new york times for wednesday

new york times for wednesday

Short bursts of intense exercise might benefit type 2 diabetics

Short sessions of high-intensity exercise may provide more health benefits for people with type 2 diabetes than longer bouts of less intense activity, a new Canadian study suggests.

The research included 76 adults recently diagnosed with type 2 diabetes. Their average age was 67. They were randomly assigned to do either one 30-minute exercise session five days a week at 65 percent of their target heart rate, or three 10-minute workouts a day, five days a week, at 85 percent of their target heart rate.

The participants were assessed three months later. Compared to those in the lower-intensity group, those in the high-intensity group did more exercise and had larger decreases in cholesterol and blood sugar levels, lost more weight, and had greater improvements in heart health.

The patients in the high-intensity group showed a more than two-fold greater decrease in hemoglobin A1C levels. A1C is a blood test that provides a rough estimate of average blood sugar levels for the past two to three months, according to the American Diabetes Association.

While it was already known that exercise benefits people with type 2 diabetes, the focus has been on low-intensity, sustained workouts, said study co-author Avinash Pandey, an undergraduate student at the University of Western Ontario.

“However, more may be accomplished with short bursts of vigorous exercise, in which patients achieve a higher maximum target heart rate, and may be easier to fit into busy schedules,” Pandey said in an American Heart Association news release.

He also noted that since people could fit the high-intensity exercise into their schedules, they were more consistent with exercise and ended up working out more each week.

High-intensity exercise may use energy in a different way from less intense workouts, the study authors suggested.

Pandey added that the researchers hope to study bursts of intensive exercise in larger and more diverse groups of people.

“With further study, burst exercise may become a viable alternative to the current standard of care of low-intensity, sustained exercise for diabetes rehabilitation,” he said.

The study was scheduled to be presented Tuesday at the American Heart Association’s annual meeting in Orlando, Fla. Findings presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

Obese kids as young as 8 show signs of heart disease

Obese children can develop signs of heart abnormalities as young as age 8, which might drive up their risk for early death as adults, new research suggests.

“It is both surprising and alarming to us that even the youngest obese children in our study who were 8 years old had evidence of heart disease,” said study lead author Linyuan Jing, a postdoctoral fellow with Geisinger Health System in Danville, Pa.

“Ultimately, we hope that the effects we see in the hearts of these children are reversible,” Jing added. “However, it is possible that there could be permanent damage.”

For the study, Jing’s team conducted MRI scans of 40 children between 8 and 16 years old. Half were obese; half were of normal weight.

The obese kids had an average of 27 percent more muscle mass in the left ventricle region of their heart, and 12 percent thicker heart muscle overall. Both are considered indicators of heart impairment, Jing said.

Also, among 40 percent of the obese children, scans showed thickened heart muscle had already translated into a reduced ability to pump blood. Kids with this reduced heart capacity were deemed to be at “high risk” for adult cardiac strain and heart disease.

“This should be further motivation for parents to help children lead a healthy lifestyle,” Jing said.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, called the findings “alarming.”

He and Jing said the structural heart changes detected by the scans are associated with more complicated health conditions in adulthood as well as early death in adults.

The changes in heart muscle mass “suggest a significant increase in risk of heart failure, arrhythmia [irregular heartbeat] and premature cardiovascular death in children with obesity,” said Fonarow, who was not involved with the study.

Jing said the study results suggest obese children even younger than 8 years old likely have signs of heart disease, too. “Understanding the long-term ramifications will be critical as we deal with the impact of the pediatric obesity epidemic,” she said.

Obesity among 6- to 12-year-olds in the United States more than doubled over the last three decades and quadrupled among teens, according to the U.S. Centers for Disease Control and Prevention. As of 2012, more than one-third of children between ages 6 and 19 were either overweight or obese.

Some of the obese children in the study were struggling with health complications often associated with excess weight, including asthma, high blood pressure and depression, the researchers said. But none displayed customary warning signs of heart disease such as fatigue, dizziness or shortness of breath, Jing said.

Given that the study excluded kids with diabetes and those too large to fit inside the MRI scanning machine, the study may actually underestimate the extent of the problem, she said.

Jing said parents have a responsibility to help their children maintain a healthy weight. They should buy healthy foods instead of cheap fast food and fruit juice, “which is high in sugar but low in fiber,” she said.

Parents should also limit TV, computer and video game time, while encouraging more outdoor activities, she said.

“In addition, schools and communities need to do a better job at educating both the parents and children about the health risks of overweight and obesity,” said Jing.

Fonarow agreed, adding that “substantially increased efforts are needed to prevent and treat childhood obesity.”

The findings were scheduled for presentation Tuesday at the annual meeting of the American Heart Association in Orlando, Fla. Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

Heavy drinking may strain the heart

Heavy drinking may dramatically increase a person’s risk of heart failure, even if they’re young and healthy, a new study suggests.

People who abuse alcohol are 70 percent more likely to develop heart failure, according to findings that were to be presented Tuesday at the American Heart Association’s annual meeting in Orlando, Fla.

The detrimental effects of hard drinking were particularly pronounced in young and middle-aged adults, and people who were otherwise in good health, said lead researcher Dr. Isaac Whitman, an electrophysiologist at the University of California, San Francisco. However, the study did not prove that heavy drinking causes heart failure.

These results suggest that younger adults need to take it easy on the booze, especially if they don’t have any risk factors for heart disease, Whitman said.

“In the case of alcohol, I don’t think it’s prudent to say I can abuse alcohol because I’m young and healthy,” he said. “You may be hurting yourself relatively more than your older counterparts. You have more to lose.”

Other studies have shown mixed results for heart health when it comes to light or moderate drinking. For example, moderate drinking seems to help lower cholesterol levels, but also increases your risk of irregular heart rate, Whitman said.

The researchers analyzed the records of more than 858,000 California patients treated between 2005 and 2009. Patients ranged in age from the 30s to the 70s.

Doctors had diagnosed about 4 percent of these people as alcohol abusers. Overall, about 12 percent developed congestive heart failure, the investigators found.

Alcohol abuse emerged as a strong predictor of congestive heart failure, even after researchers adjusted for other risk factors, such as age, high blood pressure, diabetes, smoking and elevated cholesterol levels.

In addition, the study authors found that alcohol abuse was even worse for the hearts of healthy people who don’t have other heart risk factors, Whitman said.

“If you are a healthier person, your heart is disproportionately more susceptible to the toxicities of alcohol,” he said.

For example, people were more affected by heavy drinking if they were younger than 60, had normal blood pressure and didn’t already suffer from heart disease or chronic kidney disease, Whitman said.

This might be because people with other heart risk factors already are in poor health, and so alcohol can’t harm them as much, Whitman suggested.

“Your heart is already sick, so the added toxicity from alcohol does not have as much of an impact,” he explained.

Heavy drinking can harm the heart in both direct and indirect ways, said Dr. Robert Eckel, a professor and cardiologist at the University of Colorado Anschutz Medical Campus.

Alcohol can make the heart muscle less effective, harming its ability to pump blood, Eckel said.

Whitman added that there’s a condition called alcoholic cardiomyopathy that affects people who have five or more drinks a day over a number of years, in which the heart becomes bloated and enlarged.

“It becomes a sack and it barely squeezes,” Whitman said. “You quit drinking, and it goes away.”

Hard drinking also increases blood pressure, which causes all manner of harm to the heart and blood vessels. “The more you drink, the higher your blood pressure,” Eckel said. “Once you’re drinking three or four drinks a day, your blood pressure elevates.”

Eckel said that while those who tipple occasionally might enjoy some positive effects from their nightly glass of wine, alcohol abuse is clearly bad for a person’s health.

“Too much alcohol can take us down 15 to 20 different paths when it comes to detrimental effects on health,” Eckel said.

Research presented at medical meetings is considered preliminary until published in a peer-reviewed journal.