How Physical Inactivity Increases Risk for Chronic Diseases

Evidence shows that inactivity or lack of movement that is best exemplified by prolonged sitting, actively promotes dozens of chronic diseases, and these risks apply even if you’re very fit.1,2 In fact, sitting for too long, too often, is an independent risk factor for ill health and reduced longevity.

physical inactivity effect

Story at-a-glance

  • Inactivity, marked by prolonged sitting, actively promotes dozens of chronic diseases. These risks apply even if you’re very fit, as sitting is an independent risk factor for poor health and early death
  • An interactive body map published by The Conversation allows you to select a body part and/or disease to see the scientific support linking any given health problem and inactivity
  • Inactivity raises your risk of general ill health by 114 percent, Alzheimer’s disease by 82 percent, and uterine and colon cancer by 66 and 30 percent respectively. Overall, chronic sitting has a mortality rate similar to smoking

Dr. James Levine is co-director of the Mayo Clinic and the Arizona State University Obesity Initiative and author of the book “Get Up! Why Your Chair Is Killing You and What You Can Do About It.”

According to Levine, there are at least 10,000 published studies showing that sitting harms health, irrespective of other lifestyle habits, including an excellent exercise program.

Watch the video discussion. URL:

Your Risk for Chronic Diseases Skyrocket If You’re Inactive

An interactive body map published by The Conversation allows you to select a body part and/or disease to see the scientific support linking any given health problem and inactivity.3,4

For example, physical inactivity raises your risk of general ill health by 114 percent, your risk of Alzheimer’s disease by 82 percent and your risk of depression by 150 percent.

Overall, chronic sitting has a mortality rate similar to smoking.5 It even increases your chances of lung cancer by more than 50 percent. Your risk for uterine and colon cancer also increases by 66 and 30 percent respectively.

Fortunately, the remedy is simple: Avoid sitting and get more movement into your life. As the dangers of inactivity have become more widely recognized, a number of excellent books have been published on the subject. One of my favorites is Kelly Starrett’s book, “Deskbound: Standing Up to a Sitting World.”

It’s filled with helpful guidance that can improve your health and well-being, covering both tips to naturally increase your daily movement and proper body mechanics. It is one of the best books I read this year and I believe it’s an important resource for anyone that has a sitting job.

Why Sitting Causes so Much Harm

Inactivity affects your health in a number of different ways, but one foundational mechanism of harm relates to the molecular cascades that occur simply by standing. Within 90 seconds of standing up, your muscular and cellular systems that process blood sugar, triglycerides and cholesterol are activated.

Most of these systems are influenced by insulin. As you probably know, one of the primary benefits of exercise is improved insulin receptor sensitivity, thus lowering insulin resistance. But even the act of standing (as opposed to sitting) will have a beneficial effect.

On the other hand, sitting for more than eight hours a day has been shown to increase your risk of type 2 diabetes by 90 percent.6

Essentially, what science tells us is that, at the molecular level, your body was designed to be active pretty much all day long and regularly neglecting this requirement will result in health challenges.

Sitting impairs these molecular events that are necessary for optimal biological functioning, thereby setting the stage for disease. In other words, while we certainly need to rest from time to time, that rest is supposed to break up activity, not the other way around.

Inactivity simply isn’t supposed to be a way of life, as excessive sitting switches off the natural fueling systems in your body and down-regulates your metabolism. As a consequence of sitting, blood sugar, blood pressure and cholesterol imbalances arise.

The modern sitting posture is also very bad for your back, neck, wrists and arms, leading to a variety of chronic pains. Pills are not the solution for any of these problems. The real answer is to get up and avoid sitting as much as possible. As a basic guideline, if you’ve been sitting down for a full hour, you’ve sat too long.

The Biological Imperative of Movement

Research looking for clues about people’s natural movement patterns reveals there appears to be “biological imperatives to movement” built into our system.

One such study7 found that not only do people tend to move and rest in logical intervals, physical activity also appears to affect your body’s internal clock mechanisms and circadian rhythms.

The intervals of movement and inactivity were more consistent in younger people than older ones. As noted in the featured article:8

“In essence, the young people’s bodies seemed to be somehow remembering and responding to what that body had just been doing, whether sitting or moving, and then calculating a new, appropriate response — moving or sitting.

In doing so, the researchers felt, the body created a healthy, dynamic circadian pattern.”

Another study,9 this one looking at the movement of mice, also concluded that exercise plays a role in maintaining a healthy circadian rhythm, allowing the animals to maintain more natural activity patterns. Without exercise, the animals’ activity levels became more random. According to The New York Times:10

“By prompting the release of a wide variety of biochemicals in the body and brain … exercise almost certainly affects the body’s internal clock mechanisms and therefore its circadian rhythms, especially those related to activity.

Exercise seems to make the body better able to judge when and how much more it should be moving and when it should be at rest.”

Diabetes, Heart Disease and Cancer Are All Related to Inactivity

Diabetes, cancer, heart and neurodegenerative diseases are the most common diseases in the developing world, especially the U.S., and all are significantly influenced by your level of physical activity.

Starting with diabetes, I just described the metabolic consequences of sitting versus standing. Diabetes in turn raises your risk of both heart disease and cancer (plus many others, including dementia), so by reducing your risk of diabetes you automatically raise your protection against other chronic diseases as well.

Globally, cardiovascular disease (CVD) accounts for 38 percent of all deaths, and rates are rising even in developed nations where the condition has historically been low, in large part due to a more natural diet and higher physical activity levels.

According to a recent investigation, over 78 percent of Nigerians now live a sedentary lifestyle and 30 percent have high blood pressure. According to Dr. Casmir Amadi, a senior consultant cardiologist at the Lagos University Teaching Hospital in Nigeria, these health effects are the result of urbanization and increased use of motorized vehicles.11

Villagers who still walk long distances on a daily or near-daily basis do not have the same high rates of disease as city dwellers. Even children are starting to experience the adverse effects of modernization and the proliferation of junk food. As noted by Amadi, who urges all Nigerians to exercise daily:

“Once a child gets exposed to junk food early enough in their life, the chances [are] that they will get bigger and once they become obese, they can start having diabetes very early in life, and diabetes and obesity are all CVD risk factors.”

An Active Lifestyle ‘Insulates’ You From Cancer

Many studies have also highlighted the role of physical activity in both the prevention and treatment of cancer. Again, one of the primary mechanisms responsible for driving down your cancer risk is the fact that exercise decreases your insulin resistance. By creating a low sugar environment in your body, the growth and spread of cancer cells are significantly discouraged.

Movement also improves circulation, driving more oxygen into your tissues and circulating immune cells in your blood. According to a 2003 paper,12 more than 100 epidemiologic studies looking at the impact of physical activity on cancer prevention reveal that:

“[P]hysically active men and women have about a 30 to 40 percent reduction in the risk of developing colon cancer, compared with inactive persons … With regard to breast cancer, there is reasonably clear evidence that physically active women have about a 20 to 30 percent reduction in risk, compared with inactive women.”

This pattern of a 20 to 40 percent risk reduction appears again and again in studies looking at the effects of exercise on cancer, although some show even higher rates of protection. A small sampling of such studies includes the following:

A recent Danish study, which followed more than 5,130 middle-aged men for 44 years, found that the better a man’s respiratory fitness, the less likely he is to die from cancer. More specifically, for every 10 mL/kg/min increase in VO2 Max at baseline (around the age of 49), the risk of dying from cancer was reduced by 17 percent, and the risk of dying from any cause in the next 40+ years was reduced by 11 percent.13,14

Being fit in middle age also cut men’s risk of being diagnosed with lung cancer by 55 percent and bowel cancer by 44 percent, and reduced the risk of dying from lung-, bowel- and prostate cancer (if they did get it) by 32 percent.15,16

Animal research suggests regular exercise may be the key to significantly reduce your chances of developing liver cancer, which is among the most common types of cancer.17,18

Breast- and colon cancer patients who exercise regularly have half the recurrence rate as non-exercisers.19

Weight training cut men’s risk of dying from cancer by 40 percent, and similar findings have been reported in other studies involving both men and women.

Exercise Helps Protect Your Neurological Health Too

Exercise also helps protect your neurological function. In fact, it may be part and parcel of staying “sharp as a tack” well into old age. As with the rest of your body, a number of mechanisms are at play. For example, research shows that exercise:

Increases blood flow to your brain, which allows it to almost immediately function better. It also promotes genetic changes. The increased blood flow adapts your brain to turn different genes on or off, and many of these changes help protect against diseases such as Alzheimer’s and Parkinson’s.
Promotes growth of new brain cells. In your hippocampus, these new brain cells help boost memory and learning.20
Helps preserve both gray and white matter in your brain, which prevents cognitive deterioration that can occur with age.21,22
Triggers the release of neurotransmitters, including endorphins, serotonin, dopamine, glutamate and GABA. Some of these are well-known for their role in mood control. Not surprisingly, exercise is one of the most effective prevention- and treatment strategies for depression.
Increases brain derived neurotrophic factor (BDNF). Exercise stimulates the production of a protein called FNDC5 that then triggers the production of BDNF, which has remarkable rejuvenating abilities. In your brain, BDNF both preserves existing brain cells,23 and activates brain stem cells to convert into new neurons, effectively making your brain grow larger.24
Decreases BMP and boosts Noggin: Bone-morphogenetic protein (BMP) slows down the creation of new neurons, thereby reducing neurogenesis. If you have high levels of BMP, your brain slows and grows less nimble. Exercise reduces the impact of BMP, allowing your adult stem cells to continue performing their vital functions of keeping your brain agile.

In animal research, mice with access to running wheels reduced the BMP in their brains by half in just one week.25,26 In addition, they also had a notable increase in another brain protein called Noggin, which acts as a BMP antagonist.

So, exercise not only reduces the detrimental effects of BMP, it simultaneously boosts the more beneficial Noggin as well. This complex interplay between BMP and Noggin appears to be yet another powerful factor that helps ensure the proliferation and youthfulness of your neurons.

Reduces plaque formation: By altering the way damaging proteins reside inside your brain, exercise may help slow the development of Alzheimer’s disease.27

Regular Movement Is Critical for Optimal Health

The average American adult spends about 10 hours or more each day sitting, and research shows you simply cannot offset 10 hours of stillness with one hour of exercise. You ideally require near-continuous movement throughout the day, even if it’s just standing rather than sitting. So, strive to sit for less than three hours a day, and make it a point to walk more.

A stand-up desk is a great option. But even then you should move, not just stand, as lack of movement, not just sitting, is the primary catalyst for metabolic dysfunction. A fitness tracker or smartphone can be used to ensure you’re getting the recommended 7,000 to 10,000 steps per day, but that doesn’t mean you stop at 10,000 steps. When you have time you can go for walks twice as long.

Next you’ll want to incorporate a more regimented fitness routine, and while virtually any exercise is better than none, high-intensity exercises are the most potent. Benefits of high-intensity interval training (HIIT) include cardiovascular fitness, improved muscle growth and strength and the generation of “anti-aging” human growth hormone (HGH), also referred to as “the fitness hormone.”

It also effectively stimulates your muscles to release anti-inflammatory myokines, which increase your insulin sensitivity and glucose use inside your muscles. They also increase liberation of fat from adipose cells, and the burning of the fat within the skeletal muscle.

Strength training is another important component, as are mobility therapies such as those described by Starrett in his book, “Deskbound.” A foam roller is an inexpensive fitness tool that can be quite useful for this. Whatever you choose to do, please do take the time to exercise, and be sure to incorporate as much physical activity into your life as you can on an hourly basis.

Ibuprofen Kills Thousands Each Year, So What Is The Alternative?

A recent Reuters’ article opened with the following stunning sentence:

Long-term high-dose use of painkillers such as ibuprofen or diclofenac is ‘equally hazardous’ in terms of heart attack risk as use of the drug Vioxx, which was withdrawn due to its potential dangers, researchers said.”  

The 2004 Vioxx recall, as you may remember, was spurred by the nearly 30,000 excess cases of heart attacks and sudden cardiac deaths caused by the drug between 1999-2003. Despite the fact that scientific research had accumulated as early as 2000 linking Vioxx to increased heart attacks and strokes, the drug’s manufacturer Merck, and the FDA, remained silent as the death toll steadily increased.

Ibuprofen Kills Thousands Each Year, So What Is The Alternative?

The Reuters report focused on new research published in Lancet indicating the risk of heart attack increases as much as a third and the risk of heart failure doubles among heavier users of NSAID drugs.

INFLAMED: Our Default Bodily State

Why are so many folks taking NSAID drugs like ibuprofen anyway?

Pain and unhealthy levels of inflammation are fast becoming default bodily states in the industrialized world. While in most cases we can adjust the underlying pro-inflammatory conditions by altering our diet, and reducing stress and environmental chemical exposures, these approaches take time, discipline and energy, and sometimes we just want the pain to stop now. In those often compulsive moments we find ourselves popping an over-the-counter pill to kill the pain.

The problem with this approach is that, if we do it often enough, we may kill ourselves along with the pain…

Ibuprofen really is a perfect example of this. As mentioned above, this petrochemical-derivative has been linked to significantly increased risk of heart attack and increased cardiacand all-cause mortality (when combined with aspirin), with over two dozen serious adverse health effects, including:

  1. Anemia[1]
  2. DNA Damage[2]
  3. Hearing Loss[3]
  4. Hypertension[4]
  5. Influenza Mortality[5]
  6. Miscarriage[6]

Ibuprofen is, in fact, not unique in elevating cardiovascular disease risk and/or mortality. The entire category of non-steroidal anti-inflammatory drugs (NSAIDs) appears to have this under-recognized dark side; cardiovascular disease and cardiac mortality score highest on the list of over 100 unintended adverse health effects associated with their use. See also our analysis of the rarely acknowledged dark side to aspirin: The Evidence Against Aspirin And For Natural Alternatives.

So, what does one do? Pain is pain. Whether it happens to you, or you witness it in another (which can be worse), finding relief is a top priority.

Ibuprofen Kills More Than Pain, So What Is The Alternative?

Research on Natural Alternatives To Ibuprofen

Here is some evidence-based research on alternatives to ibuprofen, sourced from the National Library of Medicine:

  1. Ginger – A 2009 study found that ginger capsules (250 mg, four times daily) were as effective as the drugs mefenamic acid and ibuprofen for relieving pain in women associated with their menstrual cycle (primary dysmenorrhea). [7]
  2. Topical Arnica – A 2007 human study found that topical treatment with arnica was as effective as ibuprofen for hand osteoarthritis, but with lower incidence of side effects.[8]
  3. Combination: Astaxanthin, Ginkgo biloba and Vitamin C – A 2011 animal study found this combination to be equal to or better than ibuprofen for reducing asthma-associated respiratory inflammation.[9]
  4. Chinese Skullcap (baicalin) – A 2003 animal study found that a compound in Chinese skullcap known as baicalin was equipotent to ibuprofen in reducing pain.[10]
  5. Omega-3 fatty acids: A 2006 human study found that omega-3 fatty acids (between 1200-2400 mg daily) were as effective as ibuprofen in reducing arthritis pain, but with the added benefit of having less side effects.[11]
  6. Panax Ginseng – A 2008 animal study found that panax ginseng had analgesic and anti-inflammatory activity similar to ibuprofen, indicating its possible anti-rheumatoid arthritis properties.[12]
  7. St. John’s Wort – A 2004 animal study found that St. John’s wort was twice as effective as ibuprofen as a pain-killer.[13]
  8. Anthrocyanins from Sweet Cherries & Raspberries – A 2001 study cell study found that anthrocyanins extracted from raspberries and sweet cherries were as effective as ibuprofen and naproxen at suppressing the inflammation-associated enzyme known as cyclooxygenase-1 and 2.[14]
  9. Holy Basil – A 2000 study found that holy basil contains compounds with anti-inflammatory activity comparable to ibuprofen, naproxen and aspirin.[15]
  10. Olive Oil (oleocanthal) – a compound found within olive oil known as oleocanthal has been shown to have anti-inflammatory properties similar to ibuprofen.[16]
  11. There are, of course, hundreds of additional substances which have been studied for their pain-killing and/or anti-inflammatory effects, and there are also aromatherapeutic approachesthat do not require the ingestion of anything at all, but there is also a danger here. When we think of taking an alternative pain-killer to ibuprofen, we are still thinking within the palliative, allopathic medical model: suppress the symptom, and go on about our business. It would behoove us to look deeper into what is causing our pain. And when possible, remove the cause(s). And that often requires a dramatic dietary shift away from pro-inflammatory foods, many of which most Westerners still consider absolutely delightful, e.g. wheat, dairy,nighshade vegetables and even wheat-free grains, etc.

    [1] Direct cytotoxicity of non-steroidal anti-inflammatory drugs in acidic media: model study on human erythrocytes with DIDS-inhibited anion exchanger. Pharmazie. 2002 Dec;57(12):848-51. PMID: 12561250

    [2] Genotoxicity of ibuprofen in mouse bone marrow cells in vivo. Drug Chem Toxicol. 2012 Jan 27. Epub 2012 Jan 27. PMID: 22283434

    [3] Analgesic use and the risk of hearing loss in men. Am J Med. 2010 Mar;123(3):231-7. PMID: 20193831

    [4] Effect on blood pressure of lumiracoxib versus ibuprofen in patients with osteoarthritis and controlled hypertension: a randomized trial. J Hypertens. 2008 Aug;26(8):1695-702. PMID: 18622250

    [5] The effect on mortality of antipyretics in the treatment of influenza infection: systematic review and meta-analysis. J R Soc Med. 2010 Oct;103(10):403-11. PMID: 20929891

    [6]  Taking non-aspirin NSAIDs in early pregnancy doubles risk of miscarriage, study shows. BMJ. 2011 ;343:d5769. Epub 2011 Sep 9. PMID: 21908536

    [7] Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. J Altern Complement Med. 2009 Feb 13. PMID: 19216660

    [8] Choosing between NSAID and arnica for topical treatment of hand osteoarthritis in a randomised, double-blind study. Rheumatol Int. 2007 Apr;27(6):585-91. Epub 2007 Feb 22. PMID: 17318618

    [9] Summative interaction between astaxanthin, Ginkgo biloba extract (EGb761) and vitamin C in suppression of respiratory inflammation: a comparison with ibuprofen. Phytother Res. 2011 Jan;25(1):128-36. PMID: 20632299

    [10] The antiinflammatory and analgesic effects of baicalin in carrageenan-evoked thermal hyperalgesia. Anesth Analg. 2003 Dec;97(6):1724-9. PMID: 14633550

    [11] Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surg Neurol. 2006 Apr;65(4):326-31. PMID:16531187

    [12] Potential analgesic and anti-inflammatory activities of Panax ginseng head butanolic fraction in animals. Food Chem Toxicol. 2008 Dec;46(12):3749-52. Epub 2008 Oct 1. PMID:18930781

    [13] Antinociceptive activity of methanolic extracts of St. John’s Wort (Hypericum perforatum) preparation. Pak J Pharm Sci. 2004 Jul;17(2):13-9. PMID: 16414593

    [14] Cyclooxygenase inhibitory and antioxidant cyanidin glycosides in cherries and berries. Phytomedicine. 2001 Sep;8(5):362-9. PMID: 11695879

    [15] Antioxidant and cyclooxygenase inhibitory phenolic compounds from Ocimum sanctum Linn. Phytomedicine. 2000 Mar;7(1):7-13. PMID: 10782484

    [16] Molecular mechanisms of inflammation. Anti-inflammatory benefits of virgin olive oil and the phenolic compound oleocanthal. Curr Pharm Des. 2011 ;17(8):754-68. PMID:21443487


Vigorous Exercise May Significantly Lower Your Stroke Risk.

Story at-a-glance

  • A new study shows that vigorously exercising at least four times per week can reduce your risk of a stroke, especially if you’re a man; the results are unclear if you’re a woman
  • This study (and some prior studies) seem to suggest that women may respond better to less vigorous exercise, such as walking, although most studies don’t take into account that all forms of cardio are not equal
  • Vigorous exercise is important for overall health, but conventional cardio is risky due to the extreme stress on your heart, which may cause inflammation, plaque, arrhythmias, and even heart attack or stroke
  • Regardless of your gender or age, you can optimize your exercise benefits by doing high-intensity interval training, which pushes your body hard enough for a challenge while allowing adequate time for recovery and repair
  • You can further reduce your stroke risk by getting adequate sunshine for the vitamin D and nitric oxide benefits, grounding yourself to the earth, and consuming adequate fiber, especially the soluble variety.
  • Vigorous Exercise

Exercise is one of the best ways to keep yourself healthy. The benefits of exercise for lowering your heart attack risk, reducing stress, and helping to prevent obesity and diabetes are widely known.

Well, now you can add another big one to your list of benefits from breaking a sweat: reduced risk of stroke.

The American Heart Association reports 800,000 Americans suffer from stroke each year. Stroke is the leading cause of disability in the US and the fourth leading cause of death. Up to 80 percent of strokes are preventable, because for the most part, strokes are the result of unhealthy lifestyle choices.

Recent research published in the journal Stroke1 found that, if you’re inactive, you have a 20 percent higher risk for having a stroke or mini-stroke (transient ischemic attack) than people who exercise enough to break a sweat at least four times a week.

The study involved more than 27,000 Americans for an average of 5.7 years, male and female, Caucasian and African-American. It included a larger proportion of people from the “Stroke Belt” states, where stroke rates are higher (Virginia, Tennessee, the Carolinas, Mississippi, Louisiana, Georgia, Florida, Arkansas, and Alabama).

The connection between vigorous exercise and stroke risk was very clear in men, but interestingly, less clear in women. Lead researcher Dr. Michelle McDonnell speculates that women may benefit more from less vigorous exercise, such as walking, which this study did not examine.2

Stroke Rates Increasing Among Younger People

Your risk of stroke increases with age, with most occurring after age 55. However, younger people are increasingly at risk, according to the latest statistics.

The rate of strokes among younger people (under age 55) nearly doubled between 1993 and 2005.3 The primary driving forces behind this are increasing rates of obesity, diabetes and high blood pressure—which can all increase your risk for suffering a devastating stroke.

Stress is also a significant risk factor for stroke, just as it is for heart attack. According to a 2008 study in Neurology,4 the more stressed you are, the greater your stroke risk—especially a fatal one. Heart attacks and stroke have many other risk factors in common, including:

A Stroke Is a ‘Heart Attack in Your Brain’

Heart attacks and strokes are both events in which cells die from lack of oxygen. With a heart attack, your heart is the affected organ, but with a stroke, it’s your brain.

A stroke involves either a rupture of an artery that feeds your brain (hemorrhagic stroke), or an obstruction of blood flow (ischemic stroke), with the ischemic type representing 75 percent of all strokes. In both types, your brain does not get enough oxygen and glucose, in addition to pooled blood putting physical pressure on areas of your brain.

And then there are mini-strokes, or TIAs (transient ischemic attacks). Each year, as many as 500,000 Americans experience TIAs, caused by temporary blockages in cerebral blood vessels, with symptoms similar to those of a stroke but oftentimes milder and shorter in duration.

Although less imminently dangerous than a full stroke, they should NOT be ignored. According to an article by Loyola University Medical Center’s journal,Expert Review of Neurotherapeutics, 10 to 15 percent of people experiencing TIAs will experience a full-blown stroke within three months, and 40 percent of those will occur in the first 24 hours.5 Stroke victims experience a variety of sudden symptoms, the most common being those listed in the table that follows.

Weakness, numbness, or paralysis in one arm or leg Sudden speech difficulties
Loss of coordination or trouble walking Confusion, memory loss or other sudden cognitive deficit
One-sided facial paralysis or facial droop Sudden visual problems
Sudden severe headache Dizziness

If you or someone you love suffers a stroke, getting medical help quickly can mean the different between life and death, or permanent disability. This is an area where conventional medicine excels, as there are emergency medications that can dissolve a blood clot that is blocking blood flow to your brain. If done quickly enough, emergency medicine can prevent or reverse permanent neurological damage—but you typically need treatment within one hour, which means the faster you recognize the warning signs, the better the prognosis. The National Stroke Association recommends using the FAST acronym to help remember the warning signs of stroke:6

F = FACE: Ask the person to smile. Does one side of the face droop?

A = ARMS: Ask the person to raise both arms. Does one arm drift downward?

S = SPEECH: Ask the person to repeat a simple phrase. Does their speech sound slurred or strange?

T = TIME: If you observe any of these signs, call 9-1-1 immediately.

Exercise Reduces Stroke Risk—But ONLY the Right Kind of Exercise

There have been a number of scientific studies about the benefits of exercise in stroke prevention, and recovery from stroke. Differences between men and women, in terms of the type of exercise that is best, have appeared in more than one study to date. The thing to keep in mind is, not only is it important to get enough exercise, but you must be doing thecorrect kind of exercise if you want to reap the benefits, which I’ll be discussing in more detail shortly. Further research is definitely needed in order to clarify how much and what type of exercise is best for men and women, in terms of preventing stroke.

  • ·A 2013 study published in Stroke7 concluded that walking at least three hours per week reduces stroke risk in womenbetter than inactivity, but also better than high intensity cardio. This may have something to do with the inordinate amount of physical stress “conventional cardio” has on the heart, and the fact that people generally do too much of it for too long. Perhaps women are more susceptible to these risks than men.

Conventional cardio can cause arrhythmias, and in some cases, atrial fibrillation (A-fib), which is a known risk factor for stroke. It would be of value to study the effects of high-intensity interval training (HIIT) on stroke risk in both men and women, which is very different than conventional cardio. But unfortunately, when cardio has been studied, it’s usually the conventional type.

  • ·In 2009, a study in Neurology8 found that vigorous exercise reduces stroke risk in men, as well as helping them recover from a stroke better and faster. However, moderate to heavy exercise was not found to have a protective effect for women. I would expect the right type of cardio would be found to lower stroke risk in both men and women, but those studies have not yet been done.
  • ·In 2012, Canadian researchers found that stroke patients who exercised were able to improve problems with their memory, thinking, language and judgment by close to 50 percent in just six months. Notable improvements in attention, concentration, planning and organizing, as well as benefits to muscle strength and walking, were seen among stroke patients who exercised.
  • ·In 2008, a study published in Neurology9 found that people who are physically active before a stroke have less severe problems and recover better, compared to those who didn’t exercise prior to their stroke.

Several recent scientific studies indicate that conventional cardio, especially endurance exercises such as marathon and triathlon training, pose significant risks to your heart, some of which may be irreversible and life threatening. Long-distance running can lead to acute volume overload, inflammation, thickening and stiffening of the heart muscle and arteries, arterial calcification, arrhythmias, and potentially sudden cardiac arrest and stroke.

I don’t think anyone can argue against the fact that vigorous exercise is beneficial to your heart and brain, but conventional cardio is just not the way to do it. This could be why the cardio benefits to women are not being detected in these studies… but that’s just a theory.

Ideally, to get the most benefits from your exercise, you need to push your body hard enough for a challenge while allowing adequate time for recovery and repair to take place. One of the best ways to accomplish this is with HIIT, or high intensity interval training, which consists of short bursts of high-intensity exercise, as opposed to extended episodes of exertion. This is a core part of my Peak Fitness program, which Phil Campbell was instrumental in helping me develop. Briefly, a Peak Fitness routine typically includes:

  • ·Warm up for three minutes
  • ·Exercise as hard and fast as you can for 30 seconds. You should feel like you couldn’t possibly go on another few seconds
  • ·Recover for 90 seconds
  • ·Repeat the high intensity exercise and recovery cycle 7 more times

You can do HIIT by running/sprinting (if you love running), or by using gym equipment such as a treadmill or elliptical machine, or you can accomplish the same thing without running at all by doing super-slow weight training, as I demonstrate in the video above. HIIT maximizes your secretion of human growth hormone (HGH), optimizes your metabolism and helps regulate your insulin and blood sugar. And it takes far less time than training for a marathon! You can do a complete Peak Fitness workout in 20 minutes or less.

The Importance of Recovery

Remember, adequate recovery is crucial between workouts. This includes not only resting your body, but also giving it the nutrients it needs for complete recovery. Your post-workout meal can support or impair your recovery. For instance, consuming a fast-assimilating protein such as high-quality whey protein within 30 minutes of your workout will essentially “rescue” your muscles out of their catabolic state and supply them with the nutrients they need to make their repairs. Any sort of intense exercise should also be balanced with strength training, proper stretching, core strengthening, stress reduction, good sleep and an optimal nutrition plan. You’ll find much more information about HIIT and other types of exercise in the fitness section of my website.

Three Bonus Tips for Stroke Prevention

Here are three simple tips for further lowering your stroke risk—but by no means is this a comprehensive list. For more information about lifestyle changes specific to preventing stroke, please refer to this recent stroke prevention article.

  1. SunshineSunlight causes your skin to produce nitric oxide, a critical compound for optimizing your blood pressure, which reduces your risk for both heart attack and stroke. Nitric oxide enhances blood flow, promotes blood vessel elasticity, and functions as a signaling molecule in your brain and immune system.

And of course, exposing your skin to the sun also helps optimize your vitamin D level, which should be between 50 and 70ng/ml, or higher if you have a serious illness.

  1. Grounding. Walking barefoot on the Earth, aka “earthing” or “grounding,” has a potent antioxidant effect that helps alleviate inflammation throughout your body. It also makes your blood less prone to “hypercoagulation”—so, less apt to clot—and that reduces your stroke risk.

There is a constant flow of energy between our bodies and the earth. When you put your feet on the ground, you absorb large amounts of negative electrons through the soles of your feet, which reduces the tendency of your blood cells to “clump together.” Technically, grounding increases the zeta potential of your red blood cells causing them to repel each other and become less sticky, very similar to a natural anticoagulant.

Research has demonstrated that it takes about 80 minutes for the free electrons from the earth to reach your blood stream and transform your blood, so make it a point to regularly walk barefoot on grass or on wet sand for about 90 minutes to two hours, if possible.

  1. Fiber. If you eat more fiber, you will probably reduce your chances of a stroke, according to a report in the journalStroke.10 For every seven grams more fiber you consume daily, your stroke risk is decreased by seven percent, according to this study.

Fiber is the non-digestible part of plants, which can be either soluble or non-soluble; soluble fiber was found to lower stroke risk the most. Soluble fiber can also help nurture beneficial gut bacteria, which are critical for good health. The American Heart Association and UK health authorities recommend adults consume 25 grams of dietary fiber each day, but I think you should get upwards of 32 grams per day and most Americans don’t get anywhere near this amount.

Great sources of fiber include seeds (especially chia, psyllium, sunflower, and organic flax), berries, vegetables such as broccoli and cauliflower, root vegetables and tubers (including onions and sweet potatoes), almonds, and beans (legumes).

Epilepsy Drug Warnings May Slip Through Cracks.

One-fifth of American neurologists are unaware of serious safety risks associated with epilepsydrugs and are potentially risking the health of patients who could be treated with safer medications, a new study reveals.

The 505 neurologists who took part in the survey between March and July 2012 were asked if they knew about several epilepsy drugs’ safety risks recently identified by the U.S. Food and Drug Administration.

These risks included increased danger of suicidal thoughts or behaviors linked with some newer drugs, a high risk for birth defects and mental impairment in children of mothers taking divalproex (brand nameDepakote), and the likelihood of serious hypersensitivity reactions in some Asian patients treated with carbamazepine (Tegretol).

One in five of the neurologists said they did not know about any of these risks. Neurologists who treat 200 or more epilepsy patients per year were most likely to know all the risks, according to the study, which was published online recently in the journal Epilepsy.

Although this study focused on epilepsy drugs, the findings suggest that the FDA needs to find better ways to inform doctors about newly discovered drug safety risks, said the researchers from Johns Hopkins University School of Medicine. Their results show that warnings about these risks are not getting through to doctors making important prescribing decisions.

There is no single place for neurologists to find updated drug risk information, said study leader Dr. Gregory Krauss, a professor of neurology. A few get emails from the FDA, while others get the information from neurology societies, continuing medical education courses or journal articles.

“There is poor communication from the FDA to specialists, and there’s some risk to patients because of this,” Krauss said in a Johns Hopkins news release.

“Unless it’s a major change requiring the FDA to issue a black box warning on a product, important information appears to be slipping through the cracks,” he said. “We need a more systematic and comprehensive method so that doctors receive updated safety warnings in a format that guarantees they will see and digest what they need to protect patients.”


High-Sensitivity C-Reactive Protein and Cardiovascular Disease.


The role of inflammation in the propagation of atherosclerosis and susceptibility to cardiovascular (CV) events is well established. Of the wide array of inflammatory biomarkers that have been studied, high-sensitivity C-reactive protein (hsCRP) has received the most attention for its use in screening and risk reclassification and as a predictor of clinical response to statin therapy. Although CRP is involved in the immunologic process that triggers vascular remodeling and plaque deposition and is associated with increased CV disease (CVD) risk, definitive randomized evidence for its role as a causative factor in atherothrombosis is lacking. Whether measurement of hsCRP levels provides consistent, clinically meaningful incremental predictive value in risk prediction and reclassification beyond conventional factors remains debated. Despite publication of guidelines on the use of hsCRP in CVD risk prediction by several leading professional organizations, there is a lack of clear consensus regarding the optimal clinical use of hsCRP. This article reviews 4 distinct points from the literature to better understand the current state and application of hsCRP in clinical practice: 1) the biology of hsCRP and its role in atherosclerosis; 2) the epidemiological association of hsCRP with CVD; 3) the quality of hsCRP as a biomarker of risk; and 4) the use of hsCRP as a tool to initiate or tailor statin therapy. Furthermore, we highlight recommendations from societies and important considerations when using hsCRP to guide treatment decisions in the primary prevention setting.

Source: Journal of the American College of Cardiology


Elevated Glucose Levels Associated with Dementia.

Higher glucose levels are associated with increased dementia risk, according to a prospective cohort study in the New England Journal of Medicine.

Researchers followed roughly 2100 people aged 65 and older who were free of dementia at baseline. Over a median follow-up of 6.8 years, patients had at least five measurements of glucose or glycated hemoglobin taken. About a quarter of patients developed dementia.

For all participants, the risk for dementia increased with increasing glucose readings. For patients without diabetes, an average glucose level of 115 mg/dL was associated with an 18% higher risk for dementia, compared with a level of 100 mg/dL. For those with diabetes, 190 mg/dL was associated with a 40% increased risk, relative to 160 mg/dL.

The authors speculate that microvascular disease of the central nervous system could contribute to the association.

Source: NEJM

Living Longer With Obesity Increases Heart Risk.

We all know that carrying around extra weight increases the risk of heart disease, but the length of time a person has been toting that weight appears to be a factor as well. Children and adolescents who are obese — about 18% of the adolescent population right now — are in far more danger of developing heart disease than anyone ever considered.

Heart disease is the leading cause of death among men and women in the US, accounting for 600,000 deaths per year. Coronary heart disease, the most common form, develops when the arteries that supply the heart with blood, oxygen, and nutrients become damaged or diseased.

The usual cause is plaque, a combination of calcium, fat, cholesterol, and other substances. The accumulation of plaque, called atherosclerosis, is often the precursor to a heart attack or stroke.

Among those who were obese for over 20 years, 38 percent had calcification in the coronary arteries compared to 25 percent of those who never were obese. Higher rates of type 2 diabetes were also present in those who had been obese the longest.

Twenty-five years ago, at what we now know was the start of the obesity epidemic, researchers enrolled nearly 3,300 white and African-American adults between the ages of 18 and 30 in a study designed to look at the development of coronary artery disease in young adults. The participants were examined by a physician every two to five years and had CT scans at 15, 20, and 25 years into the study to detect calcification (hardening) in the coronary arteries.

The information collected on each participant included their body mass index, whether they smoked or not, cholesterol, blood pressure, physical activity level, and whether or not they developed type 2 diabetes.

How long a person had been overweight or obese was linked to accelerated atherosclerosis. Coronary artery calcification was discovered in nearly 28 percent of the participants. The length of time each person was obese, based on their physical exams over the years, correlated with the presence and the extent of blockage in the arteries. Among those who were obese for over 20 years, 38 percent had calcification in the coronary arteries compared to 25 percent of those who never were obese.

The risk of developing plaque increased by two to four percent for every year the young adults were obese, independent of all other factors measured on the participants. Those who had been obese the longest and who had abdominal obesity had increased odds of developing high blood pressure and elevated cholesterol and were more likely to be onmedications to control those conditions. Higher rates of type 2 diabetes were also present in those who had been obese the longest.

Overall, the study implies that the earlier one becomes obese, the more likely it is that major heart problems will develop by middle age. Given the fact that over the past thirty years the rate of obesity has doubled among children and tripled among adolescents, more of today’s children and teens are likely to experience coronary events as they reach mid-life.

People are becoming obese at younger ages than previous generations. The results of this study make clear that this will likely have significant implications on the incidence of heart disease in the future and underscore the need for programs aimed at tackling obesity among our children and teens.

Source: Journal of the American Medical Association.


Obese Moms More Likely to Give Birth Extremely Prematurely.

Women who are overweight or obese in early pregnancy face increased risk for premature delivery, and the association is most pronounced between very obese women and extremely premature delivery, according to a JAMA study.

Using Swedish national registries, researchers examined associations between early pregnancy body-mass index and delivery outcomes for some 1.6 million live singleton births. Overall, 5% of births were premature (before 37 weeks’ gestation).

As maternal BMI increased, so did the risks for premature delivery. In particular, compared with normal-weight women, women with BMIs of 35 or higher had two to three times the risk for extremely premature delivery (22–27 weeks’ gestation). Increased risks were seen for both spontaneous and medically indicated extremely premature delivery.

The authors suggest that the effects of obesity on inflammatory markers contribute to the increased risks observed.

Source: JAMA

Tobacco smoke biomarkers and cancer risk among male smokers in the Shanghai Cohort Study.

Tobacco smoke constituent metabolites are established biomarkers of cigarette smoke exposure. ► This paper demonstrates that some of these metabolites are also biomarkers of cancer risk in male smokers from Shanghai. ► The biomarkers of cancer risk are total cotinine, total NNAL, PheT, and total NNN.


Metabolites of tobacco smoke constituents can be quantified in urine and other body fluids providing a realistic measure of carcinogen and toxicant dose in a smoker. Many previous studies have demonstrated that these metabolites – referred to as biomarkers in this paper – are related to tobacco smoke exposure. The studies reviewed here were designed to answer another question: are these substances also biomarkers of cancer risk? Using a prospective study design comparing biomarker levels in cancer cases and controls, all of whom were smokers, the results demonstrate that several of these biomarkers – total cotinine, total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), r-1-,t-2,3,c-4-tetrahydroxy-1,2,3,4-tetrahydrophenanthrene (PheT), and total N′-nitrosonornicotine (NNN) – are biomarkers of cancer risk. Therefore, these biomarkers have the potential to become part of a cancer risk prediction algorithm for smokers.


Source: cancer letters




Postpartum management of hypertension.

Hypertension in the postpartum period affects several groups of women, including those with previous chronic hypertension, gestational hypertension, pre-eclampsia, and eclampsia. In addition, pre-eclampsia may present for the first time in the postnatal period. Although the underlying causes and clinical presentation of these types of hypertension vary, patients can be investigated and treated in a similar manner. This review covers management of postpartum hypertension and its future consequences. Hypertension affects 6-10% of pregnancies,1 but few studies have reported the incidence of postpartum hypertension. This review is relevant to general practitioners, obstetricians, and specialists in secondary care who may see women with postpartum hypertension.