PRE. I have been in his room, as a 15 year old high school sophomore listening as his father shared stories about the determination and the drive of his "little boy", as a father of children myself it must have brought pride and joy to his heart. His room is empty now, but in 1995 it was not, I have seen the silhouette of the shadow of Pre as a youth hanging on the wall...in many ways the shadow of this one man still rests over all who lace up and hit the trails. He is the standard, the benchmark, he is the greatest regardless of whether he won an Olympic or World Championship medal. That is not the standard by which he is judged, he is judged for never giving up, never giving in, and expecting no matter what the outcome he would ALWAYS give his best. What does that truly mean?

To me, it means that every second of his race, with every step, with every breathe the defeatest attitude and mindset did not exist. I believe every second mattered to him and whether it was 1500 meters or 10000 meters, cross country or a road race, or Life, his thought of personal determination mattered to him. How many of us have ever completed a race, looked back and considered how many times we eased up, let up, thought about what to do now to save a little for later, how many have finished the race knowing that for every step of the race they were not a quitter in any way shape or form regardless of the outcome? Whether it is 4th place or dead last, the effort, the mindset is relative to your moment to choose to do more with the distance spread before you. He said before the 1972 Olympic 5000 meter final race, "I'm going to work so that it's a pure guts race at the end, and if it is, I am the only one who can win it." Was that statement pure arrogance? I do not think so, I think it was a verbal acknowledgement that there would not be one moment regardless of the outcome where he would believe that he could not give more, that he could not expect more, that his passion for his performance was not based on the result at the finish line but rather the distance and moments in between.

The Passion of Pre exists in the hearts and the minds of the running community. While it does seem that time has moved on and an effort exists to forget Steve Prefontaine His Passion still resonates and matters. It is owned by none, a gift freely given to all those who hope for more and are willing to sacrifice. Prefontaine's outlook on running is a gift. Many of us have never met him or felt the determination he must have had during every single race but we share in his legacy, a legacy of love for effort. With a mile to go I can imagine Pre saying within his mind, "The best pace is a suicide pace, and today is a good day to die."

He said, "To give anything less than your best is to sacrifice the gift". The gift is life, the opportunity to begin anew each and everyday. To not be defined by your past mistakes, imperfections, or weaknesses. Rather, to choose this moment to be more, to do more, to expect more from yourself. To use the gift of your moment to never give anything less than your best.

Heart beating. Blood Dripping. Pre never gave up. His heart willing him to victory. 

Documentary of Prefountaine

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Get moving: Doctor warns we are ‘sitting ourselves to death’

Catherine Garcia, The Week, Aug. 1, 2014

In words that will strike fear in the heart of lazy people everywhere, Dr. James Levine says that sitting around could be worse for your health than smoking.

In his new book Get Up!, the director of the Mayo Clinic-Arizona State University Obesity Solutions Initiative writes that people lose two hours of life for every hour spent sitting. He says it’s not hard to get moving, and even taking a short walk after dinner is better than doing nothing. “On one hand, the good news is that this is incredibly easy,” he told the Los Angeles Times. For those that are tied to their computers for eight hours a day, though, “it’s incredibly difficult.”

In his book, Levine talks about nonexercise activity thermogenesis, or NEAT. This is the energy expenditure of an activity that isn’t a sport, like going for a walk or shoveling snow. Someone with a job that keeps them moving and active uses more NEAT calories, and “low NEAT is linked to weight gain, diabetes, heart attacks, and cancer.” He thinks employers are starting to understand that their workers can’t be sitting down all day, and that soon they’ll learn “you will make money if your workforce gets up and gets moving. Your kids will get better grades if they get up and get moving. The science is not refuted.”

Until everyone is free to frolic all day, the most important thing they can do is get up whenever they are able. “Sitting is more dangerous than smoking, kills more people than HIV and is more treacherous than parachuting,” Levine said. “We are sitting ourselves to death.”

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Running Just Minutes a Day Cuts Death Risk

By Matt Cantor, Newser, July 29, 2014

Good news for those who keep meaning to exercise, but can never seem to find the time: If you can manage a few minutes of running a day—even going slowly—you may cut your risk of death from cardiovascular disease. So suggests a new, 15-year study of more than 55,000 adults. Researchers found that the risk of death from any cause among runners in the group was 30% lower than the risk among non-runners; runners also faced a 45% lower risk of death from cardiovascular disease, according to a press release.

The fascinating part: “The benefits were the same no matter how long, far, frequently, or fast participants reported running,” the release notes. Nor did a person’s sex, age, or body mass index matter, and even smokers saw the same benefits. Runners lived an average of three years longer than non-runners. The study prompts the researchers to suggest that running should be promoted as seriously as smoking and obesity are discouraged. Researchers do, however, note a caveat: The study doesn’t prove that running causes longer life, and it’s possible—despite efforts to control for outside factors—that those who run are just healthier in general, WebMD adds. (But be careful: Earlier this year, another study found that running too much could kill you sooner.)

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How to Keep Your Muscles Strong as You Age

By Laura Landro, WSJ, June 22, 2014

Muscle strength is one of the keys to healthy aging, yet after we achieve peak mass in our early 40s, it’s pretty much downhill from there. Most people begin to lose modest amounts of muscle at that point and experience progressive deterioration as the years go by, especially if they are sedentary.

Now, with a growing population of aging baby boomers, experts are turning their attention to interventions to help stem the loss of muscle mass, quality and strength, known as sarcopenia. It is caused by a number of complex factors that are not entirely understood, including decreasing amounts of testosterone in men. Muscle decline often goes hand in hand with frailty, a decline of physical function that leads to falls, hospitalization and the need for nursing-home care.

Researchers are looking at promising treatments including inhibiting a naturally occurring protein called myostatin that curbs muscle growth. Pharmaceutical companies already have drugs in the pipeline that act by blocking myostatin or blocking the sites where it is detected in the body, potentially rebuilding muscle.

For now, however, the best medicine available to maintain muscle mass and strength is less complicated and costly—namely, exercise and a healthy diet. Yet about 60% of people over 65 are insufficiently active or overtly inactive, and many have poor nutrition, says Nathan LeBrasseur, a researcher who directs the Muscle Performance and Physical Function Laboratory and the Healthy Aging and Independent Living Initiative at Mayo Clinic in Rochester, Minn. Dr. LeBrasseur estimates that most people will lose approximately 30% of muscle mass over their lifetime, and as much as 50% by the time they reach their 80s or 90s.

Keep Your Motor Running. Muscle is also central to metabolism, or the rate at which fat and calories are burned, and can help improve resiliency to the stressors of aging, Dr. LeBrasseur says. By simply stepping up activity like walking, gardening and household tasks, “we can slow the loss and prevent crossing that critical threshold that leads to functional limitations and metabolic issues.”

Chronic diseases such as diabetes, which inhibits the metabolism of nutrients in the body, are believed to contribute to age-related muscle loss, and older obese individuals with decreased muscle mass or strength are at special risk for adverse outcomes, according to research funded by the National institute on Aging. Related conditions include cachexia, a state of general physical decline and malnutrition associated with chronic disease and cancer, and wasting disorders that can be associated with nerve disease or injury.

More Protein. In addition to the mounting evidence of the benefits of physical activity in stemming decline, Dr. Walston says there is an emerging body of research that suggests older people should eat more protein, with a focus on leaner sources.

According to guidelines published in 2010 by the Society on Sarcopenia, Cachexia and Wasting Disorders, a nonprofit group, as many as 41% of women and 35% of men age 50-plus ingest less than the recommended daily allowance of 0.8 grams of protein per kilogram of body weight (0.36 grams per pound). The group recommends that total protein should be higher in that age range, or 1 to 1.5 grams per kilogram per day (0.45 to 0.68 grams per pound), spread equally through three meals.

The group also says low vitamin D levels are associated with low muscle strength, and supplementing it in those cases has been shown to increase strength and function and reduce falls. But it’s best to talk to a physician before starting any supplements such as protein or vitamin D.

As for exercise, the group notes that resistance exercises can improve strength, while aerobic exercise can improve overall health and quality of life. The group recommends a combination of the two for 20 to 30 minutes three times a week.

Building Up Reserves. Evidence continues to show the benefits of exercise at any age. Last month, a study in the Journal of the American Medical Association found that an exercise program reduced the onset of major disability for at-risk older adults by 18% over about 2½ years.

Roger Fielding, a co-author of the study and director of the Nutrition, Exercise Physiology and Sarcopenia Laboratory at Tufts University, says the study shows that “even as we advance into very old age, physical activity can help preserve independence.”

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Hey kids, it's true: Your parents were never this slow

By Fabien Tepper, Christian Science Monitor, Nov. 20, 2013

Scientists haven’t yet discovered how many children, upon hearing of time travel, dream of heading back a few decades to visit their parents as kids. Stripped of height and authority, would parents be any fun? Maybe they would just be short versions of their bossy selves. Would they know how to play tag?

If today’s kids could wangle such a playdate, however, they might find themselves left in the sandbox dust, according to new research presented at Tuesday’s annual meeting of the American Heart Association.

Exercise physiologists at the University of South Australia who analyzed research on 25 million children around the world determined that today’s kids, on average, take a minute and a half longer to run a mile than did kids in 1975. The studies measured how far children of different ages could run in 5 to 15 minutes, and how quickly they could run distances up to two miles.

But does speed really matter, with most of either our prey or predators stored conveniently behind bars? Isn’t texting speed a bit more relevant to modern survival?

Apparently running still matters. According to these researchers and many others, several factors make running fitness a key measure of heart health.

The Associated Press reported details on the findings, which were fairly constant across gender and age groups:

"The decline in fitness seems to be leveling off in Europe, Australia and New Zealand, and perhaps in the last few years in North America. However, it continues to fall in China, and Japan never had much falloff—fitness has remained fairly consistent there. About 20 million of the 25 million children in the studies were from Asia."

The study’s lead scientist, Grant Tomkinson, said that increased bodyweights and TV/video game consumption, along with unsafe and decentralized neighborhoods, and school curricula stripped of physical education, may all make it hard for children to get the 60 minutes of daily exercise recommended by government health experts.

"We are currently facing the most sedentary generation of children in our history," said Sam Kass, a White House chef and head of first lady Michelle Obama’s Let’s Move program, in a speech to the conference.

According to Tomkinson, it’s important that parent’s limit the time that their children spend sedentary—curled over a tablet, computer, or smartphone—to less than two hours per day.

What kids really need, he says, is good old-fashioned sweaty, exhausting exercise.

"You want exercise to be fun, but there needs to be some huff and puff there as well," he said.

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Is It Better to Walk or Run?

By Gretchen Reynolds, NY Times, May 29, 2013

Walking and running are the most popular physical activities for American adults. But whether one is preferable to the other in terms of improving health has long been debated. Now a variety of new studies that pitted running directly against walking are providing some answers. Their conclusion? It depends almost completely on what you are hoping to accomplish.

If, for instance, you are looking to control your weight, running wins, going away. In a study published last month in Medicine & Science in Sports & Exercise, and unambiguously titled “Greater Weight Loss From Running than Walking,” researchers combed survey data from 15,237 walkers and 32,215 runners enrolled in the National Runners and Walkers Health Study—a large survey being conducted at Lawrence Berkeley National Laboratory in Berkeley, Calif.

Participants were asked about their weight, waist circumference, diets and typical weekly walking or running mileage both when they joined the study, and then again up to six years later.

The runners almost uniformly were thinner than the walkers when each joined the study. And they stayed that way throughout. Over the years, the runners maintained their body mass and waistlines far better than the walkers.

The difference was particularly notable among participants over 55. Runners in this age group were not running a lot and generally were barely expending more calories per week during exercise than older walkers. But their body mass indexes and waist circumferences remained significantly lower than those of age-matched walkers.

Why running should better aid weight management than walking is not altogether clear. It might seem obvious that running, being more strenuous then walking, burns more calories per hour. And that’s true. But in the Berkeley study and others, when energy expenditure was approximately matched—when walkers head out for hours of rambling and burn the same number of calories over the course of a week as runners—the runners seem able to control their weight better over the long term.

One reason may be running’s effect on appetite, as another intriguing, if small, study suggests. In the study, published last year in the Journal of Obesity, nine experienced female runners and 10 committed female walkers reported to the exercise physiology lab at the University of Wyoming on two separate occasions. On one day, the groups ran or walked on a treadmill for an hour. On the second day, they all rested for an hour. Throughout each session, researchers monitored their total energy expenditure. They also drew blood from their volunteers to check for levels of certain hormones related to appetite.

After both sessions, the volunteers were set free in a room with a laden buffet and told to eat at will.

The walkers turned out to be hungry, consuming about 50 calories more than they had burned during their hourlong treadmill stroll.

The runners, on the other hand, picked at their food, taking in almost 200 calories less than they had burned while running.

The runners also proved after exercise to have significantly higher blood levels of a hormone called peptide YY, which has been shown to suppress appetite. The walkers did not have increased peptide YY levels; their appetites remained hearty.

So to eat less, run first.

But on other measures of health, new science shows that walking can be at least as valuable as running—and in some instances, more so. A study published this month that again plumbed data from the Runners and Walkers Health Study found that both runners and walkers had equally diminished risks of developing age-related cataracts compared to sedentary people, an unexpected but excellent benefit of exercise.

And in perhaps the most comforting of the new studies, published last month in Arteriosclerosis, Thrombosis and Vascular Biology and again using numbers from the versatile Runners and Walkers Health Study, runners had far less risk of high blood pressure, unhealthy cholesterol profiles, diabetes and heart disease than their sedentary peers. But the walkers were doing even better. Runners, for instance, reduced their risk of heart disease by about 4.5 percent if they ran an hour a day. Walkers who expended the same amount of energy per day reduced their risk of heart disease by more than 9 percent.

Of course, few walkers match the energy expenditure of runners. “It’s fair to say that, if you plan to expend the same energy walking as running, you have to walk about one and a half times as far and that it takes about twice as long,” said Paul T. Williams, a staff scientist at Lawrence Berkeley National Laboratories and the lead author of all of the studies involving the surveys of runners and walkers.

On the other hand, people who begin walking are often more unhealthy than those who start running, and so their health benefits from the exercise can be commensurately greater.

“It bears repeating that either walking or running is healthier than not doing either,” Dr. Williams said, whatever your health goals.

For confirmation, consider one additional aspect of the appetite study. The volunteers in that experiment had sat quietly for an hour during one session, not exercising in any fashion, neither running nor walking. And afterward they were famished, consuming about 300 calories more than the meager few they had just burned.

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