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Some Exercise Research Creates Doubt
WASHINGTON
(AP) - A 300-page summation of decades of research on exercise
is bringing scientists face-to-face with how little they know.
Consensus
statements published by the American College of Sports Medicine
establishes that people who exercise improve their health. But
researchers often can't tell how much health-improvement payoff
will result from a given amount of work, or even if a workout
will make a difference at all.
``It is confusing,''
said researcher I-Min Lee of Harvard Medical School, lead author
of one of the 32 articles in a special supplement to ACSM's research
journal, Medicine and Science in Sports and Exercise. ``The consensus
is trying to cover different conditions and diseases, and all
may have different associations.''
The articles
are not meant to cast doubt on the value of exercise. The supplement
supports current federal minimums of at least 30 minutes a day
of moderate activity on most days of the week.
Lee's article
makes that point as it examines the relationship between physical
activity and all-cause mortality, the risk of death at any given
age. Following at least the minimal guidelines, which can help
to burn 1,000 calories a week, reduces all-cause mortality by
20 to 30 percent, the article said.
Will a person
reduce the risk more by doing more exercise? It sure looks that
way, although at the upper end of exercise, a person gets ever-smaller
reductions in risk from the incremental added effort, Lee's article
said.
Will a person
gain some benefit even from less activity? Maybe, said Lee's article,
but it's too soon to be sure. ``There are some provocative, but
not definitive, data suggesting that an even lower volume of physical
activity - perhaps half of what is currently recommended - may
be all that is needed,'' it said.
In conceding
that, however, Lee held her breath. People always want to get
by on less work, and if the lower-threshold concept turns out
to be wrong, publicizing it could lead people away from exercising
at levels that would do them good, she said.
Looking at
specific medical conditions, the data found strong benefits for
some diseases, weak indications of benefits for others, and not
enough good data to be sure on still others.
In the strong-benefit
category was cardiovascular disease. The benefit of at least moderate
exercise seems to be a 30 to 40 percent reduction in coronary
mortality, but the benefits in reduced risk seem to flatten out
with more activity, Lee said.
``The
evidence we have for physical activity and cardiovascular disease
is probably the strongest of any evidence,'' said Dr. Harold W.
Kohl III, who wrote a summary article on the question. ``Increasing
physical activity, and higher levels of physical activity, tends
to bring down an individual's risk of dying of coronary heart
disease.''
What
benefits there are against stroke is less clear, said Kohl, who
chairs ACSM's public information committee. Studies to date fail
to establish a dose-response benefit, but that may be because
they include data on two different types of stroke, he said.
Kohl
suspects exercise may reduce the risk of ischemic stroke, caused
by blockages in blood vessels in the brain, much in the manner
that heart attack is caused by blockages in arteries that feed
the heart. But he also believes the benefits against ischemic
stroke may be diluted by adding in data from a different type,
hemorrhagic stroke, in which weak spots in the blood vessels rupture.
Over
the years, research on the benefits of exercise has improved,
said Dr. Elliott Danfort, a professor emeritus at the University
of Vermont. ``The quality of the study now is markedly better
than it was when I started it out in science,'' he said. Standards
have tightened, and papers based on too few subjects, that don't
run long enough, and don't sufficiently say what they are looking
for are getting screened out, he said.
But
the quality of the research still can be better, Danforth said.
For one thing, researchers need to standardize meanings of terms,
so everybody agrees on what they are talking about as they try
to see what works, he said. And studies should be more tightly
targeted to exactly how much exercise it takes to get a specific
result, he said.
On
the Net:
American
College of Sports Medicine Healthy Activity Updates: http://www.acsm.org/media.htm
Surgeon
General's report on physical activity and health: http://www.cdc.gov/nccdphp/sgr/sgr.htm
Reference
Source 102
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