Walking Protects Women Against Stroke

Women who walked two or more hours a week or who usually walked at a brisk pace (3 miles per hour or faster) had a significantly lower risk of stroke than women who didn’t walk, according to a large, long-term study reported in Stroke: Journal of the American Heart Association.

The risks were lower for total stroke, clot-related (ischemic) stroke and bleeding (hemorrhagic) stroke, researchers said.

Compared to women who didn’t walk:

• Women who usually walked at a brisk pace had a 37 percent lower risk of any type of stroke and those who walked two or more hours a week had a 30 percent lower risk of any type of stroke.
• Women who typically walked at a brisk pace had a 68 percent lower risk of hemorrhagic stroke and those who walked two or more hours a week had a 57 percent lower risk of hemorrhagic stroke.
• Women who usually walked at a brisk pace had a 25 percent lower risk of ischemic stroke and those who usually walked more than two hours a week had a 21 percent lower risk of ischemic stroke — both “borderline significant,” according to researchers.

“Physical activity, including regular walking, is an important modifiable behavior for stroke prevention,” said Jacob R. Sattelmair, M.Sc., lead author and doctoral candidate in epidemiology at Harvard School of Public Health in Boston, Mass. “Physical activity is essential to promoting cardiovascular health and reducing risk of cardiovascular disease, and walking is one way of achieving physical activity.”

More physically active people generally have a lower risk of stroke than the least active, with more-active persons having a 25 percent to 30 percent lower risk for all strokes, according to previous studies.

“Though the exact relationship among different types of physical activity and different stroke
subtypes remains unclear, the results of this specific study indicate that walking, in particular, is associated with lower risk of stroke,” Sattelmair said.

Researchers followed 39,315 U.S. female health professionals (average age 54, predominantly white) participating in the Women’s Health Study. Every two to three years, participants reported their leisure-time physical activity during the past year — specifically time spent walking or hiking, jogging, running, biking, doing aerobic exercise/aerobic dance, using exercise machines, playing tennis/squash/racquetball, swimming, doing yoga and stretching/toning. No household, occupational activity or sedentary behaviors were assessed.

They also reported their usual walking pace as no walking, casual (about 2 mph), normal (2.9 mph), brisk (3.9 mph) or very brisk (4 mph).

Sattelmair noted that walking pace can be assessed objectively or in terms of the level of exertion, using a heart rate monitor, self-perceived exertion, “or a crude estimate such as the ‘talk test’ – wherein, for a brisk pace, you should be able to talk but not able to sing. If you cannot talk, slow down a bit. If you can sing, walk a bit faster.”

During 11.9 years of follow-up, 579 women had a stroke (473 were ischemic, 102 were hemorrhagic and four were of unknown type).

The women who were most active in their leisure time activities were 17 percent less likely to have any type of stroke compared to the least-active women.

Researchers didn’t find a link between vigorous activity and reduced stroke risk. The reason is unclear, but they suspect that too few women reported vigorous activity in the study to get an accurate picture and/or that moderate-intensity activity may be more effective at lowering blood pressure as suggested by some previous research.

Stroke is the third leading cause of death and a leading cause of serious disability in the United States, so it’s important to identify modifiable risk factors for primary prevention, Sattelmair said.

An inverse association between physical activity and stroke risk is consistent across genders. But there tend to be differences between men and women regarding stroke risk and physical activity patterns.

“The exact relation between walking and stroke risk identified in this study is not directly generalizable to men,” Sattelmair said. “In previous studies, the relation between walking and stroke risk among men has been inconsistent.”

The study is limited because it was observational and physical activity was self-reported. But strengths are that it was large and long-term with detailed information on physical activity, he said.

Further study is needed on more hemorrhagic strokes and with more ethnically diverse women, Sattelmair said.

The American Heart Association recommends for substantial health benefits, adults should do at least 150 minutes a week of moderate-intensity or 75 minutes a week of vigorous-intensity aerobic physical activity or a combination.

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Article adapted by MD Sports from original press release.
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Contact: Birdgette McNeill
American Heart Association

Moderate exercise prevents extreme weight gain with age

The old adage “use it or lose it” is truer than ever. People who maintain a vigorously active lifestyle as they age gain less weight than people who exercise at more moderate levels, according to a first-of-its-kind study that tracked a large group of runners who kept the same exercise regimen as they grew older. The study also found that maintaining exercise with age is particularly effective in preventing extreme weight gain, which is associated with high blood pressure, high cholesterol, diabetes, and other diseases.

The study, conducted by Paul Williams of the U.S. Department of Energy’s Lawrence Berkeley National Laboratory (Berkeley Lab), followed 6,119 men and 2,221 women who maintained their weekly running mileage (to within three miles per week) over a seven-year period. On average, the men and women who ran over 30 miles per week gained half the weight of those who ran less than 15 miles per week.

“To my knowledge, this is the only study of its type,” says Williams, a staff scientist in Berkeley Lab’s Life Sciences Division. “Other studies have tracked exercise over time, but the majority of people will have changed their exercise habits considerably.”

The research is the latest report from the National Runners’ Health Study, a 20-year research initiative started by Williams that includes more than 120,000 runners. It appears in the May issue of the journal Medicine and Science in Sports and Exercise.

Specifically, between the time subjects entered the study and when they were re-contacted seven years later, 25-to-34-year-old men gained 1.4 pounds annually if they ran less than 15 miles per week. In addition, male runners gained 0.8 pounds annually if they ran between 15 and 30 miles per week, and 0.6 pounds annually if they ran more than 30 miles per week.

This trend is mirrored in women. Women between the ages of 18 and 25 gained about two pounds annually if they ran less than 15 miles per week, 1.4 pounds annually if they ran 15 to 30 miles per week, and slightly more than three-quarters of a pound annually if they ran more than 30 miles per week. Other benefits to running more miles each week included fewer inches gained around the waist in both men and women, and fewer added inches to the hips in women.

“As these runners aged, the benefits of exercise were not in the changes they saw in their bodies, but how they didn’t change like the people around them,” says Williams.

Although growing older and gaining weight is something of a package deal, it isn’t the same in everyone. The lucky few remain lean as they age, most people pack on several pounds, and some people become obese. The latter group is particularly at risk for high blood pressure, high cholesterol, and diabetes. Fortunately, Williams’ results show that maintaining exercise can combat such extreme weight gain.

“Getting people to commit to a vigorously active lifestyle while young and lean will go a long way to reducing the obesity epidemic in this country,” says Williams.

Another paper published in the November 2006 issue of the journal Obesity by Williams and Paul Thompson of Hartford (CT) Hospital found that runners who increased their running mileage gained less weight than those who remained sedentary, and runners that quit running became fatter.

“The time to think about exercise is before you think you need it,” says Williams. “The medical journals are full of reports on how difficult it is to regain the slenderness of youth. The trick is not to get fat.”

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Article adapted by MD Sports Weblog from original press release.
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Contact: Dan Krotz
DOE/Lawrence Berkeley National Laboratory

Williams’ research was funded by the National Heart, Lung and Blood Institute. The study in the May issue of the journal Medicine and Science in Sports and Exercise is entitled Maintaining Vigorous Activity Attenuates 7-yr Weight Gain in 8,340 Runners.