Physical activity could reduce heart disease deaths among American Indians

Physical activity may reduce the risk of death from cardiovascular disease among American Indians, according to new research that also studied inflammation’s role in exercise and heart health.

Past studies of people from all populations show that inflammation plays a central role in heart disease, and that exercise might reduce inflammation in the body.

For the new study, researchers focused on American Indians, “a special population that, unfortunately, is not always included in studies that show the benefit of physical activity,” said the lead researcher Dr. Ozan Unlu, chief resident of quality and patient safety at Weill Cornell Medicine in New York City.

The findings will be presented Friday at the American Heart Association’s virtual Scientific Sessions. The research is considered preliminary until published in a peer-reviewed journal.

The study looked at self-reported physical activity levels from 3,135 adults in Arizona, North Dakota, South Dakota and Oklahoma, who did not initially have cardiovascular disease and who took part in the Strong Heart Study of American Indians. Researchers also looked at their levels of fibrinogen, a blood plasma protein that is considered a marker for inflammation.

Researchers tracked the study’s participants over 26 years of follow-up, during which 378 people died from heart disease. The groups were split into four equal groups, or quartiles. After adjusting for various factors, researchers found those who were the most physically active, in the top quartile, had a 44% lower risk of dying from cardiovascular disease than those in the bottom “minimal activity” quartile. The next two quartiles had a 31% and 9% lower death risk, respectively, than those in the lowest quartile.

“This study confirms that physical activity reduces cardiovascular mortality in this unique cohort of American Indians,” Unlu said. “This is a population that doesn’t always have the resources for exercise and physical activity that are available in urban settings.”

The study’s senior researcher, Dr. Parmanand Singh, said many of the participants live on reservations in rural areas where the nearest gym or other activity-related facility could be many miles away.

“We need to dig deeper and find out what sort of facilities can be constructed on reservations that are in line with the cultural value system of the population. We have to think about other interventions, too, such as bringing health fairs or other public health initiatives to the reservations,” said Singh, assistant professor of medicine and director of nuclear cardiology at Weill Cornell Medicine.

The researchers looked at participants’ fibrinogen levels and found “physical activity was possibly reducing cardiovascular deaths by inflammatory pathways,” Unlu said.

The research was limited by its retrospective nature, Singh said. The findings need to be confirmed by future studies in which participants gradually get more physically active and researchers see if that impacts fibrinogen readings, he said.

Dr. Carl Lavie said the idea that exercise lowers fibrinogen levels and cardiovascular death rates “is nothing new, but the new thing is that in this American Indian population, the benefit of the physical activity is, at least statistically, explained by the lower fibrinogen.” He is a medical director of cardiac rehabilitation, prevention and exercise at the Ochsner Clinical School/University of Queensland School of Medicine in New Orleans.

Lavie, who was not involved in the study, said more research is needed to figure out if fibrinogen is a valid way to measure cardiovascular risk. But even now, he said, “if one happened to measure a fibrinogen level and it was high, this would even provide further support for recommending physical activity.”

Source: Read Full Article

Physical distancing polices not enough to protect lower-income people

A new Boston University School of Public Health study of the first four months of America’s coronavirus epidemic, published in the journal Nature Human Behaviour, shows that physical distancing (also called “social distancing”) policies had little effect on lower income people still needing to leave their homes to go to work—but does show them staying home when they could.

“If lower-income people were simply ignoring the trend towards physical distancing, we would have expected them to continue going to places like supermarkets, liquor stores, and parks at the same rates as before. Instead, their visits dropped at almost the same rates as the very highest-income group,” says study lead author Dr. Jonathan Jay, assistant professor of community health sciences at BUSPH.

“This indicates that lower income people were just as aware and motivated as higher-income people to protect themselves from COVID-19, but simply couldn’t stay home as much because they needed to go to work,” he says.

Jay and colleagues used anonymized mobility data from smartphones in over 210,000 neighborhoods (census block groups) across the country, each neighborhood categorized by average income. They were able to see whether people from these neighborhoods stayed home, left home and appeared to be at work—staying at another location for at least three hours during typical working hours, or making multiple stops that looked like delivery work. The researchers also tracked movement to “points of interest”: beer, wine and liquor stores; carryout restaurants; convenience stores; hospitals; parks and playgrounds; places of worship; and supermarkets.

“The difference in physical distancing between low- and high-income neighborhoods during the lockdown was just staggering,” says study co-author Dr. Jacob Bor, assistant professor of global health and epidemiology at BUSPH.

“While people in high-income neighborhoods retreated to home offices, people in low-income neighborhoods had to continue to go to work—and their friends, family, and neighbors had to do the same,” he says. “Living in a low-income neighborhood is likely a key risk factor for COVID-19 infection.”

To analyze the role that policies played in these mobility patterns, the researcher used the COVID-19 U.S. State Policy Database (CUSP), a project led by study co-author Dr. Julia Raifman, assistant professor of health law, policy & management at BUSPH.

They found that the huge drop in mobility early in March had little to do with state policy, following similar patterns in different states regardless of when their orders went into effect. When state policies did go into effect, they modestly decreased mobility further—but did nothing to close the gap between low- and high-income neighborhoods.

“The orders did not have the effect of making it easier for lower-income people to stay home,” Jay says. But they did stay home to the degree possible, visiting non-work non-home locations less—which counters a major narrative about how different groups of people have responded to COVID, Jay says. “Early in the pandemic, there was a lot of talk about ‘non-compliance,’ and it was rarely directed at the people with the most power and privilege,” he says.

“We found strong evidence of compliance among the people who are most economically marginalized, which because of structural racism disproportionately includes people of color. As the pandemic has played out, the evidence of poor safety practices at the very highest levels of power has become more clear.

“Still, it’s deeply troubling that throughout the pandemic, staying home has been a choice for some people and not for others.”

The researchers say that closures are an important tool for states and cities to prevent the spread of the coronavirus, but that they need to be accompanied by other policies that make it easier for frontline workers to protect themselves.

“That people living in low-income households are more likely to face exposure to COVID-19 at work increases the importance of complementary policies, such as mask requirements in indoor spaces, that protect essential workers from COVID-19,” Raifman says.

“One of the most important arguments for mask mandates is that they protect the folks who are in public spaces not because they want to be, but because showing up is how they make ends meet,” Jay says. He also points to “policies that make it easier to work from home, stay home sick, and not to take a risky new job just to put food on the table.”

Source: Read Full Article

Relationship Explored Between Physical Activity and Lymphoma

TUESDAY, Oct. 13, 2020 — High levels of physical activity may lower the risk for developing lymphoma, according to a review/meta-analysis published online Oct. 6 in BMC Cancer.

Gwynivere A. Davies, M.D., M.P.H., from the Juravinski Cancer Centre-Hamilton Health Sciences in Canada, and colleagues conducted a systematic literature review/meta-analysis to examine the association between physical activity and incident lymphoma. Eighteen studies (nine cohort, nine case-control) were included in the final analysis.

The researchers found that for all lymphoma, comparing the highest with the lowest activity categories showed physical activity was protective (relative risk, 0.89; 95 percent confidence interval, 0.81 to 0.98). In a sensitivity analysis, the effect persisted in case-control studies (relative risk, 0.82; 95 percent confidence interval, 0.71 to 0.96) but not in cohort studies (relative risk, 0.95; 95 percent confidence interval, 0.84 to 1.07). A subgroup analysis showed some protective effect of physical activity for non-Hodgkin lymphoma (relative risk, 0.92; 95 percent confidence interval, 0.84 to 1.00) but not for Hodgkin lymphoma (relative risk, 0.72; 95 percent confidence interval, 0.50 to 1.04). A protective effect was demonstrated in a dose-response analysis, with a 1 percent reduction in risk per three metabolic equivalent of task (MET) hours/week (relative risk, 0.99; 95 percent confidence interval, 0.98 to 1.00; P = 0.034).

“Dose response analysis supports these conclusions, with a linear decrease in incidence seen with increasing recreational physical activity,” the authors write.

Abstract/Full Text (subscription or payment may be required)

Source: Read Full Article