Improve depression with exercise

Exercise produces a lot of benefits. It reduces the risk of stroke and heart disease. It lowers the "bad cholestrol" while increasing the "good cholesterol." It helps to reduce blood pressure and maintain a healthy weight. According to research published online this month in Psychosomatic Medicine, exercise is also an effective treatment for depression.

Researchers tested the effectiveness of 4 types of depression treatments: a led exercise regimen, a home exercise program, an antidepressant known as a selective seritonin reuptake inhibitor (SSRI), and a placebo, or a pill that does not contain any medicine. They sorted 202 adults (153 women) with depression into each of the groups and followed them for 4 months.

They found that 41% of all patients no longer met the criteria for major depressive disorder. When they broke the groups down by treatment group, they saw improvements in all 4 groups. Secifically 45% of the led exercise group, 40% of the home-based exercise program, 47% of the antidepressant group, and 31% of the placebo group saw improvements. Interestingly, the rates of improvement were very similar for those in the led exercise group and those taking antidepressants. Further, although participants in the 3 "active" treatment groups (led exercise, home exercise, and antidepressants) had greater improvements than the placebo group, nearly one-third of those in the placebo group still got better. The investigators noted that improvements in depression may be related to factors other than treatment type, such as attention from mental health care providers and monitoring of symptoms.

Per the investigators, it is important to note that this study does not demonstrate that exercise is better than SSRIs for relieving depression. So if you are taking antidepressants, this is not license to stop your medication without first discussing the pros and cons of such a decision with your doctor. However, the study authors d0 note that exercise can increase positive thoughts, enhance self-concept, and change how the body responds to stress, all of which can lead to fewer depressive symptoms. So if you have depression or are prone to a depressed mood, try some exercise - you might see improvements in your mood, as well as other areas of your life.

Pump it up: Strength training key for premenopausal women

Few women need to be convinced that exercise is good for them. Yet many women find it very difficult to make exercise part of their lives. The reasons for not exercising abound. I'm too tired. I don't have time. It's too cold/hot/rainy outside. A gym membership is too expensive. I've tried exercise before, but I didn't lose weight. I can't get motivated. You get the picture.

New research, however, suggests that just two weekly, one-hour dates with weights can have important positive health benefits for overweight and obese premenopausal women.

Investigators randomly placed 164 women into one of two groups: (1) a treatment group, where women were taught a stretching and weight-lifting routine that included both machines and free weights; and (2) a non-treatment group, where women were mailed an informational brochure from the American Heart Association on the recommended 30-minutes daily of moderate exercise. Both groups were told not to change their eating habits, and they were followed for two years.

Although the women in the treatment group did not lose weight, they did experience changes in their body composition. The women had less total body fat, a lower overall percentage of body fat, and less abdominal/mid-section fat. Further, the women who did not lift weights actually showed increases in total body fat, in the ratio of body fat to lean body mass, and in abdominal fat. The increase in belly fat is particularly concerning, because it is associated with higher risk for cardiovascular disease and metabolic disorders, including the metabolic syndrome.

The investigators suggested that strength training can help to slow weight gain and the development of obesity in women, which is on the rise. If you currently exercise but do not strength train, you might think about adding weights to your weekly routine - especially if you are overweight. Here are some weight training tips from the Mayo Clinic, as well as a slide show of strengthening exercises for major muscle groups. And for those of you who do not exercise at all, check with your doctor. Once you get the okay, there are a number of reliable resources to get you moving. And as for those excuses...

Avandia - the next Vioxx?

In two studies published in JAMA today, it appears that a popular class of drug for diabetes, known as thiazolidinedione (popular brand names = Avandia [rosiglitazone] and Actos [pioglitazone]) is causing some heart problems. Avandia was found to increase risk for heart attack by 42% and double the risk of heart failure. Actos also was found to increase the risk of heart failure, although it reduced risk of heart attack, stroke and death.

Actos and Avandia are used most often in the treatment of type 2 diabetes. The drugs act on similar mechanisms to lower glucose (blood sugar) levels in the body. They can be prescribed alone, or in conjunction with other therapies, such as insulin.

This is not the first time research has suggested these drugs may cause serious cardiac events. This past May, the New England Journal of Medicine published two studies that also revealed Avandia caused some heart problems. In response, a federal advisory panel met to discuss the drug and voted to keep it on the market. The FDA also placed stricter warnings on both Avandia and Actos in June.

Does this sound familiar? Drs. Solomon and Winkelmayer seem to think so. They wrote a great piece on common threads between the Vioxx case and the current findings on Avandia. It seems the jury is still out, because at present GlaxoSmithKline is keeping Avandia on the market. However, if this does become another Vioxx, let's hope GSK doesn't wait too long to do the right thing.

Meantime, if you're taking Avandia or Actos, you may want to discuss this new research with your health care provider. You also want to remember that good nutrition, exercise, and maintaining a healthy weight are also important for managing your type 2 diabetes.

Metabolic Syndrome: you can decrease your risk

Most people have heard about common diseases like high blood pressure, diabetes, and arthritis. However, few people know about the metabolic syndrome, which is a disorder that affects an estimated 25% of Americans (and growing), and is associated with serious disease.

The metabolic syndrome is a group of conditions related to your metabolism that occur at the same time. These conditions include: (a) obesity, especially around your belly/mid-section; (b) high blood pressure; (c) abnormal cholesterol levels, including low levels of the "good cholesterol" (HDL) and high levels of triglycerides, or fat in your blood; and (d) insulin resistance, where the normal process your body uses to get sugar (glucose) into your cells does not work, resulting in increased levels of both insulin and glucose in your blood. Having any one of these conditions increases your likelihood of heart disease, heart attack, type 2 diabetes, and stroke. However, having them in combination can double and even triple your risk.

The good news is that lifestyle changes are key to preventing and treating the metabolic syndrome. In a study published in this month's International Journal of Obesity, researchers followed 224 people (80% of whom were women) for one year after assigning them to one of four groups: (1) use of an appetite suppressant alone, (2) a lifestyle modification program to lose weight, (3) the appetite suppressant plus the group lifestyle modification, and (4) the appetite suppressant plus brief meetings with their primary care physicians on weight loss, food diaries, healthy food choices, etc.

All weight loss treatments were successful in helping participants lose weight. Further, they found that weight loss decreased risk for metabolic syndrome: for every 2.2 pounds lost, there was an 8% reduction in the risk for the disorder. Additionally, participants who lost at least 5% of their starting body weight were 59.2% less likely to have the metabolic syndrome, and those who lost at least 10% of their starting body weight were 83.2% less likely to have the metabolic syndrome. Essentially, lose weight - even just a couple of pounds - and you can reduce your risk for the metabolic syndrome and related diseases.

Other ways to prevent and treat the metabolic syndrome? Stop smoking, exercise most days, and eat fiber-rich foods. Sounds like just healthy living to me. Couldn't we all use a little more of that?