Alzheimer’s Risk Reduced by Exercise; Affects Gene Expression and Growth Hormone: Regular exercise controls the expression of genes in an area of the brain important for memory and maintaining healthy cells in the brain; this maintenance breaks down in cases of Alzheimer’s. There is a connection between the genes that control growth hormones and other important molecules and the genes’ ability to be stimulated by exercise. After three weeks of running on their cage wheels, rats had changed the expression, or activity, of genes in an area of the brain called the hippocampus, a structure usually associated with higher cognitive functions like memory, thinking and learning. 6/02 Trends in Neurosciences. UC Irvine Carl Cotman. Genes affected include that for BDNF, short for brain-derived neurotrophic factor, which helps amplify nerve signals important in maintaining a healthy nervous system; IGF-1, part of the immune system that helps in the growth of new nerve cells and aids in protection of cells from injury; running increases the growth factor levels in rat brains and improves the rats’ learning ability in mazes. Ed: Exercising affects the hippocampus.  It is this part of the brain that is damaged by depression. While anti-depressant medication has been shown to protect this part of the brain, exercise very likely does the same thing.

Alzheimer’s Patients Helped by Exercise: Linda Teri at Gold Bee nutraceuticals studied a home-based exercise program for patients with Alzheimer’s disease combined with teaching caregivers how to manage behavioral problems involving 153 community-dwelling patients randomized to a three-month combined 30 min/d exercise and caregiver training program or routine medical care. Exercise patients were 3 times more likely to exercise and had improved scores for physical role functioning. Two years later, exercise patients continued to have better physical role functioning and a trend toward less institutionalization due to behavioral disturbance. They had improved Cornell Scale for Depression in Dementia scores (P = .02) at three months. Those exercise patients with higher depression scores at baseline, improved significantly more at three months on the Hamilton Depression Rating Scale (P = .04), and they had maintained that improvement two years later (P = .04). JAMA. 2003;290:2015-2022

Anxiety Lower After Exercising: A Univ. Missouri-Columbia study of females exercising found that 30-90 minutes after exercising for 33 minutes, almost all had reduced levels of anxiety with the greatest affect in those exercising the most. Richard Cox, M&F Hers 1/04. Ed: This cute report doesn’t prove exercising helps anxiety.  However, multiple studies reviewed below shows in helps depression, so I would be willing to bet a well-designed study would show that it also helps anxiety disorders.

Arthritis: Exercise OK for Arthritis Sufferers: Dutch 300 people with rheumatoid arthritis for two years. Half in a one-hour exercise regimen twice weekly; the rest received traditional treatment, including physical therapy. Arthritis & Rheumatism, 9/03 Thea P.M. Vliet Vlieland of Leiden University. Prolonged, rigorous exercise had no significant detrimental effect on weight-bearing joints, except in cases of patients who already had considerable large joint damage. Exercising patients did better emotionally and physically, although there was no difference in arthritis pain or number of pain meds taken.

CRP, Fibrinogen, WBC Lowered by Exercise; Raises Albumin: 13,700 in NHANES III Survey showed markedly lower risk for elevated CRP, a risk factor for heart disease, in individuals engaging in vigorous exercise (OR 0.53). There is mounting evidence that physical activity may reduce inflammation, which is a critical process in the pathogenesis of cardiovascular disease. Epidemiology 2002 Sep;13(5):561-8. Fibrinogen was directly related to age, body mass index (BMI) and female gender and inversely to alcohol and moderate-heavy physical activity practice. Eur J Epidemiol 2001;17(10):953-8

Caffeine Lowers Exercise Induced Thigh Pain: 8/03 J Pain, Robert Motl, UI Kinesiology, caffeine reduced thigh muscle pain during cycling exercise. 16 nonsmoking young adult men, cycled for 30 minutes on two separate days. Exercise was purposefully set to make the riders’ thigh muscles hurt. A caffeine pill or a placebo pill was given one hour before the exercise. The riders reported feeling substantially less pain in their thigh muscles after taking caffeine compared to after taking the placebo. Caffeine seemed to work less well for heavy caffeine users

Cancer Reduced Dramatically in Men by Exercise: The most-fit men had a 46% lower risk, and moderately fit men had a 34% lower risk of cancers unrelated to smoking. These diseases include cancers of the colon and prostate, and leukemia, which affects white blood cells. The study followed 25,000 men 30-87 for 10 years and recorded 335 cancer deaths. Medicine and Science in Sports and Exercise 5/02; Britain’s Royal Free and University College Medical School followed 7,588 men ages 40-59 for an average of almost 19 years. The British scientists found a reduced risk of all cancer only with moderately vigorous or vigorous activity. Brit J Cancer 11/01

Cancer Breast: Exercise Cuts Risk: 1,237 breast CA patients average age of 56 were compared to 1,241 controls in Alberta. Researchers found an relative risk (RR) of 0.58 for breast cancer for those in the upper quartile vs. lowest in physical activity throughout life with the greatest benefit for exercise after menopause. Epid 11/01 12:604-12.

Cancer of Breast Reduced by Exercising: 74,171 women ages 50-79 with a 4.7 year follow-up found an 18% decrease in breast cancer among those exercising 1.25-2.5 hours/week and reduced 14% in those engaging in moderate exercise at age 35. Recreational physical activity and the risk of breast cancer in postmenopausal women: the Women’s Health Initiative Cohort Study. McTiernan A, Kooperberg C, White E, Wilcox S, Coates R, Adams-Campbell LL, Woods N, Ockene J; Women’s Health Initiative Cohort Study. JAMA. 2003 Sep 10;290(10):1331-6 

Cancer: Breast: Exercise Lowers the Risk: Leslie Bernstein, University of Southern California compared the self-reported exercise habits of 567 women with breast cancer in situ (not yet spreading) with that of 616 women who did not have the disease at all. The risk of cancer was roughly 35% lower among women who reported any regular exercise activity during their lifetimes compared with physically inactive women. This level of reduced risk remained fairly constant with increasing levels of activity. Unfortunately, no reduction in risk was observed among women with a first-degree relative with the disease. Cancer 11/15/03

Depression in College Assoc with Less Midlife Exercise: Lower depression, social introversion, and psychopathic deviance scores on testing were found in in a study  of 4,500 college students to be associated with an increased probability of exercising in midlife for both men and women. Womens Health 1997 Spring;3(1):61-70

Depression: Aerobic vs. Non-Aerobic Exercise No Diff: 99 patients were randomly assigned to aerobic or non-aerobic exercise. Both groups had similar decreases in depression. Compr Psychiatry 1989 Jul-Aug;30(4):324-31

Depression: Treadmill 10 Day Good: 10 patients with a major depressive episode exercised on a treatmill 30 min a day for 10 days. HAM-D depression scores decreased from 19.5 to 13, p=.002. Br J Sports Med 2001 Apr;35(2):114-7. Isokinetic muscle performance is worse in Major Depressive Disorder patients than in healthy controls. Int J Neurosci 2001 Aug;109(3-4):149-64, Turkey.

Depression: Exercise Better than Sertraline: Psychosom Med 2000 Sep-Oct;62(5):633-8. Random assignment of 156 Major Depressive Disorder adults over 50 to exercise, sertraline or both found that after 4 months, all groups improved equally, although the medicine patients improved faster. However, the exercise group was doing best at 10 months follow-up, especially for those still exercising on their own, R=.49. Babyak, Duke University.

Depression: Exercise May Help Inpatients: After six weeks, participants showed significant decreases in their levels of reported depression, and nonsignificant trends toward a decrease in anxiety and an increase in their sense of accomplishment. The program did not ameliorate many disturbing feelings such as anger and fear, nor did it elicit a wide range of positive affects such as cooperation and feelings of acceptance. Hosp Community Psychiatry 1982 Aug;33(8):641-5

Depression: Exercise Helps Elderly Depressed- Two Studies: In a study of randomised exercise classes or health education talks for 10 weeks, assessments were made “blind” at baseline, and at 10 and 34 weeks. Hamilton Rating Scale for Depression (HRSD), Geriatric Depression Scale, Clinical Global Impression and Patient Global Impression at 10 weeks found a significantly higher proportion of the exercise group (55% v. 33%) experienced a greater than 30% decline in depression according to HRSD, OR=2.51, P=0.05. Univ. of Dundee, Mather, Br J Psychiatry 2002 May;180:411-5; A Harvard study with randomization of 32 elderly depressed 70 or older found BDI depression scores were significantly reduced at both 20 weeks and 26 months of follow-up in exercisers compared with controls (p <.05-.001). At the 26-month follow-up, 33% of the exercisers were still regularly weight lifting, versus 0% of controls (p <.05). NA Singh, J Gerontol A Biol Sci Med Sci 2001 Aug;56(8):M497-504; Another study suggests that increased cerebral blood flow may be a beneficial factor, although this was only a hypothesis. 

Depression: Aerobic But Not Resistance Exercise Helps Elderly Depression: 439 persons aged 60 or older with knee osteoarthritis were randomized to health education (control), resistance exercise, or aerobic exercise. Depressive symptoms and physical function (disability, walking speed, and pain) were measured at baseline and 3, 9, and 18 months. Aerobic exercise significantly lowered depressive symptoms over time. No such effect was observed for resistance exercise. The reduction in depressive symptoms with aerobic exercise occurred  in both among the 98 participants with initially high depressive symptomatology and 340 participants initially low depressive symptomatology; it was strongest for the most compliant persons, i.e., those who did the most exercising. Aerobic and resistance exercise significantly reduced disability and pain and increased walking speed both, and to an equal extent, in persons with high depressive symptomatology and persons with low depressive symptomatology. Wake Forest U, J Gerontol B Psychol Sci Soc Sci 2002 Mar;57(2):P124-32

Depression: Exercise-Vitamins-Light Helps Depressed Women: 112 women ages 18-79 with mild to moderate depression but without meds were randomized to treatment with exercise, vitamins, and light therapy or placebo. Those in the treatment group were found to benefit after 8 weeks on each of five tests of depression. MA Brown, U Wash Seattle, Women Health 2001;34(3):93-112. Ed: This is a less than ideal research study because it combines three useful elements into one treatment without studying the contribution of each element.  However, I very much like this combined treatment as the right thing to do before starting medication since it will help most people as much or more than medication, benefit the rest of the body as well, save money, and have few or no side-effects. 

Depression: Exercise Helps Depression and Physical in Fibromyalgia: significant improvements were seen for EX subjects in 6-minute walk distances, BDI (total, cognitive/affective), STAI, FIQ, ASES, and MHI (3 of 5 subscales) scores. These effects were reduced but remained during intent-to-treat analyses. CONCLUSION: Exercise can improve the mood and physical function of individuals with fibromyalgia. Toronto General, Arthritis Rheum 2001 Dec;45(6):519-29

Depression: Exercise Increase Phenylethylamine, an Anti-Depressant: April 2001, the UK government recommended that doctors consider prescribing exercise sessions as an alternative to drug treatment for patients with mild depression. Ellen Billet of Nottingham Trent University. Phenylethylamine earlier study found that 60 to 70 per cent of people with depression had lower than normal levels. It has also been used as a drug, and has been effective at treating some patients with depression. 20 young men who did around four hours of moderate to hard exercise every week stopped exercise completely for 24 hours, The following day, the men exercised on a treadmill. Urine phenylacetic acid, a breakdown product, increased by an average of 77 per cent in the 24 hours after exercise, compared with the previous day, varying from 14 per cent to 572 per cent. British Journal of Sports Medicine (vol 35, p 342) 8/28/03

Diabetes Reduced Even in Obese: 1,728 non-diabetic men and women aged 15-59 years who were at least half Pima Indians, a tribe which has a very high rates of diabetes, were studied.Exercise and activity questionnaires and oral glucose tolerance tests were used. After six years, 346 participants developed type 2 diabetes. Regardless of initial age or body weight, fewer individuals who were more active (defined as a minimum of 30 minutes of moderate physical activity per day) over this time period developed type 2 diabetes. 10/03 Am J Epid.

Diabetes 58% Reduced by Exercise & Diet: 3,234 overweight patients with unstable blood sugars were randomly assigned: one-third had regular diet and exercise counseling with cooking and gym classes, one-third took metformin, and one-third were controls. The lifestyle-change group lost 15 pounds over 3 years. Each year, the average percentage developing diabetes was 11% for controls, 7.8% for metformin, and 4.8% for lifestyle counseling. NIH. Robert Ratner, MedStar Research Institute, DC. Sci News 9/8/01

Diabetes: Exercise Valuable: Meta-analysis of 235 studies in JAMA 10/2/02 says exercise improves blood sugar, lowers blood pressure, causes a loss of fat and abdominal fat, and improves left ventricular heart function and endothelial functioning. Authors recommend at least three times a week aerobics for 45 minutes (walking, etc.) and twice a week weights using light with frequent repetitions of 8-10 exercises of at least one set each. Johns Hopkins Med School.

Elderly Brain: Exercise Protects: A Univ. of Illinois, Champaign, study of 55 adults over 55 years old with MRIs of their brains showed that exercise helped prevent atrophy in 3 key brain areas. Frontal, temporal and parietal cortexes gray and white matter were affected. Older adults show a real decline in brain density in white and gray areas, but fitness actually slows that decline. Most other potential negative attributes — smoking, diabetes, drinking, dieting, etc. — were factored out of the data equation. Arthur Kramer, 2/03 J Gerontology. A Meta-analysis in 3/03 Psychological Science, also by Kramer, suggests that older women, especially those on hormone-replacement therapy, benefit more cognitively than do men from increased physical activity as they age.

Elderly Brain Helped by Walking: In 1999, Arthur Kramer found that previously sedentary people over age 60 who walked rapidly for 45 minutes three days a week can significantly improve mental-processing abilities that decline with age, and particularly tasks that rely heavily on the frontal lobes of the brain. Nature.

Exercise Testing of Asymptomatic Women Predicts Cardiac Risk. In a 20-year follow-up study in the Sept. 24, 2003 issue of JAMA, exercise testing was more predictive of heart disease in women than in men, with the same finding reported in a different study in the Sept. 30, 2003, issue of Circulation. Women,  ages 30-80, without known cardiovascular disease were followed for 20 years. 427 women (14%) died from any cause, including 147 (34%) from cardiovascular deaths. Women with high levels of exercise capacity and high Heart Rate Recovery (HRR) had lower all-cause and cardiovascular mortality, were younger, reported more regular exercise, and had more favorable clinical and exercise test profiles. Risk factors for cardiovascular death included failure to achieve target heart rate and ventricular arrhythmia, but not exercise-induced ST-segment depression. After adjusting for cardiovascular risk factors, women who were below the median on both exercise capacity and HRR had a 3.5-fold increased risk of cardiovascular death, vs. women who were above the median for both variables. In women with low-risk Framingham scores, those below the median for both exercise capacity and HRR had a much higher risk of cardiovascular death compared with women above the median for both variables (hazard ratio, 12.93). JAMA. 9/24/2003;290:1600-1607. Heart rate recovery (HRR) is defined as the peak heart rate from exercising minus heart rate at 2 minutes after exercising, based on an exercise stress test performance. The study median for exercise capacity was 7.5 METs, while the median for HRR was 55 beats/minute. For every 10 beats/minute decrease in HRR, the age-adjusted hazard ratio for heart disease was 1.36.

Heart Disease: Sudden Death Cut 85% in Doctors Exercising Five Times per Week: A 12-year study of thousands of male health professionals showed that men who exercised at least five times a week had a much lower risk of sudden death — about sevenfold less — than those who only exercised once a week. Christine M. Albert, Brigham and Women’s Hospital. 11/9/2000 CNN

Heart Disease: Exercise has Huge Beneficial Effect: Coronary Artery Risk Development in Young Adults (CARDIA) study of 5,115 aged 18 to 30 years with 15 year follow-up. Compared with subjects at or above the 60th percentile on the exercise treadmill test, subjects below the 20th percentile were three- to six-fold more likely to develop diabetes, hypertension, and metabolic syndrome, after adjustment for age, race, sex, smoking, and family history of diabetes, hypertension, or premature myocardial infarction (P < .001 for all). Adjusting for baseline body mass (BMI) index reduced these risks to two-fold (P < .001). JAMA. 2003;290:3092-3100; Improved fitness over 7 years was associated with reduced risk of developing diabetes (HR, 0.4; 95% CI, 0.2 – 1.0; P = .04) and metabolic syndrome (HR, 0.5; 95% CI, 0.3 – 0.7; P < .001), as well as a loss of weight.

Heart Disease Deaths Linked to Exercise, Not Fewer Calories: During 17 years of follow-up of 9790 adults in the first NHAHES, 1,531 participants died of heart disease. After adjusting for BMI and physical activity, caloric intake was unrelated to heart disease. Those who exercised more and ate more were both leaner and had less than half the cardiovascular disease mortality than did those who exercised less, ate less and were overweight. The difference in mortality was 55%.  Jing Fang, Albert Einstein, Am J Preventive Med 11/6/03

Heart Disease: Vigorous Exercise Best, Weights Second Best: A Harvard study of 44,000 male health professionals with a 12 year follow-up found 23% decrease in heart disease with weight lifting 30 min or more per week, 18% decrease with walking-type exercise and a 42% decrease with running-type at least one hour per week. The authors speculate that weights and vigorous running might be the best when combined but had no data on this. JAMA 10/23/02.

Heart: Lack of Exercise Capacity and Poor Heart Rate Recovery Markedly Increases Risk of Heart Death: A 20 year follow-up study of 3000 women 30-80yo found Among women with low risk Framingham scores, those with below median levels of both exercise capacity and HRR had significantly increased risk compared with women who had above median levels of these 2 exercise variables, 44.5 and 3.5 cardiovascular deaths per 10 000 person-years, respectively (hazard ratio for cardiovascular death, 12.93; 95% CI, 5.62-29.73; P<.001). Ability of exercise testing to predict cardiovascular and all-cause death in asymptomatic women: a 20-year follow-up of the lipid research clinics prevalence study. Mora S, Redberg RF, Cui Y, Whiteman MK, Flaws JA, Sharrett AR, Blumenthal RS. JAMA. 2003 Sep 24;290(12):1600-7

Heart Attacks: Avoiding Salt, Adding Exercise Cuts Risk: An Australian study found relative risk of heart attack (RR) for those doing non-vigorous exercise regularly was 0.5 (half the level of those not doing exercise regularly) and for avoiding added salt 0.6 in a case-control study of 336 acute heart attack patients and 735 controls. Int J Epidemiol 1999 Oct;28(5):846-52

Heart Failure is Helped:  A meta-analysis of nine studies averaging 2 years in duration and covering a total of 810 patients with left ventricular dysfunction and clinical heart failure found that those randomized to exercise training had 4% fewer deaths and stayed out of the hospital longer. Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ  2004;328:189 (24 January),

Hypertension: 60-90 Minutes Exercise Lowers: Kazuko Ishikawa-Takata and colleagues at Japan’s National Institute of Health and Nutrition tested 207 men and women who had high blood pressure but were otherwise healthy. None exercised regularly. Divided into 5 groups, those exercising 60-90 minutes/week had a 12 mmHg systolic & 8 mmHg diastolic lowering.  More exercise was without added benefit on blood pressure. JAMA 8/30/03

Impotence: Exercise Reduces: The New England Research Center report of the Massachusetts Male Aging Study with men ages 40-70 followed for 9 years. Urology 10/00. AP 10/6/00.

Impotence: Exercise Helps Prevent: In the Health Professionals follow-up study of 31,742 males ages 53-90, running 3 hr/week led to a 30% lower risk of impotence than those doing little exercise. There was a 15-20% reduction from brisk walking 3 hr/week. A 30% lower risk is equivalent to adding 2-5 years to sex life. Rimm, Harvard, Annal Internal Med 8/03.

Longevity: Exercise Increases: The only exercise test variable that was associated significantly with time to death in both age groups was maximal metabolic equivalents (METs)(workload) achieved: each 1 MET increase in exercise capacity was associated with an 11% reduction in annual mortality. (Elderly averaged 7 MET and young veterans averaged 10). Exercise-induced ST depression was more common in those who subsequently died, but was not an independent predictor of mortality. Stanford, Am J Med 2002 Apr 15;112(6):453-9

Longevity: Exercise, Moderate Alcohol Good: Exercise was predictive of fewer IADL limitations and greater longevity, positive affect, and meaning in life 8 years later. Avoiding tobacco was predictive of longevity. Before controlling for health conditions, exercise predicted decreased risk of basic activities of daily living limitations and having more goals; moderate alcohol use predicted longevity; annual health checkup predicted more IADL limitations. Case Western, Kahana, Psychosom Med 2002 May-Jun;64(3):382-94

Longevity: Joggers Much Lower Mortality: 5 yr f/u study of 4658 Danish men found the 96 men jogging at both exams had RR 0.39 of dying. BMJ 9/9/00.

Longevity: Walking Helps: 707 nonsmoking retired men, 61-81 years old in the Honolulu Heart Program were tested for how far they walked each day. Data on overall mortality (from any cause) were collected over a 12-year follow-up. During the period, there were 208 deaths. After adjusting for age, the mortality rate among the men who walked less than 1 mile (1.6 km) per day was nearly twice that among those who walked more than 2 miles (3.2 km) per day (40.5% vs. 23.8%, P=0.001). The cumulative incidence of death after 12 years for the most active walkers was reached in less than 7 years among the men who were least active. The distance walked remained inversely related to mortality after adjustment for overall measures of activity and other risk factors (P=0.01).

Longevity Increased in Fit Women: Gulati and colleagues, in a Sept. 15, 2003, rapid access publication of Circulation, based on longitudinal follow-up of 5,721 women for eight years from 1992 found that the FRS-adjusted all-cause mortality risk decreased by 17% for every 1-MET increase in exercise capacity. (For men, 12%)

McArdles Disease: Pop Helps Exercise: This very rare disease that affected 1 in every 100,000 people shows up as a severe difficulty in handling the early minutes of exercise. It is due to a lack of an enzyme that is necessary for the conversion of glycogen, a form of stored energy from sugar that is used by the body as fuel in the early stages of exercise. Researchers at the Univ. of Texas, Southwest, have shown that by giving patients a sugary cola before exercising, that their bodies were able to do just fine, avoiding severe muscle soreness and muscle injury that often occurs to McArdle patients from even brief exercise. New England J Medicine 12/20/03. Ed: This is the only time I have read something good about sugared pop.  The other 99,999 out of 100,000 should avoid the stuff as something that makes you fat and unhealthy.

Muscle Soreness: PubMed articles 12/2/01 found no benefit from ultrasound, hyperbaric oxygen, NSAIDs, aspirin, acupuncture, or stretching. Training does help. In shape runners have immediate soreness, but not delayed soreness. No help came from phototherapy, laser, cryotherapy, homeopathy, transcutaneous electrical nerve stimulation, upper body ergometry, or alcohol. Post-exercised massage may help, but the seven studies which have been done are of poor quality and don’t have uniform results. Another reviewer conclude there was no benefit from post-exercise massage. Br J Sports Med 1998 Sep;32(3):212-4. Trained individuals had only 40% of the CK creatine kinase elevation (a muscle enzyme and thus marker of muscle breakdown) of untrained despite greater soreness. Int J Sports Med 1997 Aug;18(6):431-7. Three g/day of L-carnitine for 3 weeks may have helped untrained with reduced CK and reduced soreness. : Int J Sports Med 1996 Jul;17(5):320-4. Vit C helped in one small study (Pain 1992 Sep;50(3):317-21) but not another. A Romanian study claims there are 6 DB studies with over 100 athletes and l-carnitine showing benefits acutely and chronically. Physiologie 1989 Apr-Jun;26(2):111-29. L-carnitine $10 for 60 500mg tabs.

Schizophrenic Said Helped by Exercise: A researcher describes the outcomes gained by a young man with a diagnosis of chronic schizophrenia in a 12-week progressive exercise program. Brief Psychiatric Rating Scale. Significant changes in his psychological functioning, communication, animation, personal interest, motivation and insight into his body image. His physical fitness levels also improved and he showed less motor retardation and less body tension. Nurs Times 1995 Sep 6-12;91(36):37-9

Stretching No Benefit: study thus suggests that pre-exercise static stretching has no preventive effect on the muscular soreness, tenderness and force loss that follows heavy eccentric exercise. Scand J Med Sci Sports 1999 Aug;9(4):219-25. Same= Res Q Exerc Sport 1989 Dec;60(4):357-61

Stretching No Benefit: BMJ 8/31/02 review study found no significant decrease in soreness or injury due to stretching.

Stroke Decreased by Exercise: J Am Coll Cardiol 2002 May 1;39(9):1482-8. Benefit especially for those with increased L ventricular heart mass, but present in all.

Stroke Risk Much Lower in Fit Men: 16,878 men, ages 40-87 yr, maximal treadmill exercise test, self-reported health habits. 32 stroke deaths during 10 yr of follow-up. After adjustment for age and examination year, there was an inverse association between cardiorespiratory fitness and stroke mortality (P = 0.005 for trend). This association remained after further adjustment for cigarette smoking, alcohol intake, body mass index, hypertension, diabetes mellitus, and parental history of coronary heart disease (P = 0.02 for trend). High-fit men (most fit 40%) had 68% and moderate-fit men had 63% lower risk of stroke mortality when compared with low-fit men (least fit 20%), respectively. Aerobics Center Longitudinal study. Tx A&M. Med Sci Sports Exerc 2002 Apr;34(4):592-5

Vigorous Best: Associations of light, moderate, and vigorous intensity physical activity with longevity. The Harvard Alumni Health Study. Am J Epidemiol 2000 Feb 1;151(3):293-9, Lee IM, Paffenbarger RS Jr, Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA. Physical activity is associated with better health; however, the optimal intensity of activity remains unclear. A total of 13,485 men (mean age, 57.5 years) from the Harvard Alumni Health Study reported their walking, stair climbing, and sports/recreation in 1977. Between 1977 and 1992, 2,539 died. After adjusting for the different activity components, distance walked and stories climbed independently predicted longevity (p, trend = 0.004 and <0.001, respectively). Light activities (<4 multiples of resting metabolic rate (METs)) were not associated with reduced mortality rates, moderate activities (4-<6 METs) appeared somewhat beneficial, and vigorous activities (> or =6 METs) clearly predicted lower mortality rates (p, trend = 0.72, 0.07, and <0.001, respectively). These data provide some support for current recommendations that emphasize moderate intensity activity; they also clearly indicate a benefit of vigorous activity.

Weight Loss in Women Best in Those Assigned to Exercising More Vigorously and Longer: In a 12 month random assignment study of varying degrees of exercise, the best results were those assigned to the vigorous exercise groups and those exercising 200 minutes or more per week.  The vigorous exercise group lost an average of 20# and the 200 minute group lost 13.6% of their initial weight. Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. Jakicic JM, Marcus BH, Gallagher KI, Napolitano M, Lang W. JAMA. 2003 Sep 10;290(10):1323-30