You live Hawai'i, you live longer

 You live in Hawai’i, you live longer.

This has been the case for a while, and in the latest statistics, the Islands continue to have the highest life expectancy of any state in the U.S. 

If you live here, on average you can expect to live to age 80.7 years, compared to a national average of 76.1. We are the only state with a life expectancy of more than 80.

The online publication The Hill just discovered the news, and wrote about it this week. 

At Raising Islands, we have covered this issue before.

It’s about exercise, the outdoor life, a low rate of smoking and a comparatively low rate of obesity.

Our rate of death from heart disease is the second-lowest in the country, after Minnesota (must be the ice fishing) and just ahead of Massachusetts (the beans?). The highest five states in heart diseases, listing the worst first: Mississsippi, Oklahoma, Alabama, Arkansas and Louisiana. Here’s the data on that. 

We also have the second-lowest cancer death rate, this time just behind Utah and ahead of Colorado. The five worst: Kentucky, West Virginia, Mississippi, Oklahoma, Tennessee. Here are those data. 

We are in the middle of the pack on death from strokes. 

There are some other factors, too. We like our beer, but deaths from alcohol are far lower than the national average. And our state spends three times per capita the average state’s spending on health care.

The Commonwealth Fund pulled together all the stats in its 2022 Scorecard on State Health System Performance. It found Hawai’i is not just at the top of the longevity list, but way ahead. 

The numbers grew even more disparate during the COVID-19 epidemic, when the number of excess deaths from all causes were less than a fifth in Hawai’i compared to the worst states—110 per 100,000 in the Islands compared to 596 per 100,000 people in Mississippi.

It’s not all great news. If there is one area that needs a lot of help, it is with mental illness. The Commonwealth Fund report found that Hawaii is the worst state in the country for adults with mental illness who did not receive treatment in 2018-2019. Two-thirds of our adults with mental illness did not receive treatment—and the statistics for Hawai’i are getting worse.

© Jan TenBruggencate 2023

Walking isnʻt just for your heart any more. Also the liver, the brain, diabetes...

The link between exercise and heart health is will understood, but new data suggests other organs, notably the liver, also benefit, and dramatically.

This doesnʻt mean you need to run marathons or go to other physical extremes. Walking is sufficient to reduce risks pretty dramatically.

The Harvard Medical School makes the point clearly: "Walking improves cardiac risk factors such as cholesterol, blood pressure, diabetes, obesity, vascular stiffness and inflammation, and mental stress.

"And if cardiac protection and a lower death rate are not enough to get you moving, consider that walking and other moderate exercise programs also help protect against dementia, peripheral artery disease, obesity, diabetes, depression, colon cancer, and even erectile dysfunction."

The article that quote comes from is a valuable lesson for the sedentary. 

The latest bit of data to support going out on regular hikes is a study that looked at 26 years of data on the exercise habits of 117,000 people. Thatʻs a big study.

The study notes that cirrhosis of the liver is increasing along with the nationʻs obesity crisis, but that regular exercise, like walking, can reverse the trend.

"Our findings show that both walking and strength training contribute to substantial reductions in risk of cirrhosis-related death, which is significant because we know very little about modifiable risk factors," said Dr. Tracey Simon, of Harvard Medical School and lead researcher on the study, which was  presented at a conference of Digestive DiseaseWeek. 

Their study found that those in the top fifth in terms of amount of walking reduced their likelihood of cirrhosis-related death by 73 percent. And those who added strength training cut their risk even more.

Simonʻs study was published in the May 2019 edition of the journal Gastroenterology.  Her co-authors were Edward Giovannucci, Kathleen E. Corey, Xuehong Zhang and Andrew T. Chan. The paper is entitled: Physical activity, including walking and strength training, are associated with reduced risk of cirrhosis-related mortality: Results fromtwo prospectice cohors of U.S. men and women.

They followed 68,000 women and 49,000 men in the Health Professionals Follow-up Study, who reported their walking, other aerobic activities and resistance exercise over a period from 1986 to 2012. And they looked at the ones who died during the period, and whose deaths were attributable to cirrhosis.

"Compared to adults in the lowest quintile of physical activity, those in the highest quintile had a 73% lower risk for cirrhosisrelated death," the report said.

The authors said thereʻs still need for more research into the best kind of exercise, amount of exercise and intensity of exercise. But it seems clear that getting out and moving it has significant benefits for long-term health.

© Jan TenBruggencate 2019

Want to lose weight? Go with your gut, or your mom, but not the internet.

You need to lose a little weight, so you go to the internet for solutions, right?

Wrong.

Asking the internet for advice is like asking random people for technical help, except that the internet is also populated with an oversupply of trolls who rejoice in misleading you, along with a whole lot of hucksters trying to sell you things that may or may not help.

I came across a news report that suggested the body’s natural messenger to prevent overeating is a hormone called leptin. So, how do you increase leptin and decrease your appetite?

I went online.

Oh my, the lies, the errors, the active commerce, and the answers from people who know less than you do. 

Here’s Wikihow, which has a long list of tips, including that you should eat protein for breakfast, and definitely not cereal, because after all, cereal is “full of lectin, which actually binds to your leptin receptors, keeping leptin from being able to do its job.”

Of course, then you go to Livestrong.com and the first recommendation is to eat plenty of cereal with fruit, because of the fiber: “Fiber gives you a feeling of fullness, causing your intestinal tract to send a signal to your brain to release more leptin.” 

Some sites say get lots of sleep, because if you don’t sleep your leptin levels drop and you eat.

This guy says it’s all about diet. 

These paleo diet folks say it’s all about diet and lifestyle. They’ll sell you a daily diet program.

These guys will sell you a different diet program to help you “master your metabolism.” All you need to do is buy their book. They’ll also sell you dietary supplements like collagen protein, and “performance coffee”, which cost more than the book.

There are lots of websites that talk about secret foods you must never eat. And others that talk about supplements you must use—and particularly the high quality supplements available exclusively through their particular firms.

I appreciate Healthline for telling you what you already knew. They key to health and weight is no secret: Eat more protein, fewer carbs, more fiber, avoid processed food, sleep better, exercise

Wow. Forget about leptin. Eat right, sleep well and stay fit. You didn’t need the internet for that. Your mom could have handled the job.

© 2017 Jan W. TenBruggencate 

Finess yields longer life, lower inflammation, healthier kids, better memory. Get out there!

Need reasons to get out and get fit? Here are a bunch of new ones.

As the nation’s healthiest state for five years running, Hawai`i folks don’t seem to need much of an excuse.  

But maybe you need a little boost to get you out the door. Here you are.

If you’re older, being more fit means you probably also get a better memory as a bonus.

“Cardiorespiratory fitness is one individual difference factor that may attenuate brain aging, and thereby contribute to enhanced source memory in older adults,” says this study led by researchers from the Boston University School of Medicine. 

They say that being fit “may contribute to neuroplasticity among older adults, reducing age-related differences in some brain regions, consistent with the brain maintenance hypothesis, but accentuating age-differences in other regions, consistent with the brain compensation hypothesis.”

And you may be reading a lot about anti-inflammatory diets and the issues with inflammation in the body. Well, these researchers from the University of California at San Diego said that 20 minutes of exercise can reduce inflammation. 

You don’t need to go all out, but you shouldn’t dawdle, either, they write. A fast walk is sufficient, they say..

“Decreased inflammatory responses during acute exercise may protect against chronic conditions with low-grade inflammation,” the authors wrote.

So, this isn’t news to most of us. Here’s here is one more study that says that if you exercise moderately to vigorously, you’re less likely to die early.

It’s a pretty good-sized study. More than 5,000 people. The health effect of exercise applies to both men and women. And the positive impacts of exercise on mortality are impressive, as long as you do moderate to vigorous physical activity. Dawdling, once again, does not have quite the same positive impact. 

Okay, and here’s one that makes perfect sense. 

If you want your kids to be fit and healthy, you need to set the example. This study suggests that parents who stay fit will have kids who will exercise at a higher level. 

The researchers actually attached equipment to family members to measure their physical activity. They found, as you might expect, that couch potato parents tended to have kids who lazed around more. And active parents had more active kids.

“Considering how to reduce parental sedentary behavior and increase (physical activity) behaviors could be a powerful point of intervention,” wrote the authors, led by Shari Barkin of the Department of Pediatrics at Vanderbilt University Medical Center.

© Jan TenBruggencate 2017

How long will you live? Exercise plays bigger role than diet, smoking and a lot of other factors.

Finally some clarity.

You aren’t what you eat.

You are what you DO.

A new study suggests you can get away with a fair number of dietary and other lapses, as long as you stay active.

There are Hawai`i data that make sense of this.

We’ve got our health issues in the Islands. Diet alone is an issue. Think fast food burgers, kalua pork and bento lunches with five kinds of meat. 

(People outside Hawai`i will question this, but I recently had a box lunch with rice, pickled vegetables and Korean barbecue ribs, barbecue chicken, teriyaki beef, Goteborg sausage and Vienna sausage.)

Despite such excesses, Hawai`i has the highest life expectancy in the nation. More than 81 years on average. This isn’t news. Here’s just one citation, from the Centers for Disease Control. 

Hawai`i also has one of the highest rates of exercising in the nation. One Gallup survey from 2013 said 62 percent of Island residents said they exercise at least 3 times a week. 

And it’s not just the nice weather. We’re second highest in the nation for exercise after Vermont. And Montana and Alaska are right up there, too. All are also in the top third in longevity. 

So, is there a connection? 

Sure there is, according to these researchers from the American Heart Association and Queen’s University. They say exercise trumps diet and lots of other risk factors toward living a long life. (Here's the Eureakalert review of the paper we're citing.)

And you don’t have to be a triathlete. 

“Moderate levels of physical activity consistent with current recommendations may be all that is needed to derive a clinically significant benefit for habitually sedentary individuals,” said Dr. Robert Ross, of Queen’s U.

---------------------------

Those are the basics. Let’s get into the details.

The report is called Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign. It was published in the American Heart Association journal, Circulation.

The report says that your level of physical fitness, referred to here as cardiorespiratory fitness (CRF), is a key to mortality. 

It's dead simple. Low fitness, high mortality. Even moderate fitness, lower mortality.

“Mounting evidence has firmly established that low levels of cardiorespiratory fitness are associated with a high risk of cardiovascular disease, all-cause mortality, and mortality rates attributable to various cancers,” the paper says.

It goes on: “A growing body of epidemiological and clinical evidence demonstrates not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus, but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes.”

Any one study gives you a pinpoint view of a very broad subject. This is different. This particular report is not new research, but is a review of the known literature on health and mortality over the past 30 years, and an attempt to get a better handle on risk factors. And it looks at studies with thousands of participants.

One study after another has confirmed the role of exercise in living longer. Here are some of the study results.

A study of nearly 10,000 men: “Survival increased in subjects who improved exercise capacity.”

A study with more than 3800 participants: “Fitness was a strong predictor of outcomes irrespective of weight status.”

A study with more than 15,600 participants: “Moderately fit had 50% lower mortality than those with low CRF.”

The upshot: “A consistent finding in these studies was that after adjustment for age and other risk factors, CRF was a strong and independent marker of risk for cardiovascular and all-cause mortality.”

And as we said earlier, you don't have to go to extremes in exercise.

The report looks at studies of high intensity training compared to continuous moderate intensity training, and does not find a compelling case for one over the other. Both improve cardiorespiratory fitness, it says, but there are concerns about injury and “cardiac complications in selected patients” with higher intensity workouts, it says.

So, what kind of exercise should you consider? Here is the language from the report:

“Exercise that involves major muscle groups (legs, arms, trunk) that is continuous and rhythmic in nature (eg, brisk walking, jogging, running cycling, swimming, rowing, cross-country skiing, climbing stairs, active dancing), in contrast to high-resistance muscle-strengthening activities that produce limited CRF benefits.”

If you’re getting started, depending on your condition, it recommends building up to a regimen of three to five days a week, for 30 to 60 minutes at a time. You should start slow and easy if you’re just beginning an exercise regime, and breaking the initial sessions up into batches of at least 10 minutes is okay.

If you're in poor shape, the study recommends increasing activity in coordination with your medical provider. And it wouldn't hurt to read the whole report. It's free and available as a PDF from the heart association website. 

© Jan TenBruggencate 2016

Wanna stay mentally alert as you age? Exercise both the body and the brain.

If you want to keep your wits about you as you age, you need to work those wits—but you also need to work your body.

Exercise, particularly aerobic exercise is very important to brain function. That’s been known for some time, and the evidence keeps building. 

As far back as 2004, a Hawai`i study found that elderly adults who walk a lot have lower rates of dementia. The report in the Journal of the American Medical Association reviewed tests done on hundreds of elderly men, comparing their physical activity with rates of dementia.

“Our findings suggest that physically capable elderly men who walk more regularly are less likely to develop dementia,” wrote the authors of the study, Walking and Dementia in Physically Capable Elderly Men.

The Mayo Clinic Proceedings in 2011 stated the case clearly: “A rapidly growing literature strongly suggests that exercise, specifically aerobic exercise, may attenuate cognitive impairment and reduce dementia risk,” Mayo wrote. 

Scientific American was in there, too, with the headline, “Aerobic exercise bulks up hippocampus, improving memory in older adults.”

A 2010 study in the Proceedings of the National Academy of Science said regular aerobic exercise increased the size of the hippocampus, a part of the brain that tends to shrink with age. 

“Exercise training increased hippocampal volume by 2%, effectively reversing age-related loss in volume by 1 to 2” years, said this study.  

A 2014 study showed that specifically in elderly women, exercise increased the size of the hippocampus—the part of the brain associated with verbal memory and learning. 

That study, from the British Journal of Sports Medicine is here. 

A Finnish study in February of this year, 2016, found similar results: “Aerobic exercise, such as running, has positive effects on brain structure and function, for example, the generation of neurons (neurogenesis) in the hippocampus, a brain structure important in learning. 

That study, done on rats rather than humans, in the Journal of Physiology is here. 

And this article in the New York Times argues that it needs to be aerobic exercise, not just muscle-building work. 

Most of the work indicates that the effect of exercise isn’t huge but it’s real. 

Still, physical activity isn’t everything. You also need to exercise the brain directly.

The American Psychological Association says specific kinds of brain training can help stave off dementia. But not all brain training.

“The mistake some people make is thinking that all brain training is the same. Lumping all brain training together is like trying to determine the effectiveness of antibiotics by looking at the universe of all pills, and including sugar pills and dietary supplements in that analysis. You’ll find that some work and some do not. To then conclude that brain training does not work — or is not yet proven—is based on flawed analysis.” So says Jerri Edwards, PhD, of the University of South Florida, who led a study on the subject, published by APA, above.

Another study suggests intensive learning can actually cause chemical changes in the brain, increasing the amount of a protein that helps protect against memory loss, and even Alzheimer’s Disease.

"You're keeping the machinery going. It makes sense that the more time spent intensely focused on learning, the more your brain is trained to process information and that doesn't go away. That intense kind of learning seems to make your brain stronger," said Auriel Willette, an assistant professor of food science and human nutrition at Iowa State University. 

© Jan TenBruggencate 2016

A random wander through recent science: peat, compost, flying, rain in dead forests and coffee

Coffee sparks athletic performance, don’t drain those peat bogs, composting, et cetera.

Today, we’ll take a random walk through some recent science papers. No particular theme, just stuff that caught my attention.

PEAT 

Here’s an interesting, although somewhat misleading piece out of Denmark.

It goes under the headline, “Growing crops on organic soils increases greenhouse gas emissions.” But what it really found is that if you drain a peat bog to make farmland, the peat decomposes and releases higher levels of carbon dioxide than it would if you hadn’t drained the bog.

So, it seems that it’s more the draining of the peat bog than the growing of crops that causes the problem. If you want to stop the carbon dioxide production, just let the water back in: “The climate can be given a helping hand by taking the organic soils out of rotation,” the authors say.

COMPOST

Everybody already knows composting is a better solution than tossing your organic scraps into the trash, right? This new study confirms that, generally, but not always. It is, predictably, published in the journal Compost Science & Utilization.  

The key piece of information is that if you toss food into the trash and it gets landfilled, it produces a lot of methane, which is a powerful greenhouse gas—considerably worse for the climate than carbon dioxide. If you compost, not so much. On the other hand, if a landfill is well managed and the methane is captured for reuse, it can turn the numbers around.

The study uses a couple of measures, including the U.S. EPA Waste Reduction Model (WARM). It concludes, “The WARM model suggests that landfilling yard waste is superior to composting.”

The message, perhaps, is that if your community has a really good landfilling methane recapture system--perhaps making electricity out of it--the landfill is not so bad. Otherwise, compost.

TREES

When a forest dies, it makes sense that rainfall will fill streams instead of being sucked up by the trees, right? Nope, according to a study of pine forests killed by the mountain pine beetle. 

A study in the journal Water Resources Research says that a series of test sites showed that stream flows stayed the same or actually declined in the areas where trees were dying.

The proposed cause was both increased evaporation and increased activity by the understory plants after the death of the canopy trees: 

“Although counter to initial expectations, these results are consistent with increased transpiration by surviving vegetation and the growing body of literature documenting increased snow sublimation and evaporation from the subcanopy following die-off in water-limited, snow-dominated forests.”

FLYING

A lot of folks talk green, but hardly act green, and air travel is a big example. 

The environmental community may talk a lot about saving the planet, but this has not reduced folks’ flying habits—even though flying is perhaps a human’s most climate-destroying activity.

“Despite the fact that flying can be more damaging than any other activity that an individual can undertake, many otherwise green consumers still choose to fly, offering an opportunity to elicit narratives about the differences between their attitudes and behaviours,” write the authors of this paper, “Flying in the face of environmental concern: why green consumers continue to fly.”

This “do as I say, not as I do” behavior is pervasive, they say.

“There is evidence across a wide range of environmentally responsible behaviours that people advocate specific products or product groups, conservation behaviours and lifestyle choices but that awareness or approval does not necessarily lead to behaviour change.”

What’s clear is that people on the green side do understand the impacts. Some of them try to justify their behavior, suggesting they take more efficient flights, and switch to other form of transportation like trains for shorter trips, but they still travel.

“For the majority of this sample, the ‘doing without’ option was not considered for long-haul flights nor was the possibility of changing travel destinations to accommodate not flying,” the authors said. 

The study was based on interviews with 29 individuals identified as environmentalists.

COFFEE 

And finally, on a pretty unrelated subject, some researchers, writing in the International Journal of Sports Nutrition and Exercise Metabolism, found that a cup of coffee before you exercise can improve how you do at it. 

It’s not an actual physical study, but a review of numerous studies done on coffee, other sources of caffeine, and exercise. This won’t be news to a lot of athletes, but it reports that most scientific review of the topic finds that a cup of coffee both increases your performance and also makes you feel like you aren’t working so hard.

“Based on the reviewed studies there is moderate evidence supporting the use of coffee as an ergogenic aid to improve performance in endurance cycling and running,” the authors write

© Jan TenBruggencate 2015