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Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort
- Maria G. Joyanes, Ingrid M. Outschoorn (4 April 2009)
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Blood viscosity is the common factor in the aging process, physical activity and smoking.
- Les O. Simpson (20 April 2009)
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Cycle Health Promotion for NHS Employees.
- Christopher Jack, Max Edwards, Mirant Parikh, Samuel Rajaratnam (20 April 2009)
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Maria G. Joyanes, Researcher CNA-AESAN Ministry of Health and Cosumer Affairs of Spain, Ingrid M. Outschoorn
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We congratulate the authors for their elegant design and long term follow-up study. Physical activity improves quality of life in a dose dependent manner. However, physical activity increased in parallel with mortality rate in the first five years of follow up in men who enhance their physical activity between the ages of 50 and 60. It appears that strength physical activity constitutes a stress factor when initiated at 50y, but later, if they adapt it shows a positive effect. It could be of interest to consider also the psychological influence in this age cohort. Because the increased depression play a major role in the mortality of aging populations and at the same time physical activity improves mental health. Byberg L, Melhus H, Gedeborg R, Sundström J, Ahlbom A, Zethelius B, Berglund LG, Wolk A, Michaëlsson K.Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort. BMJ. 2009 Mar 5;338:b688. doi: 10.1136/bmj.b688. Martin CK, Church TS, Thompson AM, Earnest CP, Blair SN. Exercise dose and quality of life: a randomized controlled trial. Arch Intern Med. 2009 Feb 9;169(3):269-78. Competing interests: None declared |
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Les O. Simpson, retired experimental pathologist Dunedin, New Zealand 9077
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The number of significant, relevant omissions in this paper raises the important question, " What is the value of doing medical research if the published findings are ignored by others ?" Perhaps of even greater importance is that the journal referees also were unaware of the omissions. Mortality was related to leisure time activities in an aging cohort followed for 35 years, and the beneficial effects of physical activity were compared with the benefits which follow the cessation of smoking. But no where in the text is the "Why" question raised. Why did leisure activities reduce age-related mortality ? Why were the beneficial effects of such activities similar to those which followed stopping smoking ? The answers to such questions have been available for a long time. What is most surprising is that during the 35 year follow-up, none of the 8 co-authors had by chance stumbled across any of those reports which showed (a) that the aging process is accompanied by an increase in blood viscosity (1); (b) that regular low intensity physical activity lowered blood viscosity (2); (c) that cigarette smoking increased blood viscosity, while cessation of smoking led to the normalisation of blood viscosity (3). Because the authors chose to ignore the published information about the adverse effects of increased blood viscosity, participants would remain unaware of the potential benefits, for example, of an appropriate diet. While the authors may have achieved their objective, it is a pity that they were unable to explain to the participants why physical activity was important in countering the changes which occur during the aging process. References. 1. Ajmani RS, Rifkind JM. Hemorheological changes during human aging. Gerontology 1998; 44: 111-20. 2. Ernst E. Influence of regular physical activity on blood rheology. Eur Heart J 1987; 8 (Suppl G): 59-62. 3. Ernst E, Matrai A. Abstention from smoking normalises blood rheology. Atherosclerosis 1987; 64: 75-7. Competing interests: None declared |
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Christopher Jack, SpR Bromley Hospitals NHS Trust, Max Edwards, Mirant Parikh, Samuel Rajaratnam
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In response to Lyberg et al. excellent paper Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort we feel that health promotion is even more important. The cycle to work scheme was introduced by the department for transport as part of the government’s green travel plan. It allows a tax exempt loan to purchase a push bike and associated equipment when bought through the scheme. Cyclescheme customers are not limited to any particular bike or accessory brand. Previous authors have shown that cycling reduces the risk of heart disease, high blood pressure, obesity and type II diabetes.1,2,3,4 New cyclists covering short distances can reduce their risk of death by as much as 22%, primarily due to the reduction of heart disease.5 It can assist in weight loss burning approximately 300 calories an hour.2 30 minutes of cycling a day meets the Government's target on exercise. Regular cycling also has a positive effect on mental health.2,4,5,7 The strength and co-ordination that regular cycling brings make injuries from falls less likely.4,5,8,9 The department of transport suggests that 'even a small amount of cycling can lead to significant gains in fitness'. Department of Transport research suggests people who do not exercise who start cycling move from the third of the population who are the least fit, to the fittest half of the population in just a few months.8 Cycling is 'one of the few physical activities which can be undertaken by the majority of the population as part of a daily routine'.8 Cyclists and pedestrians absorb lower levels of pollutants from traffic fumes than car drivers.4,11 Despite all of these known health benefits of cycling to work, the majority of NHS employees do not have access to this scheme. Only 67 of the 418 trusts are participating, and those who do require repayment over twelve monthly salary deductions. The scheme is easily transferable between participating employers. We therefore advocate en-bloc participation of all NHS trusts. This will ensure the opportunity for health promotion to all the roughly 1.2 million people that it employs, including those rotating through different trusts. References 1. Carnall D. Cycling and health promotion. A safer, slower urban road environment is the key. BMJ 2000; 320: 888. 2. Mersy DJ. Health benefits of aerobic exercise. Postgrad Med 1991; 90: 103-7 and 110-2. 3. Kelley GA. Effects of Aerobic exercise in normotensive adults: a brief metaanalytic review of controlled clinical trials. South Med J 1995; 88: 42-46. 4. www.nationalcyclingstrategy.org.uk 5. Rutter H. Modal shift. Transport and health. A policy report on the health benefits of increasing levels of cycling in Oxfordshire www.modalshift.org/reports/tandh/print_version.htm 6. Leeds cycling action group. Cycling and Health www.leedscyclists.org.uk/health.htm 7. Scully D, Kremer J, Meade MM et al. Physical exercise and psychological wellbeing. In MacAuley D (Ed.) Benefits and hazards of exercise. London: BMJ Books 1999. 8. Fentem PH. ABC of sports medicine. Benefits of exercise in health and disease. BMJ 1994; 308: 1291-5. 9. Joakimsen RM, Magnus JH, Fonnebo V. Physical activity and predisposition for hip fractures: a review. Osteoporosis Int 1998; 7: 503- 13. 10. Rank J, Folke J, Jespersen PH. Differences in cyclists and car drivers exposure to air pollution from traffic in the city of Copenhagen. Sci Total Environ 2001; 279: 131-6. 11. Department of the Environment, Transport and the Regions. A new deal for transport: Better for everyone. Chapter 2 Sustainable transport. Published 20 July 1998. Competing interests: None declared |
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