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It's never too late to start exercising — large US study

ExerciseIt's truly never too late to begin exercising, research shows. Medical Xpress reports that a major study has found that even for people who were "couch potatoes" in their youth, embarking on a regimen of regular exercise in middle-age can still greatly cut the odds for death from any cause.

The study tracked the health – and lifetime exercise patterns – of more than 315,000 people who were members of AARP (formerly the American Association of Retired Persons). The investigators found that folks who'd exercised all their lives had a 36% lower risk of dying during the study period, compared to people who'd never exercised. But, perhaps surprisingly, people who'd been inactive in youth but decided to get more physical in their 40s and 50s saw almost the same decline – 35% – in their odds for an early death.

This suggests "that midlife is not too late to start physical activity," according to the research team led by Pedro Saint-Maurice of the US National Cancer Institute. "Inactive adults may be encouraged to be more active, whereas young adults who are already active may strive to maintain their activity level as they get older," the study authors wrote. What's more, a mid-life start to physical activity seemed to cut the odds of death from the two major killers – heart disease and cancer. The study found that for people who began exercising in their 40s and 50s, rates of death from heart disease fell by 43% compared to people who'd never exercised, and the cancer death rate fell by 16%. Those declines were similar to those seen in people who'd exercised all their adult lives, the researchers noted.

"This study, once again, portrays the importance of physical activity in relationship to one's long-term mortality," said cardiologist Dr Evelina Grayver, who wasn't involved in the new research. "Whether or not you start exercising when you are younger or older, the benefits will always be there," said Grayver, who directs the coronary care unit at North Shore University Hospital in Manhasset, New York.

She did offer up one caveat, however: "This does not mean that starting exercising at a later age, and getting the same mortality benefit, means that one should not exercise in your younger years." Grayver said that she still believes that it is "overall continuous cumulative effects of continuous physical activity" that subsequently decreases the odds for an early death.

Indeed, the report says, the study authors seemed to agree, stressing that in the study, "participants who maintained the highest amount of (exercise) in each age period were at lower risk" for death from any cause.

Dr Sunny Intwala directs sports cardiology at Lenox Hill Hospital in New York City. He noted that current federal government health guidelines "recommend that Americans should move more, sit less and squeeze in at least 150 minutes of moderate-intensity exercise weekly." Trouble is, just one in five American adults meets those guidelines, Intwala said. But the new research "demonstrates the crucial relationship between physical activity in the prevention of heart disease and death at any age," he added.

And you don't have to start running marathons at 55 to reap the benefit of exercise, Intwala said in the report. "As I tell my patients that are not keeping up with their New Year's resolutions to exercise, doing something is better than doing nothing, and doing more is even better than doing something," he said.

Abstract
Importance: Although the benefits of leisure-time physical activity (LTPA) in middle age are established, the health effects of long-term participation and changes in LTPA between adolescence and middle age have not been documented.
Objective: To determine whether an association exists between LTPA life course patterns and mortality.
Design, Setting, and Participants: This prospective cohort study used data from the National Institutes of Health–AARP (formerly American Association of Retired Persons) Diet and Health Study established in 1995 to 1996. Data analysis was conducted from March 2017 through February 2018. Data were analyzed for 315 059 adult AARP members living in 6 states, namely, California, Florida, Louisiana, New Jersey, North Carolina, or Pennsylvania, or 2 metropolitan areas, Atlanta, Georgia, or Detroit, Michigan.
Exposures: Self-reported LTPA (hours per week) at the baseline interview for ages grouped as 15 to 18, 19 to 29, 35 to 39, and 40 to 61 years.
Main Outcomes and Measures: All-cause, cardiovascular disease (CVD)–related, and cancer-related mortality records available through December 31, 2011.
Results: Of 315 059 participants, 183 451 (58.2%) were men, and the participants were 50 to 71 years of age at enrollment. Ten LTPA trajectories (categorized as maintaining, increasing, and decreasing LTPA across time) were identified, and 71 377 deaths due to all causes, 22 219 deaths due to CVD, and 16 388 deaths due to cancer occurred. Compared with participants who were consistently inactive throughout adulthood, participants who maintained the highest amount of LTPA in each age period were at lower risks for all-cause, CVD-related, and cancer-related mortality. For example, compared with participants who were consistently inactive, maintaining higher amounts of LTPA was associated with lower all-cause (hazard ratio [HR], 0.64; 95% CI, 0.60-0.68), CVD-related (HR, 0.58; 95% CI, 0.53-0.64), and cancer-related (HR, 0.86; 95% CI, 0.77-0.97) mortality. Adults who were less active throughout most of the adult life course but increased LTPA in later adulthood (40-61 years of age) also had lower risk for all-cause (HR, 0.65; 95% CI, 0.62-0.68), CVD-related (HR, 0.57; 95% CI, 0.53-0.61), and cancer-related (HR, 0.84; 95% CI, 0.77-0.92) mortality.
Conclusions and Relevance: Maintaining higher LTPA levels and increasing LTPA in later adulthood were associated with comparable low risk of mortality, suggesting that midlife is not too late to start physical activity. Inactive adults may be encouraged to be more active, whereas young adults who are already active may strive to maintain their activity level as they get older.

Authors
Pedro F Saint-Maurice; Diarmuid Coughlan; Scott P Kelly; Sarah K Keadle; Michael B Cook; Susan A Carlson; Janet E Fulton; Charles E Matthews

[link url="https://medicalxpress.com/news/2019-03-middle-age-boost-life-span.html"]Medical Xpress report[/link]
[link url="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2727269"]JAMA Network Open abstract[/link]

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