Wellness Check: Exercise | 2 minutes medicine


Aerobic activity and strengthening physical activity may have an association between dose response and mortality

1. In this study, compared with no aerobic physical activity (PA), mortality risk reduction was significantly associated with 1 hour per week of aerobic PA and stabilized at 3 hours/week.
2. Muscle-strengthening exercises (MSE) give an additional reduced risk of death on average once a week, but are no longer beneficial at 7 times a week.

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Despite its many benefits, more than one billion adults do not meet the World Health Organization’s standard recommendations. Although recent analyzes have examined the relationship between physical activity and the risk of all-cause mortality, there is little evidence surrounding lower effective doses. As a consequence, the aim of the prospective cohort study was to determine the association of dose-response and the minimum effective doses of aerobic PA and MSE required to cause a clinically significant reduction in the risk of all-cause mortality.

The current study used National Health Interview Survey data (1997-2014) and included 416,420 adults from the United States (US). Participants were excluded if they were not permanent residents of the United States, were in correctional facilities, active duty military personnel, or in long-term care facilities. Activity levels were reported using a standardized questionnaire. The study adhered to the STROBE Reporting Enhancement Guidelines. Cox proportional hazards models were used to assess the relationship between physical activity and all-cause mortality.

The results showed that, compared with no aerobic PA, significant mortality risk reduction was associated with 1 hour per week of airway PA and stabilized at 3 hours/week. Muscle-strengthening exercises (MSE) additionally reduce the risk of death at once per week but are no longer beneficial at 7 times per week. Despite these findings, the study was limited by the self-reported nature of physical activity. However, this longitudinal analysis of data from a large sample of US adults allowed a greater understanding of the relationship between PA/MSE and mortality, and may inform US health care providers.

Regular physical activity may protect against the negative consequences of COVID-19

1. In this study, engaging in regular physical activity had a lower risk of infection, hospitalization, severe COVID-19 illness, and COVID-19-related death compared to inactive peers.

2. The greatest benefit was achieved at 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity per week.

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Physical activity is known to have many beneficial health effects in addition to boosting immunity. So far, the relationship between regular physical activity and COVID-19 outcomes has not been well understood. As a result, the aim of the current systematic review and meta-analysis was to determine the relationship between physical activity and risk of COVID-19 infection and hospitalization, severe illness and death in adults.

Of the 4,063 records identified, 16 studies were included in the systematic review (n=1853610) from the start of the database through March 2022. Studies were eligible if they examined the effects of physical activity (questionnaires or objective measures) on COVID-19 outcomes. Studies were excluded if participants themselves reported a COVID-19 infection or were hospitalized. The quality of the evidence was assessed using rating recommendations, and GRADE was used for assessment. Statistical analysis was performed using the inverse random effects variance model.

The results showed that engaging in regular physical activity had a lower risk of infection, hospitalization, severe COVID-19 illness, and COVID-19-related death compared to inactive peers. Furthermore, the greatest benefit was achieved at 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity per week. Despite these results, the study was limited by the potential for the pooled estimates to be confounding. However, these findings may help guide clinicians in encouraging physical activity among patients to reduce the burden of COVID-19 health outcomes.

Occupational and recreational physical activity may have varying effects on inflammation

1. Decreased leisure time physical activity and increased occupational physical activity were associated with increased levels of high-sensitivity C-reactive protein (hs-CRP).
2. When analyzed as continuous variables, only leisure-time physical activity was strongly associated with hs-CRP levels.

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Paradoxically, physical activity related to one’s occupation has been shown in the literature to increase cardiovascular disease and mortality; The result does not apply to leisure-related physical activity. Although several mechanisms have been proposed, persistent systemic inflammation (measured by hs-CRP levels) may be an important contributor. In order to further study this association, the aim of the current cross-sectional study was to determine the extent to which physical activity during work and leisure time is associated with systemic inflammation.

The current study used data from the Copenhagen Group on Aging and Life Expectancy (CAMB). Of the 12,656 invited participants, 5304 blood samples, including the hs-CRP biomarker, were taken. Occupational physical activity was measured based on a self-reported occupational history with a job exposure matrix. Leisure-time physical activity was reported using the CAMB questionnaire. The two types of physical activity and hs-CRP were associated using multivariate linear regression models as well as post hoc analyses.

The results showed that lower leisure time physical activity and higher occupational physical activity were associated with increased levels of high-sensitivity C-reactive protein (hs-CRP). Furthermore, when analyzed as continuous variables, only leisure-time physical activity was strongly associated with hs-CRP levels. Despite these findings, the study was limited by the risks of misclassification, as physical activity was based on job title. However, the inclusion of a large number of participants reinforced the results of the current study and the fact that systemic inflammation may in fact explain the physical activity paradox.

Lower extremity arthritis may be more common in retired athletes

1. In this study, one in four retired Olympians reported developing osteoarthritis (OA), in which injury is associated with an increased risk of osteoarthritis and pain in the knee, hip, and ankle.
2. After adjusting for risk factors, athletes were more likely to have knee and hip injury after injury than the general population.

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Injury to the joint may be a risk factor for the future development of arthritis, especially for elite sports participants. So far, few studies have compared the amount of OA at different sites of the body in elite athletes (such as athletes) and the general population. As a result, the aim of the current cross-sectional study was to compare the prevalence of physician-diagnosed lower limb arthritis and pain in retired athletes, as well as to identify contributing factors.

The current study included self-reported data from an online survey of Olympians (through Olympic Federation platforms) and the general population (in three different phases). 3,357 retired Olympians (mean age = 44.7 years) and 1,735 (mean age = 40.5 years) individuals from the general population completed the survey between April 2018 and June 2019. Retired Olympians must have been 16 or older and compete in the summer of At least one and/or Winter Olympics. General controls for the population included those over 16 years of age who had not competed in the Olympic Games. For statistical analyzes, independent t-tests, Mann-Whitney U-tests, Chi-square test, and logistic regression were used.

The results showed that one in four retired Olympians reported developing osteoarthritis (OA), and the injury was associated with an increased risk of osteoarthritis and knee, hip and ankle pain. Furthermore, after adjusting for risk factors, athletes were more likely to have knee and hip injury after injury, compared to the general population. Despite these findings, the study was limited to representing only 4% of the total number of Olympic retirees. However, the current findings may help guide prevention strategies to reduce the risk of lower extremity inflammation in athletes after retirement from their sport.

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