Approach Parkinson’s Like An Olympic Athlete

 

Does your competent? doctor even know of the need for this? So, EXACT PREVENTION PROTOCOLS CAN BE INITIATED! Your doctor's responsibility to get you recovered enough to become an athlete! Don't let him/her weasel out of that responsibility by using the craptastic saying; 'All strokes are different, all stroke recoveries are different'! If that comes out of their mouth, YOU NEED TO START SCREAMING INCOMPETENCE! In my opinion any stroke medical 'professional' that says that is COMPLETELY FUCKING INCOMPETENT! Because they have given up on solving stroke and are going thru the motions of treating you with interventions learned way back in medical school, nothing newer!

Parkinson’s Disease May Have Link to Stroke March 2017 The latest here: 

Approach Parkinson’s Like An Olympic Athlete

This transcript has been edited for clarity. 

Indu Subramanian, MD: Welcome, everyone, to Medscape. We’re so excited to have Professor Bas Bloem here today, speaking about all things related to lifestyle choices. He has really been a world expert in this area. He’s the director at Radboudumc Center of Expertise for Parkinson’s and Movement Disorder at Radboud University Medical Center in Nijmegen, Netherlands. I’ve been practicing that a little bit. 

I’m Indu Subramanian, at UCLA, coming to you from Los Angeles, California. Bas is inspiring in this field that he has been cheerleading for decades. The Wellness Task Force that I’m on at the Movement Disorder Society had a paper about a prescription for lifestyle choices, and Bas, you had a paper on the scientific basis and the pathophysiology behind this. 

Bas, welcome. Thank you for joining me. 

Bastiaan R. Bloem, MD, PhD: Thank you for inviting me on the show. It’s an honor to be here. 

Wellness and Lifestyle: A Perfect Pairing

Subramanian: Interestingly, these two papers came out right at the same time, and it was exciting because I think they pair very well. We have this idea of a prescription that can be given to pretty much anyone, even somebody living in Africa without any resources.

The thought is that we can do things around, sleep, diet, exercise, social connection, and stress management, yoga, mindfulness, tai chi, and things like that. We put out our paper, and then you had a beautiful paper talking about the pathophysiology and how we can think about the effects on the brain and the body in somebody living with Parkinson’s.

Maybe you can tell me a little bit about your thoughts.

Bloem: First of all, congratulations on your own paper on wellness. I think it’s a seminal contribution to the field.

Subramanian: Thank you.

Bloem: We’re seeing the shift away from treating tremor or treating bradykinesia until the doctor is happy toward wellness, which means more to people in their daily lives. Your paper was, to my mind, seminal in that regard and people should read it. 

The way to reach that state of wellness is, of course, partially pharmacotherapy, but increasingly I regard myself as a holistic doctor, and part of that holistic approach is lifestyle interventions. In a separate interview, we talked about exercise, but lifestyle is more than just exercise. Lifestyle is also healthy nutrition and that is now question number one when I see people with Parkinson’s in my clinic. I think exercise has moved from a belief into an evidence-based treatment.

Nutrition is lagging behind. We still need good clinical trials. At the same time, having a high-fiber diet and ample fluids to keep your bowel movements going is essential. We believe that a Mediterranean, probably plant-based, diet is good for people with Parkinson’s. 

What we don’t know, but what I suspect is good, is organic food free of or low in pesticides because we now know that pesticides and other toxic chemicals are not only the cause of Parkinson’s, but also they probably lead to a faster disease progression after your diagnosis. Once you’ve been diagnosed, you want to steer away from toxic chemicals as much as you can in your life. Organic food, even though there is no trial to prove it, to my mind is one avenue to achieve that healthier lifestyle.

The third element is stress. Stress is bad for everybody, but it is particularly bad for people with Parkinson’s. It worsens symptoms. Tremor, I always say, is the thermometer for stress. It worsens under stress, but freezing of gait is worse, dyskinesias, the involuntary movements induced by medication, get worse under stress. There is animal work to suggest that chronic stress may hasten disease progression, meaning that stress management, on a positive note, could slow down disease progression. 

I’m excited to announce that we now have two big trials in my center. One is the Plants for Parkinson’s study, where in the first large-scale, randomized clinical trial, we are testing a plant-based Mediterranean diet for primarily symptomatic effects, but secretly we’re looking at biomarkers for disease modification as well. We have a big trial of mindfulness, the MIND-PD study, where again, the primary goal is to look at symptomatic relief, but we’re doing neuroimaging and blood-based biomarkers to also see whether alleviation of stress may slow down the disease progression in Parkinson’s.

Now, things get really important because doctors either don’t talk about lifestyle, or because lifestyle is gaining momentum, they say, “Hang on, Mr. Johnson. You have to exercise, eat well, and avoid stress. Time to go. Bye-bye.”

The patient goes home and says, “What?” They have no idea. Doing one thing is difficult. Doing three things at the same time is extra difficult. I always say to do one thing and do it well, and after you’ve implemented it in a sustainable way in your life, start with a second.

Implement, Sustain, Perfect 

Bloem: I think it is essential that physicians address lifestyle issues with people with Parkinson’s. If you are living with Parkinson’s yourself, bring it up in a conversation with your physician, and my key advice is to prioritize. 

If you are full of energy, you may be able to do all three lifestyle interventions at the same time. If not, discuss with your physician, physiotherapist, or nurse which one should receive the highest priority in your life. Build it up, implement it, make it sustainable, and only then you move on to the second element of lifestyle. You don’t have to do it all at the same time because you may end up doing nothing properly. 

At the end of the day, I do strongly feel that combining interventions will have at least additive effects and maybe synergistic effects. “Synergistic” is the doctor’s terminology for 1 and 1 adds up to 3. I think, ultimately, if you manage to implement multiple lifestyle interventions, you’ll be even better off by just doing one thing, but build it up one at a time.

Subramanian: The paper was very exciting because it actually shows why it’s so hard to study any one of these interventions in a randomized, controlled fashion. I think we have these very old-school ways of thinking about how these studies should be done, and then often they end up being negative because it’s hard to really tease things apart, while following populations over time. 

You beautifully document the different overlapping areas of pathophysiology that many of these lifestyle interventions can impact. When we were writing our paper, we found that something like exercise can impact sleep, which can impact Parkinson’s. The notion that many of these things can be a web and impact different things in different ways is very exciting. 

It may be hard to tease out any one chemical that’s going up that’s improving something specifically. I think that we can look at these interventions holistically and think about quality of life and how the patient’s doing overall, rather than looking at just one chemical, a tremor score, or something like that. That’s my thought, what’s your sense, Bas?

Bloem: I absolutely agree. You mentioned sleep. If you look at the whole package of lifestyle as we already discussed — exercise, nutrition, and stress — it’s also sleep. It is supplements, which are important to people with Parkinson’s, and it is social connections. What I see is that many people with Parkinson’s become isolated. Remaining connected to your family, your friends, your neighbors is essential for the wellness concept that you introduced to the International Parkinson and Movement Disorder Society. 

Taken together, there are multiple knobs that you can turn. Think carefully about which knob you want to turn first and work on it. Ultimately, you want all the knobs to be turned. I drew an analogy between having Parkinson’s and being a professional athlete. 

The Olympics will soon be in northern Italy. For the athletes competing at the Olympics, everything needs to be right, including your training program, your nutrition, your stress, and your workouts. 

If you’ve got Parkinson’s, everything needs to be perfect, and it’s not just medication. Medication is important, but turn the other knobs as well. Sit down with your team, prioritize, and work on turning those knobs one by one to optimize your quality of life and to reach your state of wellness. 

Subramanian: I love that. Thank you so much, Bas, for taking the time. I know you have a crazy busy schedule yourself, so I appreciate you coming on here and helping us cheerlead this space.

Thank you, everyone, for joining us.

Physical Activity Over the Adult Life Course and Risk of Dementia in the Framingham Heart Study

 

3 years post stroke at a physical I had a resting heart rate of 54 at age 53, level of an athlete. My doctor asked what exercises I was doing, 'I've done no exercises for the past 3 years'. So now after 19 years of little exercise I'm no longer that athlete. Hopefully that physical activity in my midlife is enough to prevent dementia

Physical Activity Over the Adult Life Course and Risk of Dementia in the Framingham Heart Study

Francesca R. Marino, PhD¹ Chenglin Lyu,MS¹ Yuqing Li,MPH² Author Affiliations  

1 Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts 

2 Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts 

3 Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts 

4 Department of Neurology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts 

5 Slone Epidemiology Center, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts 

6 The Framingham Heart Study, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts 

7 Boston University Alzheimer’s Disease and Chronic Traumatic Encephalopathy Center, Department of Neurology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts 

Key Points

 Question When during the adult life course is physical activity most associated with risk of incident dementia? 

Findings

 In this cohort study of 1526 early adult–life, 1943 midlife, and 855 late-life participants in the Framingham Heart Study, individuals with the highest levels of physical activity at midlife and late life had 41% and 45% lower risk of all-cause dementia, respectively, compared with those with the lowest levels of physical activity, a statistically significant difference. Early adult–life physical activity was not associated with dementia risk. 

Meaning

  These findings suggest that timing efforts to promote physical activity during midlife or late life may be warranted to help delay or prevent dementia. 

Importance

 Being physically active is protective against dementia. Yet, it is unknown when during the adult life course physical activity is most associated with dementia risk. 

Objective

 To determine whether higher physical activity levels in early adult life, midlife, or late life are associated with lower risk of all-cause or Alzheimer disease (AD) dementia. 

Design, Setting, and Participants

 This prospective cohort study used data from the Framingham Heart Study Offspring cohort. The offspring of participants in the original Framingham Heart Study cohort who were dementia free and had physical activity measured at baseline (early adult life [1979-1983], midlife [1987-1991], or late life [1998-2001]) were followed up for a mean (SD) of 37.2 (7.1), 25.9 (8.5), or 14.5 (6.6) years for the development of incident all-cause or AD dementia until December 31, 2023. 

Exposure

 Physical activity was self-reported using the physical activity index, a composite score weighted by hours spent sleeping and in sedentary, slight, moderate, or heavy activities. Physical activity was divided into quintiles (Q). 

Main Outcome and Measure

 All-cause and AD dementia were classified by expert consensus based on established diagnostic criteria. 

Results

 This study included 1526 early adult–life (mean [SD] age, 36.7 [4.7] years; 821 [53.8%] female), 1943 midlife (mean [SD] age, 54.0 [5.8] years; 1010 [52.0%] female), and 885 late-life (mean [SD] age, 71.0 [4.5] years; 473 [53.4%] female) participants. There were 567 cases of incident all-cause dementia during follow-up. Higher levels of midlife and late-life physical activity were associated with lower risk of all-cause dementia. Midlife and late-life physical activity levels in Q4 or Q5 were associated with lower risk of all-cause dementia compared with Q1 (midlife Q4: HR, 0.60; 95% CI, 0.41-0.89; midlife Q5: HR, 0.59; 95% CI, 0.40-0.88; late-life Q4: HR, 0.64; 95% CI, 0.42-1.00; late-life Q5: HR, 0.55; 95% CI, 0.35-0.87). There were no associations between early adult–life physical activity and dementia risk. Findings were similar for incident AD (369 cases). 

Conclusions and Relevance

 In this cohort study of adults in the Framingham Heart Study Offspring cohort, higher levels of midlife and late-life physical activity were associated with similar reductions in risk of all-cause and AD dementia. These findings may inform future efforts to delay or prevent dementia through timing interventions during the most relevant stages of the adult life course.

Physical Activity and Dementia: Is Timing Everything?

 

Now your competent? doctor needs to get you recovered enough to do this exercise and hopefully prevent dementia/Alzheimers. From age 56 to 68 I probably walked on average 10,000 steps a day. Absolutely nothing about that was from my doctor or therapists, spasticity prevents me walking normally, so I'm destroying my left knee.

My midlife exercise capability(50-56) was almost reduced to nothing because my incompetent? doctor had nothing to get me 100% recovered.

3 years post stroke at a physical I had a resting heart rate of 54 at age 53, level of an athlete. My doctor asked what exercises I was doing, 'I've done no exercises for the past 3 years'. So now after 19 years of little exercise I'm no longer that athlete.

Nothing here is useful in any sense to create protocols that will be repeatable and guarantee prevention of dementia.

Physical Activity and Dementia: Is Timing Everything?

This transcript has been edited for clarity. 

Hello. I’m Dr JoAnn Manson, professor of medicine at Harvard Medical School and Brigham and Women’s Hospital. In several studies, regular physical activity has been linked to lower risk for cognitive decline and dementia. But a key question is whether physical activity during certain adult life stages is most associated with dementia risk.

This important question was addressed in a recent study published in JAMA Network Open. The main findings of the study were that higher physical activity levels were particularly important in midlife and later life, and that higher fourth and fifth quintiles of activity(What specifically does this mean?) were associated with a 40% lower dementia risk during follow-up, when compared with the lowest levels of physical activity. Physical activity in early life was not clearly associated with dementia risk. 

The authors looked at prospective data from more than 4000 participants in the Framingham Heart Study Offspring cohort. All participants were dementia-free at baseline and had physical activity assessed at three life stages: early adulthood (26-44 years), midlife (45-64 years), and late life (65-88 years). During follow-up, 567 participants developed all-cause dementia.

Higher levels of moderate or heavy activity(EXACT definition needed!) in midlife or later life were linked with lower dementia risk. Physical activity in midlife was only associated with lower dementia risk among participants without an APOE4 Alzheimer's risk gene. Late-life activity, however, was associated with reduced dementia risk among both APOE4 carriers and noncarriers, suggesting late-life physical activity may offset some APOE4-related changes. 

There are multiple potential mechanisms underlying the reduced dementia risk associated with physical activity. Exercise reduces inflammation, helps to maintain favorable body composition, increases cerebral blood flow, and favorably affects neuroplasticity and levels of brain-derived neurotropic factor expression; the latter have previously been shown in rodent studies.

Although identifying specific life stages when physical activity appears most beneficial for preventing or delaying the onset of dementia may help inform guidelines and strategies for prevention, it's important to keep in mind that many studies, including the Bogalusa Heart Study, suggest that physical activity early in life is also critically important for coronary heart disease, stroke, and other chronic disease risk reduction. Therefore, beginning healthy lifestyle habits early in life is probably the best strategy of all in terms of cardiometabolic and general health. It seems that the policy that it's never too early and never too late to become physically active would be best.

Midlife exercise cuts dementia risk by up to 45 percent, new study shows

My midlife exercise capability(50-69) was almost reduced to nothing because my incompetent? doctor had nothing to get me 100% recovered.

3 years post stroke at a physical I had a resting heart rate of 54 at age 53, level of an athlete. My doctor asked what exercises I was doing, 'I've done no exercises for the past 3 years'. So now after 19 years of little exercise I'm no longer that athlete.

Midlife exercise cuts dementia risk by up to 45 percent, new study shows

New findings from the Framingham Heart Study show that staying active in midlife and late life has a powerful impact on long-term brain health and may significantly reduce the risk of dementia.

Study: Physical Activity Over the Adult Life Course and Risk of Dementia in the Framingham Heart Study. Image Credit: Master1305 / Shutterstock

In a recent study published in JAMA Network Open, researchers examined whether physical activity during early adulthood, midlife, or late life is most strongly associated with a reduced risk of developing Alzheimer’s disease or all-cause dementia.

Their findings indicate that higher physical activity in midlife and late life was linked to a 41-45% lower risk of all-cause dementia, with slightly stronger reductions observed in the highest activity quintile (Q5), and similar patterns were observed for Alzheimer’s disease.

Lifestyle and Timing Challenges in Dementia Prevention Research

Dementia poses a major global health challenge, and effective preventive strategies are urgently needed because current drug treatments for Alzheimer’s disease offer only modest benefits, are costly, and may cause side effects. Growing evidence suggests that modifying lifestyle factors could prevent a substantial portion of dementia cases.

Physical activity is among these modifiable factors, especially during midlife. However, it remains unclear when across adulthood physical activity matters most for long-term brain health. Past research has shown that being physically active in midlife or later life is associated with better brain structure, improved cognitive performance, and a lower risk of dementia. 

Physical activity earlier in life may also be beneficial. However, many studies rely on older adults recalling their youthful activity levels, which introduces error and the possibility of reverse causation, especially when cognitive impairment is already present. As a result, the specific life stages at which physical activity has the greatest impact remain uncertain. 

To clarify this issue, researchers used long-term, prospectively collected data from the Framingham Heart Study, which began in the early 1970s. They aimed to determine whether physical activity in early adulthood, midlife, or late life is most strongly linked with reduced dementia risk.

Participant Selection Across Early, Midlife, and Late-Life Stages

Participants were included if they were dementia-free and had physical activity data at a baseline exam corresponding to one of three life stages: early adulthood (ages 26 to 44), midlife (ages 45 to 64), or late life (ages 65 to 88).

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The final analytic samples included 1526 early adult, 1943 midlife, and 885 late life participants. All participants provided informed consent, and the study followed established guidelines.

Physical Activity Measurement Using the Activity Index

Physical activity was measured using the Physical Activity Index, which assigns weighted values to hours spent in sleep, sedentary, slight, moderate, and heavy activities. Higher scores indicate greater total activity. Scores were divided into age-specific quintiles for comparison.

Participants were followed until dementia diagnosis, death, or December 31, 2023. Dementia, all-cause or Alzheimer’s disease, was diagnosed through expert consensus using standard diagnostic criteria.

Cox proportional hazards models estimated hazard ratios for dementia risk across physical activity quintiles, adjusting for age, sex, education, body mass index (BMI), smoking, hypertension, diabetes, hyperlipidemia, and apolipoprotein E (APOE) ε4 status.

Additional analyses considered tertiles and quartiles of activity, activity intensity levels, APOE ε4 stratification, and Alzheimer’s dementia specifically.

Dementia Incidence and Early Patterns Across Life Stages

Participants in late life generally had lower education, higher BMI, and more cardiometabolic conditions than younger groups. Throughout follow-up, 567 individuals developed dementia, 4 percent of early adult, 14 percent of midlife, and 26 percent of late life participants.

Across all age groups, participants with lower physical activity had higher mortality. These results emphasize the higher risk of dementia among less active individuals, especially in midlife and late life.

After accounting for demographic and health factors, only higher physical activity during midlife and late life, not early adulthood, was associated with a significantly reduced risk of all-cause dementia.

In both midlife and late life, individuals in the highest activity quintiles had a significantly lower dementia risk than those in the lowest quintile, approximately 40 percent lower, with Q4 and Q5 showing the strongest associations. 

Early adult activity showed no significant association with dementia risk, likely reflecting the small number of dementia cases in this age group.

APOE ε4 Genetics Modify Midlife and Late-Life Activity Effects

APOE ε4 status modified these associations. The interaction between APOE ε4 and physical activity was statistically significant for midlife only, indicating that genetic risk influenced the strength of the association during this period.

Among non-carriers, higher midlife activity was linked to substantially lower dementia risk, while late-life activity predicted reduced risk for both carriers and non-carriers. In ε4 carriers, only the highest late-life activity level, Q5, reached statistical significance. 

Patterns were similar for Alzheimer’s dementia specifically, with the highest level of midlife and late-life activity associated with lower incidence. However, for Alzheimer’s disease in ε4 carriers, the association did not reach statistical significance, a nuance not attributable to insufficient sample size in the late-life group.

Moderate and heavy midlife activity were particularly protective, whereas slight activity showed no benefit. In late life, benefit was observed regardless of activity intensity.

Strengths and Limitations of the Life-Course Physical Activity Approach

The study shows that midlife and late-life physical activity are key periods during which higher activity levels are associated with reduced risk of all-cause and Alzheimer’s dementia.

Midlife benefits were tied to moderate or heavy activity, whereas late-life benefits occurred regardless of intensity. APOE ε4 status influenced these associations, with stronger effects in non-carriers during midlife and more limited effects in carriers until late life.

These findings reinforce the importance of promoting physical activity across adulthood, particularly during midlife, to support cognitive health.

The life course design, extended follow-up, comprehensive adjudication of dementia, and detailed covariate data are significant strengths of this analysis. However, the predominantly European ancestry sample, limited numbers of dementia cases in early adulthood, reliance on self-reported activity at a single time point, inability to assess earlier-life activity, and potential misclassification or survival bias may limit the generalizability of the results.

Overall, the study identifies midlife and late life as critical windows for physical-activity-based dementia prevention.

Journal reference:

• Marino, F.R., Lyu, C., Li, Y. (2025). Physical Activity Over the Adult Life Course and Risk of Dementia in the Framingham Heart Study. JAMA Network Open 8(11), e2544439. DOI: 10.1001/jamanetworkopen.2025.44439, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2841638

This 30-Second Test Can Help To Gauge Your Heart Health

 Now mine is usually around 74, tested every 3 months when giving blood.

 It is completely your doctor's responsibility to get you 100% recovered so you can get cardiovascularly fit.

Dementia Tied to Resting Heart Rate

3 years post stroke at a physical I had a resting heart rate of 54 at age 53, level of an athlete. My doctor asked what exercises I was doing, 'I've done no exercises for the past 3 years'. So now after 18 years of little exercise I'm no longer that athlete.

This 30-Second Test Can Help To Gauge Your Heart Health

Many of us know how important it is to get our blood pressure tested.

If you’ve got a womb, you’ll probably be aware of how important smear tests are, and the NHS tests your cholesterol levels during a Health Check, too.

But according to Harvard Medical School’s site, there’s another 30-second test we can run ourselves at home that may “help identify potential health problems as well as gauge your current heart health”. 

Your resting heart rate may reveal a lot about your cardiovascular healthHarvard’s site says that measuring your resting heart rate (the number of times your heart beats in a set period while you’re relaxed) is “one of the easiest, and maybe most effective, ways to gauge your health”.All you need is two fingers and a way to measure time.Place your index and middle fingers on your wrist or neck ― anywhere you can feel a pulse. Don’t use your thumb as this has its own pulse which can confuse you. Don’t do it within an hour after exercise or drinking caffeine either ― this is about your resting heart rate. Measure the beats across 30 seconds and then double it to get your beats per minute (BPM). You should repeat it a few times to make sure your reading is accurate. And if you want a really good reading, take your resting heart rate multiple times across that week at different times of day. Factors like stress, hormones, and some medications can affect your BPM. What’s normal, and when should I worry? The “healthy” range for adults is between 60-100 BPM, but most of us have a resting heart rate below 90 BPM.Dr Jason Wasfy, director of quality and analytics at the Massachusetts General Hospital Heart Center, said: “In certain cases, a lower resting heart rate can mean a higher degree of physical fitness, which is associated with reduced rates of cardiac events like heart attacks.” However, “if you have a slow heart rate and are experiencing symptoms like fainting and tiredness, you should make an appointment with your GP,” the British Heart Foundationsays. “A high resting heart rate could be a sign of an increased risk of cardiac risk in some situations, as the more beats your heart has to take eventually takes a toll on its overall function,”  2013 study found a high resting heart rate “was a risk factor for mortality independent of physical fitness (VO₂Max) and other major potential confounders” like blood pressure and weight. You can lower your resting heart rate through exercise, Dr Wasfy shared. Ultimately, your resting heart rate is only one piece of the puzzle. Looking at it alongside cholesterol levels and blood pressure captures the full picture far better. If you’re worried about your heart health or heart rate, speak to your GP.

Small amounts of physical activity could help ward off stroke in the long term

 Well shit, I was doing lots of exercise, biking 6 miles daily to/from work, 9 months per year. 25 years in a row.

3 years post stroke at a physical I had a resting heart rate of 54 at age 53, level of an athlete. My doctor asked what exercises I was doing, 'I've done no exercises for the past 3 years'. So now after 18 years of little exercise I'm no longer that athlete.

Small amounts of physical activity could help ward off stroke in the long term

Even people whose physical activity levels fall short of recommended guidelines, but who manage to do some during their leisure time, are likely to have a lower risk of stroke than their sedentary peers, suggests a pooled data analysis of the available evidence, published online in the Journal of Neurology Neurosurgery & Psychiatry.

The effects are independent of age and sex, the findings show, prompting the authors to suggest that everyone should be encouraged to do whatever level of physical activity they can manage in their leisure time.

There's no doubt that moderate to high levels of leisure-time physical activity curb stroke risk. But it's not clear if even modest amounts confer protection, and if any such effects depend on age and sex, explain the authors.

While international guidelines recommend 150 minutes or more a week of moderate intensity physical activity or 75 minutes or more of vigorous intensity activity to lower the risk of cardiovascular disease, including stroke, not many adults achieve this, say the researchers.

To find out if lower levels of physical activity might still confer protection, the authors trawled research databases for relevant studies. They pooled the results of 15, involving 752,050 adults whose health had been monitored for an average of 10.5 years. 

Each study assessed the potential impact of between 3—none, below target, and ideal—and 5—none, insufficient, low, moderate and intense— levels of leisure time physical activity on stroke risk.

The pooled data analysis of 5 studies assessing 3 levels of leisure time physical activity showed that, compared with no physical activity, the highest 'ideal' amount cut the risk of stroke by 29%, but that some 'below target' activity still reduced the risk by 18%.

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Similar findings emerged for the pooled data analysis of the six studies reporting on 4, and the two reporting on 5 levels of leisure time physical activity. Compared with none, a moderate level of physical activity cut the risk of stroke by between 27% and 29%.

These effects were independent of sex and age, the analysis showed.

The authors acknowledge several limitations to their findings, chief among which were the variable definitions of different levels of activity used in the included studies and the reliance on subjectively assessed levels of physical activity.

Nevertheless, the authors conclude that recreational physical activity, even in small amounts could help ward off stroke in the long term.

"According to our results, all levels of [leisure time physical activity] can be beneficial for stroke prevention, including levels currently regarded as low or insufficient," they write. "People should be encouraged to be physically active even at the lowest levels."

Source:

BMJ

Journal reference:

De Santis, F., et al. (2024) Risk of stroke with different levels of leisure-time physical activity: a systematic review and meta-analysis of prospective cohort studies. Journal of Neurology Neurosurgery & Psychiatry. doi.org/10.1136/jnnp-2023-332457.

Watermelon juice: potential functional drink for sore muscle relief in athletes

This can go with your using it to clear your arteries. And the exercise you get helps neurogenesis.
Watermelon juice reverses hardening of the arteries    It's only 2 years old, I'm sure your doctor has no idea about watermelon juice.
Watermelon juice: potential functional drink for sore muscle relief in athletes

Tarazona-Díaz MP¹, Alacid F, Carrasco M, Martínez I, Aguayo E.

Author information

Erratum in

• J Agric Food Chem. 2013 Nov 20;61(46):11241.

Abstract

l-Citrulline is an excellent candidate to reduce muscle soreness, and watermelon is a fruit rich in this amino acid. This study investigated the potential of watermelon juice as a functional drink for athletes. An in vitro study of intestinal absorption of l-citrulline in Caco-2 cells was performed using unpasteurized (NW), pasteurized (80 °C for 40 s) watermelon juice (PW) and, as control, a standard of l-citrulline. l-citrulline bioavailability was greater when it was contained in a matrix of watermelon and when no heat treatment was applied. In the in vivo experiment (maximum effort test in a cycloergometer), seven athletes were supplied with 500 mL of natural watermelon juice (1.17 g of l-citrulline), enriched watermelon juice (4.83 g of l-citrulline plus 1.17 g from watermelon), and placebo. Both watermelon juices helped to reduce the recovery heart rate and muscle soreness after 24 h.

Tested: If Mental Work Genuinely Affects Physical Tiredness

This could easily explain stroke fatigue. But I bet your doctor won't change the stupid admonition to exercise more. Three years after my stroke I had a physical where my resting heart rate was 54 at the age of 53. That means my cardiovascular fitness was that of an athlete. Yet I was still completely fatigued everyday. All researchers would have had to do is talk to a few stroke survivors to learn this. It's not rocket science, it is simply cause and effect which I don't think a lot of our stroke medical 'professionals' understand.

Tested: If Mental Work Genuinely Affects Physical Tiredness 

For the research, participants repeatedly squeezed on a hand-grip while performing mental tasks designed to fatigue them.

At the same time, an area of the brain called the prefrontal cortex was monitored.

The prefrontal cortex is the part of the brain at the front above and behind the eyes.

This area is vital to our personalities, how we plan complex actions, and more.

The researchers found that the prefrontal cortex became more ‘tired’ when people were performing both mental and physical tasks.

It appears the brain devotes some of its resources to physical tasks and some to mental tasks.

The research is one of the first to show how mental and physical tasks can interact to fatigue the brain.

Dr Mehta said:

“Not a lot of people see the value in looking at both the brain and the body together.

However, no one does purely physical or mental work; they always do both.”

So, it appears the brain is like a muscle in the sense that work — whether mental or physical — weakens its strength.

The study was published in the journal Human Factors (Mehta & Parasuraman, 2015).

More at the link.

Want To Work Out More? Think Of Yourself Like This

Is your doctor giving you the tools to think of yourself as an athlete so you do your therapy more? 

Want To Work Out More? Think Of Yourself Like This

Cigarette smoking: an underused tool in high-performance endurance training

Read the first paragraph critically and then use this to buffalo your doctor into the belief that since its good for endurance athletes the fatigue experienced by survivors should also be helped by the same protocol. The results will tell you the intellectual ability of your doctor. 

Cigarette smoking: an underused tool in high-performance endurance training

Kenneth A. Myers, BSc

Additional article information

Abstract

The review paper is a staple of medical literature and, when well executed by an expert in the field, can provide a summary of literature that generates useful recommendations and new conceptualizations of a topic. However, if research results are selectively chosen, a review has the potential to create a convincing argument for a faulty hypothesis. Improper correlation or extrapolation of data can result in dangerously flawed conclusions. The following paper seeks to illustrate this point, using existing research to argue the hypothesis that cigarette smoking enhances endurance performance and should be incorporated into high-level training programs.

Performances in endurance sports have been shrouded in controversy for the past 30 years because many athletes, intent on winning races and achieving faster times, have turned to banned performance-enhancing drugs. The World Anti-Doping Agency’s 2009 list of prohibited substances and methods includes erythropoietin, other erythropoiesis-stimulating agents and various methods designed to enhance oxygen transfer.¹ The effects of these agents and methods are thought to be primarily beneficial in endurance sports such as distance running and cycling. Despite the prohibition, the use of these drugs and techniques persists, as evidenced by continued positive results of drug tests in and out of competition.

Altitude training has also become common among endurance athletes, because it has been associated with an increase in performance and in serum hemoglobin and hematocrit levels. However, this response is transient — the physiologic variables return to their baseline soon after the athlete returns to sea level.² This moderate performance benefit is outweighed by several severe and life-threatening risks, including pulmonary edema,³ cerebral edema⁴ and severe flatulence.⁵

While athletes endanger their careers and well-being in attempts to gain small benefits with illicit or inconvenient practices, a legal, nonprescription alternative has been largely ignored by athletes, coaches and exercise physiologists alike. Cigarette smoking has been shown to increase serum hemoglobin and hematocrit levels, increase lung volume and stimulate weight loss — characteristics all known to enhance performance in endurance sports. This paper will discuss the potential benefits of cigarette smoking to endurance performance and make recommendations as to how individuals and national bodies could effectively integrate this practice into high-performance training programs.