Exercise may reduce injuries from falls in older men

Gill et al in a BMJ article reported findings of potential beneficial effect(s) exercise may have in reducing falls among the elderly.   The authors derived their data from the Lifestyle Interventions and Independence for Elders (LIFE) trial.  The research included 1635 sedentary men and women aged 70-89 years with functional limitations, as defined with a short physical performance battery score (SPPB) equal to or less than 9, but who were able to walk 400 meters. 

The SPPB consists of a battery of tests that combines results from gait speed, standing from a chair and balance as was described by Guralnik etal.  Scores range from 0 (worst performance) to 12 (best performance). Thus SPPB has been used as a predictive tool for assessing possible disability and/or for monitoring of function in older people. 

The participants in the LIFE study were randomly assigned to a structured, moderate intensity physical activity program (n=818) conducted in a center and at home that included aerobic, strength, flexibility, and balance training activities, or to a health education program (n=817) consisting of workshops on topics relevant to older people and upper extremity stretching.

The study found that the rate of falling did not differ significantly between those who received health education versus those who were asked to increase their physical activity.  Over two years, 61.2 percent reported at least one fall in the first group, while 60 percent did in the second.  Serious fall injuries, defined as a fall that resulted in a fracture and/or injury that led to a hospital admission, was experienced by 84 (10.3%) in the health education group and 75 (9.2%) of the participants in the physical activity group.

The investigators found the male participants in the exercise group boosted their physical activity, and also had greater improvements in gait, balance and muscle strength comparing to those in the health education group.  This resulted in a 38 percent lower risk of serious fall injuries, a 53 percent lower risk of fall-related fractures, and a 59 percent lower rate of fall injuries requiring hospitalization for the men in the workout group. However, the exercise program did not appear to reduce women’s risk of serious injuries.

Approximately 30 per cent of the elderly fall each year.  In 2010, 2.3 million non-fatal fall injuries were treated in U.S. emergency departments, and more than 662,000 of these patients were admitted to the hospital.  The results of this study are suggestive that even modest interventions in physical activity as those practiced by the participants in this study may result in a reduction in the number of falls and in the associated morbidity and mortality from the resulting injuries.  The sense of security due to enhanced sense of balance may also result in better-quality of life among the elderly.

Cancers linked to Obesity

Obesity is a major contributor to the development of cancer.  According to the National Cancer Institute obesity is associated with increased risks for cancer of the esophagus, pancreas, colon and rectum, breast (after menopause), endometrium, kidney, thyroid, and gallbladder.

 

NHANES 2007-2008 survey found 68 percent of the U.S. adults age 20 years and older are overweight or obese and 17 percent of children and teens ages 2 to 19, are obese.  According to NCI Surveillance, Epidemiology, and End Results (SEER) data, it is estimated that in 2007 in the United States, about 34,000 new cases of cancer in men (4 percent) and 50,500 in women (7 percent) were due to obesity.

In 2003, Calle et al published in NEJM the results of a study of more than 900,000 healthy adults that were followed for 16 years.  The study authors concluded that excess fat could account for 14% of all deaths from cancer in men and 20% of those in women.

A recent study of 92,834 British women enrolled in a database for cancer screening, Fourkala et al reported in an article published in BMJ Open that women who go up a skirt size every decade between their 20s and their 60s are at increased risk of postmenopausal breast cancer.  They also found that “an increase of one size every 10 years led to a 33 percent rise in the risk of postmenopausal breast cancer, while an increase of two sizes per decade led to a 77 percent rise in risk.

Bhaskaran et al study of 5.2 million adults that was published in Lancet found that 166 955 individuals developed cancer and that body-mass index (BMI) was associated with 17 of 22 cancers.  Although the effects varied substantially by site, increase in BMI was roughly linearly associated with cancers of the uterus, gallbladder, kidney, cervix, and leukemia.  BMI increase was positively associated with liver, colon, ovarian, and postmenopausal breast cancers overall. They estimated inverse associations with prostate and premenopausal breast cancer risk, both overall and in non-smokers. By contrast, for lung and oral cavity cancer, they observed no association in non-smokers.  Assuming causality, 41% of uterine and 10% or more of gallbladder, kidney, liver, and colon cancers could be attributable to excess weight. They conclude that extra weight could contribute to more than 12,000 cases of cancer in the UK population every year.

Related Resources:

Physical Activity and Cancer

Energy balance: Weight and Obesity, PhysicalActivity, Diet