Lung power

Lung power is the number-one predictor of how long you’ll live. How well you breathe determines how long you’ll stay active and healthy.
The medical journal Chest did a 29-year follow up to the Buffalo Health Study, which followed over 1,100 people up to age 89. They found that the better your lungs work, the less likely you are to die of any cause. The correlation was even stronger for heart disease.
This makes me wonder about all those workout “gurus.” They keep telling you to do “cardio” which only wears down your heart and lungs. The studies prove that lungpower – not wearing down your heart with hours of aerobics – will keep you going.
Most doctors aren’t aware of this, either. They don’t bother to measure your lungpower during a doctor visit. Yet it’s easy to do, and I measure it at my clinic.
The best way to tell how powerful your lungs are is a measurement called VO2 max.
That’s because VO2 max measures the amount of oxygen your lungs can use while you’re exercising at your maximum capacity. And the more oxygen you can get to your body, the better your body works.
VO2 max is usually written in milliliters of volume per kilograms of body weight (ml/kg) because oxygen and energy needs are different depending on how big you are.
VO2 max typically declines with age.

The American Journal of Epidemiology looked at respondents from the famous Harvard Health study, which followed over 13,000 people for 15 years. They found that people live longer if they do vigorous exercises, but not if they only do light or moderate workouts.
And the risk of death kept getting lower and lower not for those who expended energy for the longest time, but who expended the most energy. In other words, intensity is the key to lowering the likelihood of death.

Neck pain

Exercises you can do to relieve your neck pain:
1. Side Neck Stretch with Resistance – Reach one hand over the opposite side of your head, and hold with your fingers just above the ear. Gently pull your head toward your raised arm until you feel a stretch in your neck muscles. To strengthen, push back with your head as you pull with your hand. Hold for 15-30 seconds and repeat 3 times.

2. Chin Tuck – Stand or lie down with both hands by your sides. With your head in a neutral position, push slowly forward and down, trying to press your chin into your chest. Hold the stretch for 15 seconds. If you’re standing, slowly lifting your head back to neutral will strengthen the muscles at the same time you stretch them.

3. Head Retraction – This is designed to improve the strength of muscles at the base of the neck. Glide your head straight back, lifting your chin, and hold for 15 seconds. Repeat 3-5 times. Lifting slowly will give those muscles more strength as well.

4. Neck Press with Resistance – For a little more rigorous exercise, clasp your fingers behind your head, elbows out to the sides. Slowly pull forward on your head, while resisting with your neck. Do this for 10 seconds at a time, and repeat up to three

Parkinson's disease

Ibuprofen was associated with a 38% lower risk of Parkinson's disease, but we didn't find any significant protective effects for other NSAIDs [nonsteroidal anti-inflammatory drugs], for example, aspirin or acetaminophen," lead study author Xiang Gao, MD, PhD, from the Channing Laboratory at the Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, said in an interview.
Their results were supported by those of a separate meta-analysis of other such trials included in this report. The findings were presented last year at the American Academy of Neurology 62nd Annual Meeting in Toronto, Ontario, Canada.
Neuroinflammation may contribute to the pathology of Parkinson's disease, the study authors note, and use of NSAIDs in general, and ibuprofen in particular, has previously been linked to reduced risk for the disease.
Dr. Gao and colleagues published a previous report in 2003 using data from NHS and HPFS showing a reduced risk for PD with NSAIDs but not aspirin (Arch Neurol. 2003;60:1059-1064). A subsequent article by Dr. Gao's Harvard School of Public Health colleagues, using data from the American Cancer Society's Cancer Prevention Study II Nutrition Cohort, showed that ibuprofen, but not other NSAIDs, was associated with a reduction in PD risk of about 35% (Ann Neurol. 2005;58:963-967).
In the present study, the study authors analyzed data on 136,197 men and women included in the prospective cohorts of the NHS and the HPFS who were free of PD and other diseases at baseline in 1998 for the NHS and 2000 for the HPFS. The use of NSAIDs was assessed by questionnaire. For this analysis, they included only new incident cases since their previous report.
During 6 years of follow-up, there were 291 incident cases of PD. The study authors report that users of ibuprofen had a significantly lower risk of developing PD than nonusers and, further, that there was a dose-response relationship between the number of tablets taken per week and PD risk (P for trend = .01).
Further adjustment for self-reported gout, use of other types of analgesics, sleep duration, bowel movement, and use of antidepressants "did not materially change these results," they write.
They also performed an additional meta-analysis combining 5 published prospective studies, Dr. Gao added. "We found similar results," he said. "The use of ibuprofen is associated with around 30% lower risk of PD in this meta-analysis."
The mechanism of an apparent advantage for ibuprofen is not clear, but ibuprofen can activate the PPARγ pathway, Dr. Gao noted. "That's a very important pathway for Parkinson's disease because it inhibits apoptosis, suppresses oxidative damage, and moderates inflammation in the brain," he said. "So we thought that is a potential mechanism why ibuprofen but not other NSAIDs are associated with a lower risk of Parkinson's disease but this is just a hypothesis."
If it's confirmed in a future clinical trial, ibuprofen could be a very useful and inexpensive new treatment for Parkinson's disease.
An important next step is to see whether use of ibuprofen can slow disease progression among PD patients, Dr. Gao said. "I hope in the future we'll have the opportunity to look at this potential effect of ibuprofen. If it's confirmed in a future clinical trial, ibuprofen could be a very useful and inexpensive new treatment for Parkinson's disease."
In an editorial accompanying the publication, James H. Bower, MD, MSc, from the Department of Neurology at Mayo Clinic, Rochester, Minnesota, and Beate Ritz, MD, PhD, from the Department of Epidemiology at the University of California, Los Angeles. School of Public Health, are cautious in their assessment of the relationship between ibuprofen use and PD.
Although these observational studies are well-conducted and analyzed and have "excellent" participation rates that would minimize selection bias, short follow-up of 6 years could miss PD cases that can take up to 20 years to manifest, they suggest.
In addition, they ask, "Could gastrointestinal symptoms cause a patient with preclinical PD to be less likely to take ibuprofen regularly, thus explaining the association? The 2-year lag they employed and the long-term 'ibuprofen' use sensitivity analysis would not suffice to refute this alternative hypothesis."
Still, they are intrigued by the possible biological explanation suggested by the study authors that ibuprofen may act as a ligand for PPARγ, an inhibitor of apoptosis and oxidative damage.
"Are we ready to tell our patients with PD that they should start taking ibuprofen? Absolutely not," they conclude. "Nor should we tell them to start smoking, drinking coffee, and eating liver pâté in hopes of developing gout."
However, "just as prior epidemiologic associations have inspired the development of clinical trials for transdermal nicotine (smoking), istradefylline (coffee), and inosine (uric acid), a clinical trial for ibuprofen, or perhaps a safer PPARγ antagonist, may be warranted."
The study was supported by a grant from the National Institutes of Health (NIH)/National Institute of Neurological Disorders and Stroke (NINDS) and in part by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences. Dr. Gao reports he has received research support from NIH/NINDS. Disclosures for other coauthors appear in the article. Dr. Bower reports research support from the NIH. Dr. Ritz reports receiving research support from the NIH, the US Department of Defense, Environmental Protection Agency, Health Resources and Services Administration, and the Foundation for Psychocultural Research.

Depression in Men

Tough economic times and profound societal change currently under way may mean rates of depression among men from Western nations are likely to increase, predict the authors of a commentary published in the March issue of the British Journal of Psychiatry.
It's well known that women are nearly twice as likely as men to develop major depressive disorder in their lifetime, but this difference may well change in the coming decades, argue Boadie W. Dunlop, MD, director of the Mood and Anxiety Disorders Program at Emory University School of Medicine in Atlanta, Georgia, and his Emory colleague and coauthor Tanja Mletzko, MA.
Western economies are undergoing a "profound restructuring," they point out, with traditional male jobs in manufacturing, construction, and other physical-labor jobs being outsourced to low- and middle-income nations or becoming obsolete due to technological advances.
The current economic downturn has hit men particularly hard, Dr. Dunlop and Ms. Mletzko note in their article. They point to research showing that roughly 75% of jobs lost in the United States since the beginning of the recession in 2007 were held by men, leading some to dub this recession the "Mancession."
And the odds that traditional male jobs will return in significant numbers with economic recovery are slim. "Western men, particularly those with low education, will face a difficult road in the 21st century," Dr. Dunlop and Ms. Mletzko write.
Aaron Rochlen, PhD, a psychologist and associate professor in counseling psychology at the University of Texas at Austin, said he wouldn't be surprised if the occupations traditionally held by a high percentage of men continue to be those most affected by layoffs.
"Of course, it's very difficult to 'link' this with depression, but it's not uncommon for men to struggle with a range of mental health consequences when faced with unexpected layoffs. Therefore, I think men need to prepare themselves and 'diversify' their work and personal portfolios,"said Dr. Rochlen .
In their commentary, Dr. Dunlop and Ms. Mletzko also note that women are increasingly becoming the primary household breadwinners, with 22% of wives earning more than their husbands in 2007 vs only 4% in 1970. Compared with women, men attach greater importance to their roles as providers and protectors of their families, and men’s failure to fulfill the role of breadwinner may contribute to depression and marital conflict.
Men who suddenly find themselves in the homemaker/childrearing role may need help adjusting, Dr. Dunlop said. "There could be increased rates of life dissatisfaction and substance abuse. Some men who do better in this role are the older siblings in a family who already have had the experience when younger of taking care of younger siblings, but the youngest men in the family, or last born, may have the hardest time with this," he noted.
To get the conversation going, Dr. Dunlop encourages clinicians to ask "simple, nonthreatening general questions, for example, How is work going? How is life at home? How are you guys getting by with how the economy is doing?"
In shifting economic times, said Dr. Rochlen, it is important that men consider how to "redefine themselves and their conceptualizations of masculinity.
"There's at least some evidence," he said, "that men are expanding the ways they think of themselves. And I'd say, in many ways, this is a good thing."
"For example," he said, "we are seeing more active and involved fathers, including men as primary care providers for their children. I do think the idea of male as 'provider' is expanding. And while there are some growing pains with this, I'd argue that it's needed and a positive thing in the long run." Dr. Rochlen's research interests include men’s gender role socialization, help-seeking behaviors, and the lives of men in nontraditional work/family roles.
Dr. Dunlop receives research support from the National Institutes of Health and various pharmaceutical companies, including AstraZeneca, Evotec, Forest, GlaxoSmithKline, Novartis, Pfizer, and Wyeth, and has served as a consultant to Imedex, MedAvante, and Pfizer. Dr. Rochlen has disclosed no relevant financial relationships.

The "silent killer"

An alarming one in three American adults has high blood pressure. Known medically as hypertension, many people don't even know they have it, because high blood pressure has no symptoms or warning signs. But when elevated blood pressure is accompanied by abnormal cholesterol and blood sugar levels, the damage to your arteries, kidneys, and heart accelerates exponentially. Fortunately, high blood pressure is easy to detect and treat. Sometimes people can keep blood pressure in a healthy range simply by making lifestyle changes, such as losing weight, increasing activity, and eating more healthfully. This report details those changes, including a Special Section that features numerous ways to cut excess salt from your diet — a policy strongly recommended by new federal guidelines. This report also includes tips on how to use a home blood pressure monitor, as well as advice on choosing a drug treatment strategy based your age and any other existing medical issues you may have.

Muscle strength

A study from the University of Pittsburgh followed nearly 2,300 people for five years. It found that low quadriceps muscle strength made you 51 percent more likely to die.
Two other studies found that leg strength offsets the risk of death for people with certain illnesses.
In the first study, the only two things that predicted death were age and quadriceps muscle strength.
The second found that for people who had congestive heart problems, the ones with the weakest quadriceps muscles were 13 times more likely to die within two years.
Your muscles are made up of different kinds of fibers that you use for different purposes.
Traditional cardio or aerobic exercise uses the smaller muscle fibers because they are more oxygen efficient, and don’t tire as easily as large muscle fibers.
If you continue to do moderate aerobic workouts, your body will ignore the larger fibers, leaving them weak.
One study even found that long-duration running makes your leg muscles deteriorate.
Take a look at this new study that followed endurance runners during the Trans-Europe Foot Race in 2009.
They had a mobile MRI machine scan these endurance athletes every day. When the race was over, instead of the runners’ muscles getting stronger, their leg muscles had degenerated.
They had lost 7 percent of their muscle mass.4
This is why doing aerobics and running for hours on end is not a good idea.
The solution to building stronger muscles that will keep you going for years to come is PACE program (PACE stands for Progressively Accelerating Cardiopulmonary Exertion ). With PACE, you challenge your cardiopulmonary peak a little bit at a time. Your body will then respond with added lung, heart and especially muscle strength while you rest.
It draws on those larger muscle fibers, which generate more power. By exercising the larger fibers, you get stronger muscles that can handle heavy-duty demands.
Strengthening your muscles this way is the most important thing you can do to keep your mobility and independence as you get older.
The first is a warm-up set that lasts from 4-6 minutes. The second is a ramp-up set that should last for 4 minutes. You exert yourself to the point where you could still talk, but you’re out of breath.
The third is for peak exertion. It should only last from 2-4 minutes, and you should be pumping hard enough by the end that you could only grunt a word or two if you had to.
Challenging your peak this way – a little bit each time, followed by periods of rest – is what causes your body to adapt by adding muscle mass and cardiopulmonary capacity.
In between sets, you want to recover so that your heart rate is about 30 beats per minute above your resting rate. It will take only 30 seconds for some, and longer for others. But don’t worry how long it takes at first. Your body will progress as you get more fit.
This is one of the things that makes PACE different. You don’t time your recovery in strict intervals. You recover fully, and then challenge yourself again during the next exertion period.

Ischemic Stroke

Ischemic Stroke
There is a rising risk for stroke among young people, including children and teens, warn analysts from the US Centers for Disease Control and Prevention (CDC).
Presenting new numbers here at the American Stroke Association International Stroke Conference, researchers showed more hospitalizations for acute ischemic stroke among young people age 5 to 44 years at the same time rates were declining among the middle-aged and elderly.
"Acute ischemic stroke is currently considered something that mostly happens to older people," Xin Tong, MPH, a health statistician with the CDC's Division for Heart Disease and Stroke Prevention in Atlanta, Georgia, told reporters attending a news conference. "But awareness of rising rates in the young is important or else tissue plasminogen activator and other important stroke treatment may be unnecessarily delayed in younger patients."
"I think this is a very important use of epidemiological data," Lee Schwamm, MD, director of telestroke and acute stroke services at Massachusetts General Hospital in Boston, told reporters. "These are important findings about the frequency of diagnosis in young and very young patients who have typically been understudied."
Largest Inpatient Database
Using the Nationwide Inpatient Sample, the analysts tracked trends in hospitalizations from 1994 to 2007. This is the largest all-payer inpatient care database in the United States.
Tong showed increasing stroke-related hospitalizations in young patients age 5 to 44 years (P for linear trends < .01).
Increasing Stroke Hospitalizations in Patients Age 5 to 44 Years
Ischemic Stroke Patients Increase (%)
Males age 5 - 14 (31%)
Females age 5 - 14 (36%)
Males age 15 - 34 (51%)
Females age 15 - 34 (17%)
Males age 35 - 44 (47%)
Females age 35 - 44 (36%)
Conversely, they found a decline in stroke hospitalizations for older and younger age groups. The decline in hospitalizations for babies and toddlers exceeded that of middle-aged and elderly patients (P for linear trends < .01).
Decreasing Stroke Hospitalizations by Age Group
Ischemic Stroke Patients Decrease (%)
Males age 0 - 4 (31%)
Females age 0 - 4 (51%)
Males age 45 - 64 (12%)
Females age 45 - 64 (13%)
Males age 65 and older (25%)
Females age 65 and older (28%)
"We cannot link anything in particular to the trend in younger patients, but I believe the role of obesity and hypertension will prompt a big discussion," Tong said. "Unfortunately, right now we can't speculate on the causes."
We cannot link anything in particular to the trend in younger patients, but I believe the role of obesity and hypertension will prompt a big discussion.
Dr. Schwamm pointed out the decline in hospitalizations for stroke among older people is consistent with other reports and suggests that this confirms improvements in primary and secondary prevention and controlling traditional risk factors.
"Among children, the story is more complicated," Dr. Schwamm said. "It seems unlikely the increases in hospitalizations are due to traditional risk factors — particularly in patients aged 5 to15. Although in people aged 15 to 35, it also seems unlikely," he noted.
Dr. Schwamm explained that although risk factors such as obesity, hypertension, and diabetes in a child are likely to contribute to cardiovascular disease and atherosclerosis later in life, they probably won't trigger events such as stroke right away.
Better Detection?
Dr. Schwamm suggests the increase in hospitalizations may be related to better detection rather than true incidence or rate of new strokes. He questions whether more widespread use of magnetic resonance imaging is identifying more cases.
"It may also be because it's more cost-effective or leads to greater reimbursement when young adults or children are evaluated in a hospital setting," he said. "This may reflect a shift from outpatient to inpatient care."
Still, he points out, percentage increases can be somewhat misleading. "Hospitalizations for stroke might be very rare but twice as common. Raw rates are different from percentage increases," he said. "The distribution of stroke over decades is important to keep in mind."
. "Stroke in children is rare, but it does exist," lead author Franz Babl, MD, from the Royal Children's Hospital and Murdoch Children's Research Institute in Melbourne, Australia, said in a news release.
"Stroke patients in our study had previously been generally healthy, unlike their adult counterparts. Because pediatric stroke is so rare, it's not the first thing we look for," Dr. Babl said. "Stroke symptoms in children are frequently attributed to other, more common problems, such as migraine, seizures, or encephalitis."
This study was funded by the Agency for Healthcare Research and Quality. The researchers have disclosed no relevant financial relationships.