Barron’s

How I’m Staying in Shape by Turning My Daily Stroll Into Hard Exercise

Neal Templin – Dec. 3, 2022

If I read one more time that walking is the best exercise, I’m going to take a few steps and scream.

This article is about how to make walking a better exercise.

True, walking is the most practicable exercise. You can pretty much do it anywhere anytime. That is no small thing.

The problem is that ordinary walking won’t push your heartbeat rate into the same zone as running or a fast bicycle ride or even a game of pickleball, one study found.

Why does intensity matter? Vigorous workouts are a more efficient way of getting fit, says cardiologist Matthew Nayor, an assistant professor at the Boston University School of Medicine, who tested the fitness of more than 3,000 participants in the Framingham Heart Study. He found that a minute of moderate to vigorous exercise had the same benefit as two or three minutes of light exercise.

How do you know if the exercise is vigorous enough? If you can carry on a conversation easily, it is probably moderate exercise, Nayor says. “If the sentences get shorter, and it is harder to carry on a conversation, you’re headed toward vigorous exercise.”

There are simple tricks you can use to transform leisurely walks into intense exercise. That includes walking up hills, carrying a weighted backpack, or working a few sprints into your daily perambulation. Perhaps the best trick of all is to walk really fast.

I have done all these things since Aug. 14, the day I turned my bicycle too sharply onto a gravel road near my New Jersey home and was slammed down, breaking two bones in my right wrist and partially tearing a tendon. That hurt.

At the time, I was training roughly 12 hours a week in preparation for an October bike ride across Italy with high school friends.

I saw a hand surgeon the next day and he told me I probably wouldn’t need surgery but that I could forget about biking in Italy. He put my wrist in a splint and said I couldn’t drive a car, much less get on a bike for a good while.

That hurt even more. Not only was I forgoing the trip to Italy, but I had spent months getting in the best shape in years. Now I was going to lose it all.

I started walking the next day to avoid that fate. Am I in biking shape? No way. But I have kept relatively fit by going on a hard daily walk. I passed a previously scheduled heart stress test a couple of weeks after my bike crash, and my resting pulse rate—one way to measure how healthy your heart is-—is about the same as when I was riding 12 hours a week.

Like any exercise regime, you should talk to your doctor before doing intense walking. This is particularly true if you’re older.

Here are the tactics I used to step up my daily walking routine. Anybody with a pair of walking shoes can use these.

Sprint Once in Awhile

Short bursts of intense workout woven into your daily walk will greatly improve its cardiovascular benefits.

“High-intensity interval training is basically doing an activity ‘as hard as you can’ for about 30 seconds, whether it be walking, running, cycling, swimming, then taking one to two minutes of recovery at a more easy pace,” explains Edward Laskowski, a doctor of sports medicine at the Mayo Clinic in Rochester, Minn.

Walking in a hilly area is a natural sort of interval training. When you walk up the hill, that is the high intensity part. When you walk down, that is the recovery.

If you live in a flat area, try doing a few short sprints during your walk. Take your time to recover after each sprint. I prefer sprinting on grass, which I do at a local park.

Carry Weights

A weighted rucksack or vest can turn your stroll into a taxing workout. When I don’t feel like walking fast, I put on a 30-pound backpack and walk through a nearby forest with some hills. I’m exhausted by the time I get back to my house.

You can buy rucksacks with secured weight plates so things won’t bounce around. I’m a cheapskate, so I just took a weight set we had sitting around and used duct tape and cardboard to construct a stable weight that I could secure inside a backpack.

Pick Up Your Pace

This is the most tiring workout of all.

If you want to walk faster than 4 or perhaps 4.5 miles an hour, a brisk pace for most walkers, you have to bend your arms and swing them like a racewalker. Here’s a demonstration. The more you swing your arms like this, the faster you’ll step. Trained race walkers can walk at 9 or 10 miles an hour. You read that right. Here’s a video of Tom Bosworth of England walking a mile in 5 minutes and 31 seconds. It’s difficult to run a mile that fast.

The fastest I’ve managed recently isn’t quite 5 miles an hour—less than half the pace of Bosworth!—and a 4 mile walk at that pace left me completely thrashed. It was absolutely as hard as a run or a hard bike ride. My legs were almost quivering by the end because—I can’t believe I’m writing this—walking can be the best exercise if done right.

Barron’s

How Far Should You Walk to Improve Your Health? You Won’t Like the Answer.

Neal Templin – Dec. 3, 2022

Walking 10,000 steps a day is one of those mysteriously decided good things we should all do, much like drinking eight glasses of water a day. I read it comes from a Japanese marketing campaign in the 1960s.

I’d like to report the number of steps needed for full benefit was fewer, but a fair amount of research has since been done on the subject, and it found that walking 10,000 steps a day is great for your health.

Evan Brittain, a cardiologist and associate professor at Vanderbilt University School of Medicine in Tennessee, co-wrote an October 2022 study published in Nature Medicine journal that measured how much exercise people actually got using Fitbit fitness trackers during a median of four years.

The study looked for associations between step count and disease. “We looked across every human disease that showed up in unbiased analysis,” Brittain says. “We homed in on six strongly: obesity, hypertension, diabetes, esophageal reflux, sleep apnea and depression.”

The study found the biggest protections against most diseases among those who walked close to 10,000 steps a day. For example, the research found that increasing your step count to 10,000 from 6,000 reduces the incidence of diabetes by 56%.

READ MORE

• A Stroll Isn’t Exercise. What I Do to Get a Real Workout.
• A Big Chill Is Here for the Housing Market. Next Year Could Bring More Trouble.

Why is walking—or any form of exercise, really—so good for us? A few reasons, says cardiologist Chad Raymond, director of cardiac rehabilitation at University Hospitals Harrington Heart and Vascular Institute in Ohio. For starters, those same endorphins that make you feel great after exercising also open up your blood vessels and help create new blood vessels.

“Regular exercise reduces blood pressure five to eight points, often what most blood pressure medicines do,” he says.

Exercise also improves the ability of skeletal muscles ability to extract oxygen from the blood, Raymond adds. And it helps improve lung function, which in turn helps the heart. 

Stop the presses: Being a couch potato isn’t good for you. So put on those comfortable shoes and go for a walk. 

Time

Tiny Blood Clots May Be to Blame for Long COVID Symptoms, Some Researchers Say

Jamie Ducharme – December 2, 2022

Credit – Getty Images

Blood clotting is a normal, healthy process. It’s what stops the bleeding when you slice your finger in the kitchen, for example. But sometimes, clotting goes awry. Clots that block major blood vessels can lead to potentially fatal issues like strokes or heart attacks. Tiny clots in the body’s small blood vessels can also be dangerous.

Autopsies of people who died from COVID-19 have shown that some patients develop these tiny “microclots” in their lungs, potentially contributing to respiratory failure. And now, a growing group of researchers believe microclots may also be to blame, at least in part, for Long COVID symptoms.-

People with Long COVID can experience a range of health issues—everything from neurological issues to intense fatigue and gastrointestinal distress—for months, or even years, after catching COVID-19. Researchers aren’t entirely sure why this happens. Some argue it’s because remnants of the virus linger in the body, while others think the virus triggers an abnormal immune response that essentially causes the body to attack itself.

Yet another camp of researchers believes that microclots cause Long COVID symptoms by impeding blood and oxygen flow to the body’s organs and tissues. That hypothesis is alluring because it suggests an intuitive treatment approach: if you can flush clots from the blood, you should be able to get rid of symptoms.

Resia Pretorius, head of the physiological sciences department at South Africa’s Stellenbosch University, is one of the leaders of that camp. In August 2021, she co-authored the first paper to raise the microclot theory. Still, Pretorius isn’t ruling out other explanations—or a combination of them. In fact, she believes the leading hypotheses about Long COVID’s causes are interconnected. She posits that lingering viral remnants may damage the cells that line the blood vessels, prompting the formation of inflammation and microclots, which could in turn make the immune system attack itself. “It’s connected,” she says. “It can be seen as interacting with each other, not one [theory] above the other.”

David Putrino, a Long COVID researcher at New York’s Mount Sinai health system who has collaborated with Pretorius, agrees that microclots are likely a piece of the larger Long COVID puzzle. “Microclots are kind of like exhaust fumes,” he says. “They’re showing up because something systemically is going wrong.” Putrino’s research with Yale University’s Akiko Iwasaki (who has also collaborated with Pretorius) suggests Long COVID patients have high levels of systemic inflammation, which he says could lead to the formation of microclots.

“If we can modulate any part of that cascade with therapeutics,” Putrino says, “people are [hopefully] going to start to feel better.”

There is no proven cure for Long COVID. But in December 2021, Pretorius’ research group posted online a study (which has not yet been peer reviewed) showing that 24 Long COVID patients experienced improvements in symptoms, including fatigue, after being treated with blood-thinning drugs.

But some experts have doubts about that approach. Dr. Adam Cuker, clinical director of Penn Medicine’s Blood Disorders Center and a member of the American Society of Hematology, says so much remains unknown about microclots that it feels premature to begin treating people with drugs that come with significant risks, such as excessive bleeding.

“The scientific part of me would say, ‘It would be better if we had more evidence from basic science labs before we turn this into a clinical trial,’” Cuker says. “The tension is that I recognize that there are patients suffering out there and desperate for answers.”

At the moment, Cuker says some of the studies on microclots are “hypothesis-generating,” but he has doubts about some of the ways that researchers are looking for microclots in the blood. For example, the protocol developed by Pretorius’ team involves drawing blood and adding a fluorescent agent. Researchers then compare the sample’s appearance under a microscope with fluorescent-treated samples from healthy control patients. “That’s a very artificial system,” Cuker says. “It’s very different from an autopsy, where you can see with your own eyes that there were clots in the body.”

To help standardize the research process, Putrino’s team is developing an objective way to detect the presence of microclots using a computer vision algorithm. From there, he says, the next step is to determine whether the amount of microclots in a person’s body correlates with their symptom severity. His lab has already gathered some unpublished data that suggest extensive clotting is linked to increased cognitive impairment—another finding, albeit a premature one, that suggests microclots are at least partially responsible for Long COVID symptoms.

Putrino acknowledges that there’s a long way to go when it comes to microclot research, and research on Long COVID in general. But he says it’s necessary to think outside the box, “especially when people’s lives are at stake.”

NBC News

Neurologists say accelerated brain aging in Black people can be countered by lifestyle changes

Curtis Bunn – December 2, 2022

Black physicians are fascinated but not surprised by recent data that suggests Black people’s brains are likely to age faster than those of other races due to stressors such as racism. However, doctors said lifestyle changes and preventative care could help slow some of the decline.

In a study published last month in the journal JAMA Neurology, researchers from Columbia University found racial and ethnic disparities in brain markers of Alzheimer’s disease and related cases of dementia. The scientists analyzed MRI scans of nearly 1,500 participants, and found that Black adults in their mid-50s were more likely than white or Hispanic adults of the same age group to show white-matter lesions in their brains, which are indicators of cerebrovascular disease or cognitive decline.

The authors noted that “social forces” may have played a part in the accelerated brain aging seen among their Black subjects. In particular, the study says the weathering hypothesis — which states that “chronic exposure to social and economic disadvantage leads to accelerated decline in physical health outcomes”— could cause Black middle-aged adults on average to have cerebrovascular disease earlier in life.

JAMA Neurology did not immediately respond to request for interview.

Dr. Philippe Douyon, a neurologist in New Jersey at the Inle Brain Fit Institute who hosts The Brain Prophets Podcast, said he’s concerned that some may interpret the study to mean that Black people are naturally predisposed to Alzheimer’s. “That’s not the case at all. A lot of things contribute to dementia and Alzheimer’s, like high blood pressure and diabetes. Also, chronic stress kills neurons or brain cells in the part of the brain responsible for making new memories,” Douyon said.

He also noted that chronic stress as a result “of racism or health inequalities due to racism” can raise someone’s risk of developing cognitive disease. “But I would not want people to think that it has anything to do with the fact that the color of their skin is black,” he said.

Dr. Richard D. King, a neurologist and associate professor at the University of Kentucky College of Medicine, said many people who experience a deterioration in brain function do not realize there’s a problem until there’s been “quite a bit of decline.”

He added that stress can exacerbate hypertension, which can make a person more prone to cognitive decline.

“Elevated blood pressure is a very strong risk factor for worsening cerebrovascular disease,” King said. “But two people might respond to the exact same stress in very different ways. It’s a difficult thing to measure on an individual basis.”

Donald Grant, a psychologist and the executive director of Mindful Training Solutions, a firm that designs diversity, equity and inclusion programs for businesses, said the stress of being Black in America can wear on the brain.

“We’re talking about Black folks experiencing these higher degrees of racialized stress, meaning we’re watching ourselves being murdered through racism, we’re watching ourselves not get jobs because of racism,” Grant said. “We’re watching ourselves not get housing and equal opportunities through racism. That creates a unique stress that nobody else experiences and our brains are being impacted by it.”

Minimizing the risk 

Douyon said there are many ways to slow brain aging, including maintaining a healthy diet and getting proper rest.

“You can minimize your risk of dementia by eating healthy — more fruits and grains and vegetables and less animal fats and sweets in moderation,” he said. “You need to make sure you’re getting six to eight hours of sleep every night.”

Douyon said sleep deprivation in someone’s mid-life years — 20s through 50s — can raise the risk of  dementia in their 60s, 70s or 80s. He said it’s important to not only get sleep, but deep sleep, known as non-rapid eye movement (NREM) sleep.

“That’s when the brain essentially clears out the toxins that are developing throughout the day. And when these toxins build up, they develop into plaques and those are the kind of plaques that we see in people with Alzheimer’s,” he said.

King added that it’s also important to keep the mind and body active.

“Exercise is a big one,” he said, “and that’s something that we’re actually pretty good at least until we get older, when we get kind of lazy. But physical activity is my best anti-aging formula.” He recommends spending 30 minutes per day doing “something that’s kind of vigorous and gets your heart rate up — gets you a little sweaty.”

King and Douyon also suggested playing board games, solving puzzles and reading as ways to exercise the brain.

“Learning a new hobby makes a big difference,” King said. “And then staying socially active. Keeping those connections with family with friends, with church and social organizations provide meaningful interaction. If you get isolated, you just don’t do as well as those that maintain those connections.”

In addition, Grant thinks it’s equally important to find ways to manage stress.

One option is through activities like restorative yoga, which Grant said can help address stress and regulate blood pressure and brain function.

“Racism creates a unique stress that nobody else experiences,” he said. “We have to begin building stress relief techniques in school that specifically speak to race-based stress and trauma. This type of yoga is one of them.”

King noted that “the study certainly suggests that if we were able to do things like close the socioeconomic gaps and provide more opportunities and reduce the number of microaggressions Black people face, you might see some change in that.”

He added that high blood pressure and diabetes, which are prevalent in Black communities, can be managed with proper health care and while both are very common, they are “very treatable.”

“What gets measured, gets managed,” King said. “And so you have to measure it. You have to go to your primary care doctor and check your blood pressure and blood sugar level. And you have to take your medications on a regular basis.”

Douyon said a holistic approach is likely the best way to slow down brain aging.

“You want to constantly be learning, constantly evolving, learning new skills, interacting with different people, learning new languages, traveling the world, having new experiences,” he said. “Being creatures of habit is killing our neurological potential. So, you don’t want to be sedentary — that causes the brain to atrophy and to shrink. These are things that we can do every day to minimize the risk of us developing something like Alzheimer’s.”

Good Morning America

Suffering from flu, RSV or COVID-19? How you can tell the difference

Mary Kekatos – December 2, 2022

The U.S. is facing a surge of respiratory viruses, mainly driven by COVID-19, influenza and respiratory syncytial virus, or RSV.

Flu and RSV have appeared earlier than usual and have particularly affected children, leading to 78% of pediatric hospital beds being full, according to the U.S. Department of Health & Human Services.

All three viruses have symptoms that are similar, which can make them difficult to tell apart. But knowing which virus a person has can help them receive proper treatment or, if need be, let them know if they need to isolate.

MORE: Two-thirds of states reporting ‘very high’ or ‘high’ levels of flu-like activity: CDC–

Here are some questions to consider when trying to determine if you have COVID-19, flu or RSV.

What are the symptoms?

COVID-19, flu and RSV are more similar to each other than they are different in terms of symptoms.

One of the only symptoms exclusive to one virus and not the others is loss of taste and smell, which has been a hallmark symptom of COVID-19.

However, public health experts told ABC News the absence of one of the symptoms does not mean a patient doesn’t have a particular virus and that the only way to be sure is to get tested.

“In most cases, if anybody has generic symptoms, such as fever, cough, runny nose, there’s going to be no real way to distinguish which one is which without a test,” Dr. Scott Roberts, an assistant professor and the associate medical director of infection prevention at Yale School of Medicine, told ABC News.

How quickly did symptoms come about?

Flu symptoms typically appear rather quickly while symptoms of RSV and COVID-19 appear more gradually, according to the Centers for Disease Control and Prevention.

COVID-19 has an incubation period of two to 14 days while RSV has an average incubation of about five days but can be anywhere from two to eight days.

MORE: RSV cases hit 2-year high, CDC data shows

By comparison, flu has an incubation period of one to four days.

“So, if somebody says, ‘I went to Thanksgiving party yesterday where someone had flu and the next day I had a fever,’ I can already tell you that’s flu,” Roberts said. “I know it’s much too fast for it to be COVID.”

How old is the patient?

Public health experts told ABC News that depending on how old a patient is can affect the severity of the disease.

For example, RSV is most severe for infants younger than six months older and young children, particularly those with weakened immune systems or congenital lung or heart disease.

“Children under six months of age and children maybe a little bit older who have underlying medical conditions or who were premature, end up with the shortness of breath and the difficulty breathing because their airways are just so small, and they don’t have a lot of reserve there to move air through the small air passages when they’re inflamed,” Dr. Shira Doron, an infectious disease physician and hospital epidemiologist at Tufts Medical Center in Boston, told ABC News.

However, relatively young and healthy adults are not likely to have a severe case of RSV if they get infected.

“In children, we tend to see a lot more of the sort of bronchiolitis respiratory issues with RSV,” Dr. Allison Bartlett, an associate professor of pediatrics at the University of Chicago Medical Center, told ABC News. “Adults, when they get RSV, it tends to be a like a cold. It’s just like one of the colds that you would get every year.”

With COVID-19, age is the number one risk factor when it comes to severe disease and death.

MORE: RSV hospitalizations in seniors much higher than any point in prior seasons

As of the week ending Nov. 19, Americans aged 65 and older make up 92% of all deaths from the virus, according to an ABC News analysis of data from the Centers for Disease Control and Prevention.

What treatments or precautions do I need to follow?

“Not everyone needs to be tested; our pediatricians’ offices and hospitals are overloaded,” Bartlett said. However, figuring what the illness is can help treat the patient and potentially family members or close contacts, she said.

For example, with COVID-19, it’s important to follow CDC guidelines, which include isolating for at least five days — or longer if symptoms don’t improve — and wearing a mask around others.

Additionally, they can be prescribed Paxlovid if they are at risk of severe illness.

With flu, patients can receive Tamiflu to shorten the course of their illness as long as it is given early on and people who are exposed to flu can receive the treatment to prevent them from getting sick.

However, the most important thing a person can do if they are infected — when possible — is to stay home.

“If you’re really, really sick, go the hospital. If you’re not that sick, and it looks like a common cold, then you stay home and don’t infect people,” Doron said.