There has been debate whether high school students participating in organized sports should be screened for cardiac conditions before they participate in sports. Those who favor screening advocate use of an electrocardiography (ECG) while others recommend only a thorough history and physical examination. The Clinical Decisions series presented a case of whether to initiate screening in high school athletes and a panel of physician experts presented their views. Readers were allowed to join the debate by voting and posting comments on NEJM.org. The case was also presented by the same four physicians at the American Heart Association (AHA) in November 2013. Online polls received 1,266 votes from 86 countries. 18% opposed cardiac screening, 24% favored screening with history and physical examination only and 58% favored screening with ECG, history and physical examination. U.S. voters preferred screening with only a history and physical exam. Many of the comments pointed to the lack of evidence that screening prevents death, the unfavorable cost-benefit of screening, who would be paid to read and interpret millions of ECGs, as well as what recommendations should be given to children with abnormal ECG readings. Europe is recommending ECG screening for all young athletes while currently the AHA and American Academy of Family Physicians recommend screening with only a history and physical examination. What are your thoughts regarding whether screening for cardiac conditions should be expanded to include ECG along with a history and physical examination?
For additional information, please see NEJM.
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In an 11 week trial recently published in The Journal of Physiology, researchers at the Norwegian School of Sport Sciences in Oslo assessed the effect vitamin C and E have on exercise endurance. 54 participants received either 1,000 mg of vitamin C plus 235 mg of vitamin E or placebo and they exercised up to four times a week. Researchers found no difference in performance between the two groups. However, those who took vitamin C and E seemed to produce less of a specific mitochondrial marker in their muscle cells, which suggests of a decrease endurance. What are your thoughts about this study? What are your typical recommendations to patients looking to enhance their exercise endurance?
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A new study conducted by Brigham and Women’s Hospital (BWH) and the National Cancer Institute found that leisure time physical activity is associated with increased life expectancy. Data from almost 650,000 people over age 40 was evaluated in this study. Brisk walking for 75 minutes/150 minutes per week was associated with an increase in life expectancy of 1.8 years/3.4-4.5 years accordingly. What physical activity do you encourage your patients incorporate in their daily routines?
A longitudinal observational study published in the journal Neurology associated exercise in the late 70s with the reduction of brain shrinking. Researchers at Edinburgh University concluded that physical activity was associated with less atrophy and white matter lesion. These findings suggest that exercise may be neuro protective and lead to a decrease in cognitive decline. How much exercise do you recommend to your patients on a daily basis? How do you think this information will affect the elderly population at risk of dementia?
For more information see Neurology.
A recent cross-sectional study published in the American Journal of Kidney Disease suggests that people who sit for long periods may have a higher risk of developing chronic kidney disease. The study evaluated 6,379 individuals who self-reported physical activity and the amount of time they spent sitting. After adjustment of factors such as BMI, it was concluded that higher levels of sitting time was associated with more prevalence of CKD, especially in women. How long do you sit at your job? What suggestions do you offer to yourpatients who sit for long periods of time?
To find out more, please read the abstract in AJKD.
A prospective cohort study published in Pediatrics surveyed 1,843 Canadian kids between the ages of 10 and 12 to see if they played any active videogames, such as Dance Dance Revolution and Wii Fit. What they found was that not only do nearly a quarter of the surveyed kids report exergaming, but they also are playing on average 2 days per week for about 50 minutes each, providing the opportunity for kids to reduce sedetary lifestyle and to engage in physical activity. What is your opinion on the use of videogames to achieve a more active generation?
For more information, please read the article in Pediatrics.
A new study published in the Archives of Internal Medicine showed that middle aged people have a lower risk of developing chronic diseases if they are more fit. It was previously believed that the chronic diseases was inevitable and were just delayed by maintaining a healthier lifestyle, but the results of the study showed that the rate of chronic diseases were significantly reduced in both males and females. A healthy lifestyle does not only mean exercising, but it also includes a healthy diet, not smoking, limiting alcohol use, having blood pressure and cholesterol levels within normal limits. What are the challenges that middle aged adults face that prevent them from living a healthy lifestyle and how can you encourage make the needed change?
For more information, visit Archives of Internal Medicine.
Coconut water is an excellent sports drink ― for light exercise
A new analysis of coconut water was reported during the 244th National Meeting & Exposition of the American Chemical Society (ACS). Many people are aware that coconut water is a good source of electrolytes. The American diet consists of high amount of sodium and not enough potassium. Drinking coconut water can restore the balance, by replenishing much needed potassium lost from exercise and necessary for recovery and muscle cramp reduction. What other foods/drinks do you consume that provide body with electrolytes and help to recover after exercising?
For additional information please visit American Chemical Society.
Regular physical activities have shown to decrease patients’ risk for developing type 2 diabetes (T2DM). However, the role of weight training in the prevention of T2DM remains unknown. The journal Archives of Internal Medicine recently published a prospective cohort study that found an association of men who perform weight training and a lower risk of T2DM, independent of any aerobic exercises. What has your experience been thus far? What recommendations do you offer your patients to prevent T2DM?
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The BMJ recently published an article questioning the needs for the consumption of sports drinks in individuals who are exercising less than 45 minute. Sports drinks aid hydration and fuel active muscles in athletes and the general public in extreme conditions. Otherwise, drinking water and consuming electrolytes found in our diet would be enough. What are you current recommendations regarding physical activity, electrolytes and hydration?
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