Everett Chiropractic Center Blog

February 23, 2012

Back Pain Might Be The Least Of Your Troubles

Here Dr. Slosberg reviews current research and if need be he adds commentary. The email we received today reviews three studies that don’t seem to be on his site yet, but I am sure they will be. Remember that the audience is clinicians so it might get a little thick.

Here I will share the parts that I highlighted from his review. Any comments that I offer will be in [brackets]. The entire article is pinned to the Bulletin board so you can read it when you come in if you like.

Dr. Slosberg’s Research Updates

Summaries of three recent articles all related in terms of their content concerning exercise, disuse, sedentary life styles, sitting, and metabolic biomarkers of increased risk for cardiac and all cause mortality. All three papers come from highly reputable sources including the position stand on exercise prescription from the American College of Sports Medicine (ACSM) and reinforce the emerging paradigm of what fitness and wellness means and how clinicians can prescribe exercise and educate patients in order to help them achieve and maintain fitness and wellness. This information is invaluable to the practicing chiropractor who has the goal of educating patients and enhancing their sense of well-being. There is no commentary attached to the summaries, because these papers are clear and self-explanatory.

Owen N, Healy GN, Mathews CE, Dunstan DW. Too Much Sitting: The Population Health Science of Sedentary Behavior. Exerc. Sport Sci. Rev., 2010; 38(3): 105-113.

Sitting time, which can commonly be 70% to 80% of our waking hours… …associated metabolic biomarkers that place people at risk of chronic diseases & an increased risk of premature all-cause & cardiovascular mortality.

Too much sitting is distinct from too little exercise. Sedentary behavior is not simply the absence of moderate- to vigorous-intensity physical activities, but has potentially deleterious health consequences including obesity and metabolic precursors of major chronic diseases (type 2 diabetes, cardiovascular disease, breast & colon cancers).

Chronic unbroken periods of muscular unloading associated with prolonged sedentary time results in an inactivity physiology that may have deleterious biological consequences.

One may expect that in future physical activity recommendations from the American College of Sports Medicine (ACSM) & the American Heart Association (AHA) a statement on reducing sitting will be included.

…standing is not a sedentary activity.

TV watching: In a 6.5 yr study, high levels of TV time were significantly associated with increased all-cause & cardiovascular disease mortality rates. Each 1-hr increment in TV time was found to be associated with an 11% and an 18% increased risk of all cause and cardiovascular disease mortality rates, respectively. Relative to those watching less TV (<2 hr/d), there was a 46% increased risk of all-cause mortality and an 80% increased risk of cardiovascular disease mortality in those watching TV 4 hr/d or more.

The Metabolic Syndrome: ↑Weight (obesity/overweight), ↑blood sugar, ↑insulin resistance (hyperglycemia), ↑blood fats (hyperlipidemia), ↑blood pressure (hypertension), ↑risk CVD, ↑risk DM II. These increased risks were independent of traditional risk factors such as smoking, blood pressure, cholesterol level, and diet, as well as leisure time physical activity and waist circumference.[Emphasis mine. It’s bad.]

A recent US study examined sedentary behaviors in relation to cardiovascular mortality outcomes based on 21 yrs of follow-up of 7744 men. Those who reported spending >10 hr/wk sitting in automobiles (vs 23 hr of combined television time & automobile time (vs <11 hr/wk) had an 82% and 64% greater risk of dying from cardiovascular disease, respectively.

Garber CE, PhD. American College of Sports Medicine position stand. Quantity & Quality of Exercise for Developing & Maintaining Cardiorespiratory, Musculoskeletal, & Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise. Medicine & Science in Sports & Exercise. 2011; 43(7). 1334-59.

The scientific evidence demonstrating the beneficial effects of exercise is indisputable.

ACSM recommends that most adults engage in moderate-intensity cardiorespiratory exercise training for ≥30 min/d on ≥5 d/wk for a total of ≥150 min/wk, vigorous-intensity cardiorespiratory exercise training for ≥20 min/d on ≥3 d/wk (≥75 min/wk), or a combination of moderate- & vigorous-intensity exercise to achieve a total energy expenditure of ≥500-1000 MET (metabolic equivalent of task) min/wk. On 2-3 d/wk, adults should also perform resistance exercises for each of the major muscle groups, & neuromotor exercise involving balance, agility, and coordination. Adults who are unable or unwilling to meet the exercise targets outlined here still can benefit from engaging in amounts of exercise less than recommended. [Or… you could just do Tai chi.]

Benefits of Exercise: Exercise & physical activity decrease the risk of developing CHD, stroke, type 2 diabetes, & colon and breast cancers. Exercise & physical activity lower blood pressure; improve lipoprotein profile, C-reactive protein, & other CHD biomarkers; enhance insulin sensitivity, & play an important role in weight management. Exercise preserves bone mass and reduces the risk of falling. Prevention of & improvement in mild to moderate depressive disorders & anxiety can occur with exercise. [And a bunch of other benefits too numerous to mention.]

It is not enough to consider whether an individual engages in adequate physical activity but health & fitness professionals should be concerned about the time clients spend in activities such as TV watching & sitting at a desk.

Wroblewski AP, et al. Chronic exercise preserves lean muscle mass in masters athletes. Phys Sportsmed. 2011 Oct;39(3):172-8. Aging is commonly associated with a loss of muscle mass & strength, resulting in falls, functional decline, & feelings of weakness.

Conclusions: This study contradicts the common observation that muscle mass & strength decline as a function of aging alone. Instead, these declines may signal the effect of chronic disuse… … maintenance of muscle mass & strength may decrease or eliminate falls, functional decline, & loss of independence that are commonly seen in aging adults.

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1 Comment »

  1. […] Physical inactivity for example is something we have control over. It’s also a risk factor in obesity, as well as diabetes, cancer, stroke and heart disease. And obesity is a risk factor in diabetes, cancer, stroke and heart disease. […]

    Pingback by Risk Factors « Everett Chiropractic Center Blog — July 2, 2012 @ 1:58 pm


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