Comfort In Cold: Can Shivering Offer Some Benefits Of Exercise?

Brookline, Mass., 1:30 p.m. (Carey Goldberg/WBUR)

Brookline, Mass., 1:30 p.m. (Carey Goldberg/WBUR)

Just a bit of (cold) comfort if you’re stuck outside today: New research suggests that shivering, your body’s way of trying to stay warm, releases a promising hormone called irisin that appears to be connected to some health benefits of exercise.

(More on that here: A Step Toward Health Benefits Of Exercise In A Pill? and here: Exercise Hormone May Fight Obesity And Diabetes.)

So, if it makes you feel better, perhaps you can think of your chattering teeth and quivering limbs as a quick-tempo workout. (But, forgive the nag, careful not to overdo it into hypothermia and frostbite.)

The Telegraph nicely sums up the findings, though the headline — Shivering Can Help You Stay Slim — sounds far too decisive for an initial study:

A new study from scientists at Sydney University has found that placing volunteers in temperatures of less than 59F (15C) for around 10-15 minutes caused hormonal changes equivalent to an hour of moderate exercise.

These same hormonal changes have been linked to the creation of brown fat, a form of fat that actually burns up energy.

And from the press release:

According to new research into the mechanisms involved, shivering releases a hormone that stimulates fat tissue to produce heat so that the body can maintain its core temperature. This hormone, irisin, is also produced by muscle during exercise. The findings, which are published in the February 4 issue of the Cell Press journal Cell Metabolism, demonstrates that the act of shivering produces calorie-burning brown fat and improves metabolism.

Through experiments conducted in healthy volunteers, Dr. Francesco S. Celi of the National Institute of Diabetes and Digestive and Kidney Diseases and his colleagues found that the irisin, produced when the body shivers, is released in proportion to shivering intensity. Furthermore, the amount of irisin secreted as a result of shivering is of similar magnitude to that of exercise-stimulated secretion. The team also found that when human fat cells in the laboratory were treated with FNDC5, a precursor of irisin, the cells burned more energy and released more heat. Continue reading

Why To Exercise Today, Guys: Better Prostate Cancer Outcomes (And We May Know Why)

There are about 2,617,682 men currently living with prostate cancer in the United States, according to the National Cancer Institute. And sometimes, at this age, it seems like everywhere you look, another man is getting diagnosed, watching and waiting, or getting treated for prostate cancer.



Exercise has already been shown to lower the risk of death among prostate cancer patients, but now, researchers report that may have a clue why, and it’s to do with brisk walking.

It turns out that “men who walked at a fast pace prior to a prostate cancer diagnosis had more regularly shaped blood vessels in their prostate tumors compared with men who walked slowly,” according to new findings presented in San Diego at the American Association for Cancer Research-Prostate Cancer Foundation Conference on Advances in Prostate Cancer Research.

Here’s more from the news release:

Men who engage in higher levels of physical activity have been reported to have a lower risk of prostate cancer recurrence and mortality compared with men who participate in little or no physical activity. The biological mechanisms underlying this association are not known.

“Prior research has shown that men with prostate tumors containing more regularly shaped blood vessels have a more favorable prognosis compared with men with prostate tumors containing mostly irregularly shaped blood vessels,” said Erin Van Blarigan, Sc.D., assistant professor in the Department of Epidemiology and Biostatistics at the University of California, San Francisco. “In this study, we found that men who reported walking at a brisk pace had more regularly shaped blood vessels in their prostate tumors compared with men who reported walking at a less brisk pace.

“Our findings suggest a possible mechanism by which exercise may improve outcomes in men with prostate cancer,” continued Van Blarigan. “Although data from randomized, controlled trials are needed before we can conclude that exercise causes a change in vessel regularity or clinical outcomes in men with prostate cancer, our study supports the growing evidence of the benefits of exercise, such as brisk walking, for men with prostate cancer.” Continue reading

Who Needs An App For That? Most Of Us Use Old Ways To Track Diet

A little red calorie-tracking book. (Carey Goldberg/WBUR)

A little red calorie-tracking book. (Carey Goldberg/WBUR)

How apt. Recently, inspired by Project Louise, I got on the scale — and gasped at my new numerical heights, forced to face the fact that I can’t eat everything I want, even if I do work out every day. So I dug out a tiny red notebook and started to track what I eat, a proven method for weight control.

I thought about using an app, but — I don’t know. I’m already hit dozens of times a day by subconscious prompts to reach for my devices. And I like my little notebook.

Also, according to the Pew Research Center, a leading resource on how technology permeates our American lives, I’m in the overwhelming majority here. For all the buzz around FitBits and Jawbones, such health-tracking devices still have quite a market to conquer.

Susannah Fox, associate director at the Pew Research Center’s Internet & American Life Project, writes that 60 percent of American adults track their exercise, weight or diet.

But few of them – just 9% – use either an app on a mobile device or online tool to take notes. Half say they keep track in their heads, and a third use pen and paper.

Readers, theories? Mine is that few of us want to quantify ourselves with such gorgeous visualization of data that we need computing power to do it. Personally, all I need to know is how close I’ve come to 1800 calories in a given day. Not rocket science, barely even math. But what do you think? And is there an app or an online tool so seductive and indispensable it will tip the balance?

Doctor’s Orders: Get Outdoors

“So Melody, as we finish our check-up today, I have one more thing to tell you about,” Dr. Karen Sadler said as she pulled her stool closer to the examination table where 8-year-old Melody Salhudin sat, legs dangling over the edge.

You know, you come here when you’re sick and need medicine, but you know you also come to the pediatrician so we can help you stay healthy. And part of staying healthy is being active,” Dr. Salder explained as she reached for a glossy brochure and a special prescription pad. On it, she wrote a prescription for Melody to get outside and exercise.

Melody Salhudin hits the swings during a break from her walk (Martha Bebinger/WBUR)

Melody Salhudin hits the swings during a break from her walk (Martha Bebinger/WBUR)

It’s part of a program called Outdoors RX  — a partnership between the Appalachian Mountain Club and Massachusetts General Hospital. It’s funded by three foundations for one year, with a budget of $200,000. The two venerable organizations are testing the idea of having doctors write prescriptions for outdoor exercise in two communities with high rates of childhood obesity, Waltham and Framingham.

Melody, a quick study, got the point. “To help people stay strong and healthy and to make sure they get up and get their body like grooving and moving,” Melody said, giggling and twisting her hips.

The Appalachian Mountain Club isn’t known for Melody’s style of moving and grooving.

“Originally we thought of hiking or biking,” and other more traditional AMC activities, said Pam Hess, who runs Outdoors RX. But Hess soon realized that many kids in these communities are not used to, or even comfortable, spending time outdoors. Continue reading

How “Sticky” Are You When It Comes To Health?

When it comes to health and fitness, even the best intentions won’t get you far if you don’t stick with the plan.

That’s the thinking behind a new fitness tracking and motivational nudging service, called Wellocracy, that seeks to get at a person’s “stickiness” quotient. In other words, how likely is he or she to stay engaged with one of the myriad health and fitness apps currently available?

It’s the brainchild of Dr. Joseph Kvedar, founder and director of the Center for Connected Health at Partners Healthcare, the dominant hospital system in the state. I spoke with him recently about the concept of “stickiness” and the new service.

“Part of the reason we launched this effort is because we studied for about 10 years why patients adopt these technologies,” Kvedar says. “We were trying to reach people who could benefit from self-tracking as a health-improvement strategy, but either don’t know about it or find it confusing and frustrating.”

He pointed to an October 2013 survey of 2,014 adults in the U.S. which found the following about fitness-tracking behavior:

• Sixty-eight percent say encouragement from family and friends is important for achieving health goals.
• More than half of respondents aged 35-44 found it difficult to stay motivated to live in a healthier way.
• Sixty-five percent think tracking their health using a device, website or app would be beneficial, including 32% who felt it could keep them motivated in pursuing health and/or fitness. About half of those 18-44 agree that easy-to-use tracking tools are essential to following through with their health goals.
• Eighty-six percent say feeling informed about the status of their health is empowering.

Given the widespread endorsement of fitness tracking, one might think it a fairly common practice. On the contrary; the survey found the following: Continue reading

Why To Exercise Today: Overcoming Your (Genetic) Bad Attitude

Over the years, I’ve been told I have a bad attitude, a glass-half-empty outlook on life. A friend long ago said I had a near-palpable dark cloud of anxiety hovering above me. I used to attribute it to various external factors — growing up in New York, for instance, or enduring my parents’ hostile divorce. And those things may, quite possibly, play a role. But now I find genetics might also be a contributing factor, according to a new study out of British Columbia. The research, which works off the idea of our “emotionally enhanced” memories, found some people to be “genetically predisposed to see the world darkly.”

From the news release:

The study, published in Psychological Science, finds that a previously known gene variant can cause individuals to perceive emotional events –especially negative ones – more vividly than others.

“This is the first study to find that this genetic variation can significantly affect how people see and experience the world,” says Prof. Rebecca Todd of University of British Columbia’s Dept. of Psychology. “The findings suggest people experience emotional aspects of the world partly through gene-coloured glasses – and that biological variations at the genetic level can play a significant role in individual differences in perception.”

The gene in question is the ADRA2b deletion variant, which influences the hormone and neurotransmitter norepinephrine. Previously found to play a role in the formation of emotional memories, the new study shows that the ADRA2b deletion variant also plays a role in real-time perception.

The study’s 200 participants were shown positive, negative and neutral words in a rapid succession. Participants with the ADRA2b gene variant were more likely to perceive negative words than others, while both groups perceived positive words better than neutral words to an equal degree. Continue reading

Caveman Syndrome: Today’s Killer Diseases Stem From Evolutionary Mismatch


By Karen Weintraub
CommonHealth Contributor

Cavemen didn’t have flat feet or type 2 diabetes. They didn’t need orthodontia or get impacted wisdom teeth. The ones who couldn’t see their prey – or predators – from far away didn’t live long enough to pass their nearsightedness on to their children.

Indeed, the vast majority of what ails us today — from leading killers like heart disease and cancer, to smaller health woes such as back pain — is the result of a mismatch between the environments we evolved in and the ones we now inhabit, argues Harvard evolutionary biologist Dan Lieberman in his sweeping new book, “The Story of the Human Body: Evolution, Health, And Disease.”

Lord Jim/flickr

Lord Jim/flickr

Lieberman, perhaps best known for his energetic advocacy of barefoot running (which he sometimes does), convincingly makes the case for a wholesale rethinking of how we live our modern lives based on overcoming these evolutionary “mismatches.”

“Most of us in this room are probably going to die of a mismatch disease,” Lieberman told a capacity crowd Thursday night at the Harvard Museum of Natural History.

Our bodies evolved as hunter-gatherers to walk 5-10 miles a day, eat a varied diet loaded with fiber and pack on fat in times of plenty to get us through the leaner times, he said. But instead, we live in an environment where we can drive to the mall, park close to the door and take the escalator up to the food court for a dinner that barely needs chewing.

This mismatch has led, he suggests, to a proliferation of heart disease, cancer and diabetes – which were nearly unknown to our prehistoric ancestors, as well as disabling conditions like low back pain and autoimmune problems. Continue reading

Insurance May Cover More Obesity Treatments With Fat As ‘Disease’

NPR’s Patti Neighmond reports that more insurers are expected to cover a range of treatments for obesity now that the AMA has officially deemed obesity a “disease” rather than a psychological failure of will. Here’s the lede of her story:

obese kid

Under the Affordable Care Act, more insurance plans are expected to start covering the cost of obesity treatments, including counseling on diet and exercise as well as medications and surgery. These are treatments that most insurance companies don’t cover now.

The move is a response to the increasing number of health advocates and medical groups that say obesity should be classified as a disease.

Not everyone thinks this is a good idea, but this summer, the American Medical Association determined that obesity is a disease. The organization followed in the footsteps of the Obesity Society, a health advocacy group that called obesity a disease back in 2008.

Many overweight or obese individuals are victims of their own genetic history, according to Dr. Lee Kaplan, an obesity specialist and director of the Massachusetts General Hospital Weight Center. Continue reading

How To Cycle Faster And Injury-Free — Even Up Mountains

The author, at left, with his companions roughly a week after the Cascades climb, at Logan Pass in Glacier National Park, after a 3-4 hour climb.  (Courtesy)

The author, at left, with his companions roughly a week after the Cascades climb, at Logan Pass in Glacier National Park, after a 3-4 hour climb. (Courtesy)

By David C. Holzman
Guest Contributor

Early afternoon found us downshifting into low as the grade abruptly steepened. Soon we were rising high above the coastal plains, towards Stevens Pass, elev. 4061 feet.

Yet the unexpected ease of pedaling my 30-pound, 1972 Peugeot bicycle, with 20 pounds of gear in the panniers up the Cascades made that day, July 16, 1975 (the beginning of a cross-country trek from Seattle to Boston) unusually memorable. Long after the trip was over, I would dream of cycling up mountains, with the same euphoric feeling as when dreaming of flight.

What a contrast to the previous summer’s trip, a 500-mile loop from Watertown to Burlington, VT, and back. On Day One I’d knocked off, exhausted, at midday, after struggling 50 miles over six hours, gaining a mere thousand feet of altitude.

At the end of that 10-day haul, I rode back to the Bicycle Repair Collective on Broadway in Cambridge (now the Broadway Bicycle School), where I’d learned bicycle mechanics, to check out the bike. It’s normal for a bicycle chain to stretch with use. Twelve chain links should measure 12 inches, but an extra eighth of an inch is no big deal. Mine was stretched half an inch.

I was perturbed. I’d bought and installed the chain just before the trip, and I was sure the it must have been defective to have stretched so far. But the mechanic on duty was having none of it. He claimed I’d pedaled too slowly. What???!

How could this mechanic have any idea how fast I’d been pedaling? He hadn’t been riding with me! That, he said, was simple: had I been riding with proper cadence, I wouldn’t have stretched the chain half an inch in a mere 500 miles.

Besides stretching the chain, the slow pedaling apparently was putting my knee joints at greater risk for several maladies: patellar chondro-malacia (or what some doctors call patellofemoral syndrome), which can range from minor inflammation to damage to the cartilage on the underside of the kneecap; patellar tendonitis; bursitis; and even arthritis. Another potential knee injury is ileo-tibial band syndrome. In that case, the pain is on the outside of the knee.

Pedaling slowly and pushing hard increases the sheer stress you put on the bearing surfaces of your knee joint, where the cartilage of your kneecap slides along the cartilage of your femur as the joint flexes. (The femur and tibia also articulate, but for cyclists, the weak point in the joint is generally the cartilage of the kneecap.)

But Vijay Jotwani, MD, of Houston Methodist Orthopedics and Sports Medicine, says that such injuries are unlikely unless there’s a muscle imbalance or biomechanical abnormality. “A muscle imbalance refers to the variation in strength or coordination of one muscle group that opposes another,” says Jotwani. “For example, for patellofemoral syndrome, the outside part of the quadricep muscle (vastus lateralis) may be stronger than the inside part (vastus medialis), which then pulls the kneecap to the outside when the entire quadriceps contracts.”

Biomechanical abnormalities are more likely to be problems for women, says Jotwani. Their wider hips can result in a slight outward angle at the knee in an unbent leg. Pedaling pressure can then pull the kneecap slightly out of its groove. Jotwani says that various leg weight-lifting exercises can mitigate these problems.

An improperly fitting bicycle, and a too-low seat can also raise the risk of knee injury, says Greg Cloutier, MPH, Project Manager for the Human Performance and Exercise Science Lab at Northeastern University.

Frequently I see cyclists grimacing as they bear down upon the pedals, and I wonder if they think the bulkier, stronger muscles they build this way will make them faster cyclists. If so, they are wrong. While a modicum of muscle is necessary, the thing that enables one to climb steadily, or pedal all day, is power. Continue reading

Why To Exercise Today: So You Don’t Have A Stroke

runner with inhaler (Matthew Kenwrick/Flickr)

(Matthew Kenwrick/Flickr)

Don’t use the heat as an excuse.  You can always climb stairs in an air-conditioned office building or run over to the gym. Or, if you’re lucky enough to be out of town, jump in the lake for a long, glorious, vigorous swim.

In any case, you should do something. According to new research, breaking a sweat while exercising regularly may reduce your risk of stroke. You’ve heard it before. But it’s worth restating. Why wouldn’t you run around a little a few times a week to possibly avoid the horrible physical ordeal of a stroke? Particularly if you live in a part of the country known for its high stroke rate? But enough nagging.

The new, NIH-funded study of more than 27,000 Americans, 45 years and older who were followed for an average of 5.7 years, was published today in the American Heart Association journal Stroke. Most participants, equally divided between men and women, black and white, lived in regions of the southeastern U.S., known as “the stroke belt.”

From the AHA news release:

  • One-third of participants reported being inactive, exercising less than once a week.
  • Inactive people were 20 percent more likely to experience a stroke or mini-stroke than those who exercised at moderate to vigorous intensity (enough to break a sweat) at least four times a week.
    Continue reading