Once considered a disease of the affluent, hypertension now affects a third of all adults. The WHO wants nations to get organized to combat it. The World Health Organization (WHO) is taking on the world’s worst killer, laying out its first plan to conquer hypertension—a level of high blood pressure that affects one in every three adults globally. That figure has doubled since 1990. It’s now up to 1.3 billion people.
High blood pressure might sound like a disease of rich nations, but in a report released today during the United Nations General Assembly, the WHO said that three-fourths of people living with hypertension reside in low- and middle-income nations. Nearly half of them have no idea they have the condition, which causes heart attacks, kidney disease, and stroke. Four-fifths of them, including both people with a diagnosis and those who don’t know they are affected, aren’t getting adequate treatment to control it.
If that could be improved, the agency said, 76 million lives could be saved between now and the year 2050. “There are some health issues for which we lack knowledge or effective tools,” said Tedros Adhanom Ghebreyesus, the WHO’s director general—who has been open about controlling his own high blood pressure with medication—during a briefing in New York City. “Hypertension is not one of them. We have the tools. Every country can do more to use those tools.”….Continue reading….
High blood pressure is classified as primary (essential) hypertension or secondary hypertension. About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors. Lifestyle factors that increase the risk include excess salt in the diet, excess body weight, smoking, physical inactivity and alcohol use. The remaining 5–10% of cases are categorized as secondary high blood pressure, defined as high blood pressure due to an identifiable cause, such as chronic kidney disease, narrowing of the kidney arteries, an endocrine disorder, or the use of birth control pills.
Blood pressure is classified by two measurements, the systolic and diastolic pressures, which are the maximum and minimum pressures, respectively. For most adults, normal blood pressure at rest is within the range of 100–130 millimeters mercury (mmHg) systolic and 60–80 mmHg diastolic. For most adults, high blood pressure is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg. Different numbers apply to children. Ambulatory blood pressure monitoring over a 24-hour period appears more accurate than office-based blood pressure measurement.
Hypertension is twice as common in people with diabetes as contrasted with people who don’t have diabetes. Lifestyle changes and medications can lower blood pressure and decrease the risk of health complications. Lifestyle changes include weight loss, physical exercise, decreased salt intake, reducing alcohol intake, and a healthy diet. If lifestyle changes are not sufficient, then blood pressure medications are used. Up to three medications taken concurrently can control blood pressure in 90% of people.
The treatment of moderately high arterial blood pressure (defined as >160/100 mmHg) with medications is associated with an improved life expectancy. The effect of treatment of blood pressure between 130/80 mmHg and 160/100 mmHg is less clear, with some reviews finding benefit and others finding unclear benefit. High blood pressure affects between 16 and 37% of the population globally. In 2010 hypertension was believed to have been a factor in 18% of all deaths (9.4 million globally).
Severely elevated blood pressure (equal to or greater than a systolic 180 or diastolic of 120) is referred to as a hypertensive crisis. Hypertensive crisis is categorized as either hypertensive urgency or hypertensive emergency, according to the absence or presence of end organ damage, respectively. In hypertensive urgency, there is no evidence of end organ damage resulting from the elevated blood pressure. In these cases, oral medications are used to lower the BP gradually over 24 to 48 hours.
In hypertensive emergency, there is evidence of direct damage to one or more organs. The most affected organs include the brain, kidney, heart and lungs, producing symptoms which may include confusion, drowsiness, chest pain and breathlessness. In hypertensive emergency, the blood pressure must be reduced more rapidly to stop ongoing organ damage, however, there is a lack of randomized controlled trial evidence for this approach.
Hypertension results from a complex interaction of genes and environmental factors. Numerous common genetic variants with small effects on blood pressure have been identified as well as some rare genetic variants with large effects on blood pressure. Also, genome-wide association studies (GWAS) have identified 35 genetic loci related to blood pressure; 12 of these genetic loci influencing blood pressure were newly found. Sentinel SNP for each new genetic locus identified has shown an association with DNA methylation at multiple nearby CpG sites.
These sentinel SNP are located within genes related to vascular smooth muscle and renal function. DNA methylation might affect in some way linking common genetic variation to multiple phenotypes even though mechanisms underlying these associations are not understood. Single variant test performed in this study for the 35 sentinel SNP (known and new) showed that genetic variants singly or in aggregate contribute to risk of clinical phenotypes related to high blood pressure.
Blood pressure rises with aging when associated with a western diet and lifestyle and the risk of becoming hypertensive in later life is significant. Several environmental factors influence blood pressure. High salt intake raises the blood pressure in salt sensitive individuals; lack of exercise and central obesity can play a role in individual cases. The possible roles of other factors such as caffeine consumption, and vitamin D deficiency are less clear. Insulin resistance, which is common in obesity and is a component of syndrome X (or the metabolic syndrome), also contributes to hypertension.
Events in early life, such as low birth weight, maternal smoking, and lack of breastfeeding may be risk factors for adult essential hypertension, although the mechanisms linking these exposures to adult hypertension remain unclear. An increased rate of high blood uric acid has been found in untreated people with hypertension in comparison with people with normal blood pressure, although it is uncertain whether the former plays a causal role or is subsidiary to poor kidney function. Average blood pressure may be higher in the winter than in the summer. Periodontal disease is also associated with high blood pressure.
In most people with established essential hypertension, increased resistance to blood flow (total peripheral resistance) accounts for the high pressure while cardiac output remains normal. There is evidence that some younger people with prehypertension or ‘borderline hypertension’ have high cardiac output, an elevated heart rate and normal peripheral resistance, termed hyperkinetic borderline hypertension. These individuals develop the typical features of established essential hypertension in later life as their cardiac output falls and peripheral resistance rises with age.
Whether this pattern is typical of all people who ultimately develop hypertension is disputed. The increased peripheral resistance in established hypertension is mainly attributable to structural narrowing of small arteries and arterioles, although a reduction in the number or density of capillaries may also contribute. It is not clear whether or not vasoconstriction of arteriolar blood vessels plays a role in hypertension. Hypertension is also associated with decreased peripheral venous compliance which may increase venous return, increase cardiac preload and, ultimately, cause diastolic dysfunction.
Pulse pressure (the difference between systolic and diastolic blood pressure) is frequently increased in older people with hypertension. This can mean that systolic pressure is abnormally high, but diastolic pressure may be normal or low, a condition termed isolated systolic hypertension. The high pulse pressure in elderly people with hypertension or isolated systolic hypertension is explained by increased arterial stiffness, which typically accompanies aging and may be exacerbated by high blood pressure…
Quitting smoking is difficult. Research shows the best way to quit is to try several interventions at the same time.
Quitting cigarettes is good for your health. Simple. But how do you do it? Take up vaping? Counseling? Medication? Here are some of the best methods. Anyone who has tried to quit smoking will tell you how difficult it is. There’s always the temptation to share a cigarette with a friend over a beer or to escape work for a quick “smoko,” as they say in Australia.
Research studies suggest that 60-75% of people relapse in the first six months after trying to quit smoking. As with other forms of addiction, quitting cigarettes is a difficult psychological battle. Social events, depression or simple daily habits can have you craving for one. But the health benefits of long-term abstinence are huge. Risks of stroke, coronary heart disease, cancers and overall health improve substantially in a matter of weeks or months after quitting smoking.
Smoking is one of the biggest killers, with around 14% of deaths worldwide attributed to smoking-related illnesses, according to World Health Organization data in 2019. Many of those deaths are attributed to rising smoking rates in lower and middle-income countries. And more recent studies show that to be an ongoing trend…Continue reading….
From 2001 to 2010, about 70% of smokers in the United States expressed a desire to quit smoking, and 50% reported having attempted to do so in the past year. Many strategies can be used for smoking cessation, including abruptly quitting without assistance (“cold turkey“), cutting down then quitting, behavioral counseling, and medications such as bupropion, cytisine, nicotine replacement therapy, or varenicline.
In recent years, especially in Canada and the United Kingdom, many smokers have switched to using electronic cigarettes to quit smoking tobacco. However, a 2022 study found that 20% of smokers who tried to use e-cigarettes to quit smoking succeeded but 66% of them ended as dual users of cigarettes and vape products one year out.
Most smokers who try to quit do so without assistance. However, only 3–6% of quit attempts without assistance are successful long-term.Behavioral counseling and medications each increase the rate of successfully quitting smoking, and a combination of behavioral counseling with a medication such as bupropion is more effective than either intervention alone.
A meta-analysis from 2018, conducted on 61 randomized controlled trials, showed that among people who quit smoking with a cessation medication (and some behavioral help), approximately 20% were still nonsmokers a year later, as compared to 12% who did not take medication. In nicotine-dependent smokers, quitting smoking can lead to nicotine withdrawal symptoms such as nicotine cravings, anxiety, irritability, depression, and weight gain.
Professional smoking cessation support methods generally attempt to address nicotine withdrawal symptoms to help the person break free of nicotine addiction. Various methods allow a smoker to see the impact of their tobacco use and the immediate effects of quitting. Using biochemical feedback methods can allow tobacco users to be identified and assessed, and monitoring throughout an effort to quit can increase motivation to quit.
Evidence-wise, little is known about the effects of using biomechanical tests to determine a person’s risk related to smoking cessation. Breath carbon monoxide (CO) monitoring: carbon monoxide is a significant component of cigarette smoke, and a breath carbon monoxide monitor can be used to detect current cigarette use. Carbon monoxide concentration in breath is directly correlated with the CO concentration in blood, known as percent carboxyhemoglobin.
The value of demonstrating blood CO concentration to a smoker through a non-invasive breath sample is that it links the smoking habit with the physiological harm associated with smoking. CO concentrations show a noticeable decrease within hours of quitting, which can encourage someone to work on quitting. Breath CO monitoring has been utilized in smoking cessation as a tool to provide patients with biomarker feedback, similar to how other diagnostic tools such as the stethoscope, the blood pressure cuff, and the cholesterol test have been used by treatment professionals in medicine.
Cotinine: Cotinine, a metabolite of nicotine, is present in smokers. Like carbon monoxide, a cotinine test can be a reliable biomarker to determine smoking status.Cotinine levels can be tested through urine, saliva, blood, or hair samples. One of the main concerns of cotinine testing is the invasiveness of typical sampling methods.
While both measures offer high sensitivity and specificity, they differ in usage method and cost. For example, breath CO monitoring is non-invasive, while cotinine testing relies on bodily fluid. For instance, these two methods can be used alone or together when abstinence verification needs additional confirmation.
Nicotine replacement therapy (NRT) is the general term for using products that contain nicotine but not tobacco to aid smoking cessation. These include nicotine lozenges, nicotine gum and inhalers, nicotine patches, and electronic cigarettes. In a review of 136 NRT-related Cochrane Tobacco Addiction Group studies, substantial evidence supported NRT use in increasing the chances of successfully quitting smoking by 50 to 60% in comparison to placebo or a non-NRT control group.
Electronic cigarettes (ECs): There is high‐certainty evidence that ECs with nicotine increase quit rates compared to NRT and moderate‐certainty evidence that they increase quit rates compared to ECs without nicotine. Little is known regarding the long-term harms related to vaping. A 2016 UK Royal College of Physicians report supports using e-cigarettes as a smoking cessation tool.
A 2015 Public Health England report stated that “Smokers who have tried other methods of quitting without success could be encouraged to try e-cigarettes (EC) to stop smoking and stop smoking services should support smokers using EC to quit by offering them behavioural support.” However, since little is known about long term effects, other regulated options such as nicotine replacement therapy, varenicline or bupropion should be discussed primarily.
Measuring health is important for many reasons. It can help doctors and scientists understand the risk of medical problems and develop prevention strategies that can improve patient care. Monitoring health status can also help economists understand financial outcomes and help policymakers identify the likelihood of people needing caregiver assistance or retiring early, life events that can have implications for programs such as Social Security, Medicare, and Medicaid.
Further, measuring health is essential for assessing the return on U.S. health care spending which is large—close to one fifth of U.S. gross domestic product—and growing. In the United States, people usually take surveys that allow assessment of physical well-being. Self-assessments of health can help forecast life expectancy and functional ability, and whether a person may require medical care at some point in the future. However, in some cases, a better measure of health than self-assessments might be necessary.
Enter the frailty index
In June 2019, the Atlanta Fed published a working paper cowritten by Karen Kopecky, a Federal Reserve Bank of Atlanta research economist and associate adviser. Kopecky and her coauthors discussed the frailty index, an alternative method of evaluating health. This measure, pioneered by researchers at Dalhousie University in Halifax, Nova Scotia, focuses on the total number of health ailments a person has and the nature of those problems.
Kopecky worked with researchers Roozbeh Hosseini, a visiting scholar at the Atlanta Fed who is also an assistant professor at the University of Georgia, and Kai Zhao, associate economics professor at the University of Connecticut, to create frailty indexes using three surveys of Americans that include a host of questions on various aspects of health conditions.
A key finding of the researchers’ work was that the proportion of individuals in the U.S. population in good health decreases faster as people age when well-being is measured with the frailty index rather than with individual self-assessments. “For this reason the frailty index is an especially good measure for studying how health evolves with age,” Kopecky said.
The architecture of the frailty index helps explain why it can be a better predictor of health during aging. The index combines information from a range of questions about an individual’s specific health ailments to provide a summary of the person’s overall well-being. Kopecky and her colleagues used 27 health variables to construct a frailty index for a sample of more than 18,500 Americans who responded to the Panel Study of Income Dynamics (PSID) from 2003 to 2015.
The survey includes questions on specific medical conditions and activities of daily living. The variables the researchers looked at include difficulty with activities such as eating, dressing, walking, managing money, and getting in and out of bed, as well as the presence of conditions including cancer, diabetes, heart attack, stroke, and loss of memory.
The researchers derived the index by adding the total number of variables reported as ailments by an individual, then dividing that sum by the total amount of variables observed for that person overall in the year. The index captured expected variation in health: frailty was higher in older age groups compared with younger ones. Further, the sample showed that increases in frailty over time were three times more common than decreases.
Kopecky and her coauthors also compared the state of health over time using the frailty index with self-reported health status by making calculations based on the percentage of respondents in the PSID survey who self-reported their health as “excellent,” “very good,” “good,” “fair,” or “poor.” Their analysis found that when health is measured by frailty, the proportion of individuals with excellent or very good health declines faster with age.
They set cutoff values for frailty based on the distribution of self-reported health of 25- to 29-year-olds. When the cutoff values and frailty were used to determine individuals’ health categories as opposed to self-reported health, the researchers observed that health deteriorated much more rapidly with age.
In other words, the analysis showed that the fraction of people with poor self-reported health status rose with age, but when they measured health by frailty, they observed a much faster rise than with the self-reports (see the charts). For example, only 17 percent of people aged 70 to 74 had a frailty index low enough to fall into the “excellent” or “very good” health category. That compares with 39 percent of 70- to 74-year-olds who self-reported their health as “excellent” or “very good.”
“We interpret these patterns as evidence that self-reported health status underestimates the decline in observable health,” the paper says. The researchers also found that the frailty index was a better predictor than self-reported health of mortality and the probability that a person would enter a nursing home or become dependent on Social Security Disability Insurance.
Individuals’ self-assessments not always reliable
One reason frailty may be a better gauge of health than self-assessments has to do with the subjective nature of individuals’ judgments of their well-being, Kopecky said. “People tend to compare themselves to others their age” in self-reporting their health condition rather than considering how their present medical status compares with their past state, she said.
“People seem to be readjusting their self-reported health. So if you really want to map out how health evolves as people age, subjective measures don’t work well.” That isn’t to say that self-reported health information doesn’t have value. It can play a role in helping researchers understand the variation of health within an age group, Kopecky said. She added that self-reported data can also help uncover private medical information that a frailty index would not easily discern, such as hereditary conditions that may put individuals at risk for certain diseases.
Kopecky said the frailty index model holds much potential in economics. It can provide insight into such matters as the effect of health on a person’s earnings over time, a country’s labor supply, and individual consumption patterns. “It’s a step in the right direction in terms of improving our way of measuring health and as a result being able to understand how health interacts with economic variables and models,” she said.
Eating a lot of free sugars — also known as added sugars — might feel harmless in the moment, but it could increase your risk for getting cardiovascular disease, a new study has found.
Free sugars are those added during the processing of foods; packaged as table sugar and other sweeteners; and naturally occurring in syrups, honey, fruit juice, vegetable juice, purees, pastes and similar products in which the cellular structure of the food has been broken down, according to the United States Food and Drug Administration.
They don’t include sugars naturally occurring in dairy or structurally whole fruits and vegetables. Eating a high amount of free, or added, sugars from foods such as sweetened baked goods could raise your risk for cardiovascular disease, according to a new study.
Previous studies have reported that links between carbohydrate consumption and cardiovascular disease might depend on the quality, rather than the quantity, of carbohydrates consumed, according to the new study published Monday in the journal BMC Medicine.
To test that theory, the authors behind the latest research assessed diet and health data from more than 110,000 people who participated in UK Biobank, a cohort study that collected data between 2006 and 2010 from more than 503,000 adults based in the United Kingdom.
People included in the new study participated in two to five 24-hour online dietary assessments, logging their food and beverage intake multiple times within each 24-hour period. After over nine years of follow-up, the researchers found total carbohydrate intake wasn’t associated with cardiovascular disease.
But when they analyzed how outcomes differed depending on the types and sources of carbohydrates eaten, they found higher free sugar intake was associated with a higher risk for cardiovascular disease and greater waist circumference.
The more free sugars some participants consumed, the greater their risk of cardiovascular disease, heart disease and stroke was. All heart diseases are cardiovascular disease, but cardiovascular disease is the term for all types of diseases that affect the heart or blood vessels, such as stroke, congenital heart defects and peripheral artery disease, according to the US National Heart, Lung and Blood Institute (PDF).
Higher intake of free sugars was also linked with higher concentrations of triglycerides — a type of fat that comes from butter, oils and other fats people eat, plus extra calories their bodies don’t immediately need. Having high triglyceride levels — defined as more than 150 milligrams per deciliter — can increase risk for heart diseases such as coronary artery disease.
“This study provides much needed nuance to public health discussions about the health effects of dietary carbohydrates,” said Dr. Maya Adam, director of Health Media Innovation and clinical assistant professor of pediatrics at Stanford University School of Medicine, via email. Adam wasn’t involved in the study. “The main takeaways are that all carbs are not created equal.”
Free sugars vs. sugar in whole foods
The link between higher free sugar intake and cardiovascular disease risk lies in the differences between how the body metabolizes free sugar versus sugar in whole foods.
“Added sugar intake can promote inflammation in the body, and this can cause stress on the heart and blood vessels, which can lead to increased blood pressure,” said Brooke Aggarwal, assistant professor of medical sciences in the cardiology division at Columbia University Irving Medical Center. Aggarwal wasn’t involved in the study.
“Added sugars are often found in processed foods which have little nutritional value and may lead to overeating and excess calorie intake, which in turn leads to overweight/obesity, a well-established risk factor for heart disease,” Aggarwal said via email.
Based on their findings, the authors suggest replacing free sugars with non-free sugars naturally occurring in whole fruits and vegetables to lower your risk of developing cardiovascular disease — and experts in nutrition and cardiovascular health agree.
“Whole food carbohydrates take longer to break down into simple sugars, and a part of them — the fiber — can’t be broken down at all,” Adam added. “This means that whole, intact grains don’t cause the same spikes in blood sugar that we experience when we eat simple sugars. Blood sugar spikes trigger insulin spikes, which can destabilize our blood glucose and … be the underlying cause of health problems in the long run.”
Additionally, the fiber in whole food carbohydrates acts as an “internal scrub brush” when it passes through the digestive system, Adam added. “That’s why, generally speaking, we need a certain amount of these ‘good carbs’ in our diets to stay healthy.” Total fiber intake should be at least 25 grams daily, according to the FDA.
Reducing free sugar intake
Awareness is the first step toward reducing your intake of free sugars, so look at nutrition labels when shopping, said CNN Medical Analyst Dr. Leana Wen, an emergency physician and public health professor at George Washington University. Wen wasn’t involved in the study.
“Many times, people think about cutting calories or not consuming fatty foods, but they may not be aware of the dangers of free sugars,” Wen said. “When we buy packaged foods — even the ones we don’t think of as being sweet like bread, breakfast cereals, flavored yoghurts or condiments — these foods usually have plenty of added sugar, and it adds up,” Adam said.
Cut back on sugary drinks and go for water sweetened with fruit slices instead, Aggarwal suggested. Have fresh or frozen fruit for dessert instead of cakes, cookies or ice cream. Foods with higher fiber content can also help you stay fuller longer, she added.
Cooking and baking at home more often is one of the best ways to reduce sugar in your diet, Adam said. “The American Heart Association recommends that added sugars make up less than 6% of calories per day, which works out to about 6 teaspoons of sugar per day for women, and 9 teaspoons per day for men,” Aggarwal said.
Lastly, efforts to change your diet shouldn’t only happen in the kitchen or grocery store. “Aim to get at least seven to eight hours of good quality sleep per night, as we tend to choose foods higher in sugar when we’re tired,” Aggarwal said.
One of the highest sweat rates ever recorded was that of marathon runner Alberto Salazar at the 1984 Olympics in Los Angeles. In the months leading up to the games, which were expected to be oppressively hot, the marathoner was put through a regimen of temperature acclimation training with the goal of helping him adapt to running in the heat.
While Salazar placed only 15th overall, the program was deemed a success, physiologically speaking—vitals taken after the race found that Salazar’s hormonal and thermoregulatory systems were completely normal. His body had compensated by causing him to sweat at an incredibly high rate—about three liters per hour, compared to the roughly one liter per hour for an average human.
Researchers have been looking at the effects of heat on athletic performance for decades, and their results have been consistently surprising. Studies have found that, in addition to an increased rate of perspiration, training in the heat can increase an athlete’s blood plasma volume (which leads to better cardiovascular fitness), reduce overall core temperature, reduce blood lactate, increase skeletal muscle force, and, counterintuitively, make a person train better in cold temperatures.
In fact, heat acclimation may actually be more beneficial than altitude training in eliciting positive physiological adaptations, says Santiago Lorenzo, a professor of physiology at Lake Erie College of Osteopathic Medicine and a former decathlete at the University of Oregon. “Heat acclimation provides more substantial environmental specific improvements in aerobic performance than altitude acclimation,” he says.
And in contrast to the live low, train high philosophy, we more quickly adapt to heat stress than we do to hypoxia. In other words, heat training not only does a better job at increasing V02 max than altitude, but it also makes athletes better at withstanding a wider range of temperatures.
Athletes can adapt to heat in one of two ways. The first is through incremental improvements in tolerance over time—work out in the heat a little bit every day, and eventually your body will dissipate heat more effectively. The second way is through thermotolerance, which is a cellular adaptation to an extreme heat experience, like suffering such severe dehydration after a run that you need an IV.
Essentially, if you shock your system, your body will be able to withstand greater temperature stresses later on. But successful heat adaptation is difficult—and clearly dangerous—to achieve outside of controlled settings. Lorenzo explains that performance gains are possible only when athletes elevate their core body temperature, and without careful monitoring, it’s possible to elevate your core temperature to lethal levels.
When performed safely, however, heat training can have extraordinary effects. This phenomena fascinates Chris Minson, a professor of human physiology at the University of Oregon, who studies heat acclimation responses in athletes. According to his research, heat training can expand blood plasma volume, but Minson says there also seem to be inexplicable changes to the heart’s left ventricle, which helps to increase oxygen delivery to the muscles.
In addition, he says that athletes who train in warm temperatures generally get better at regulating heat by sweating earlier, as Salazar did, or developing a colder resting body temperature. A 2011 study by a group of researchers in New Zealand also found that overall volume of blood plasma increased at a greater rate when athletes did not drink water during exercise. While some coaches are carefully experimenting with dehydration, Minson and Lorenzo are not because it adds too much additional stress.
However, they do say that this type of training can be beneficial because it produces a higher number of “heat shock” protein cells. Ahead of Western States this June, ultrarunning coach Jason Koop worked on heat training with Amanda Basham and eventual winner Kaci Leckteig. Koop believes this type of acclimating is a good example of blending an academic concept with real-world training. But, says Koop, “at a certain level, you have to compromise training quality for the heat acclimation.
Acclimating to the heat is additional stress [on the body], just like more miles or intervals, so you can’t simply pile it on. Something on the training side has to give.” One method of heat acclimation that Minson uses with his athletes is to do hard workouts on colder days or earlier in the morning, and then start training in hotter conditions with less intensity. He is also looking into adding heat in ways that wouldn’t require an athlete to train in high temperatures at all—using hot tubs, for instance.
All this being said, not everyone responds to heat at the same rate or with the same physiological gains, which makes it similar to altitude training in that it might make a high-performing age grouper, college athlete, or elite a little better, but it won’t compensate for intelligent, consistent training.
How to Incorporate Heat Acclimation into Your Training Schedule
When acclimating to heat, you’ll be forced to compromise training quality, says Koop. While he understands the benefits of heat acclimation, he still prioritizes smart, solid training. But if you want to incorporate heat into your workouts, here’s how he recommends doing it safely.
1. First, pick a protocol (sauna, hot bath, or exercising in the heat) that minimizes the impact on training, both physically and logistically.
2. Koop most commonly recommends that his athletes use a dry sauna immediately after running. “It doesn’t impact training nearly as much as running in the heat, and the effects are similarly positive,” he says. He often tells his athletes to not drink water during these sessions to enhance the effect. Koop recommends spending 20-to-30-minutes in the sauna, depending on tolerance.
3. Koop says that when he has his athletes exercise in the heat—either naturally or by wearing extra clothing to simulate the experience—it will be on a long, slow day for 60 to 90 minutes. The time completely depends on the athlete’s tolerance and previous experience. But he stresses to not do this on a recovery day, because heat training is an added stress on the body. Koop recommends drinking 30 to 40 ounces of an electrolyte drink per hour during these sessions And for safety, he advises using low-traffic sidewalks and bike paths—not trails.
4. Despite the benefits of heat training, Koop reminds his athletes that running in the heat is extremely difficult and usually replaces a hard day. “You are substituting one potential gain for another one,” he says. In other words, use it carefully.
Although training in the heat offers some benefits, it does have drawbacks too.
The Mayo Clinic reports exercising in a high temperature environment can sometimes result in heat-related illness. The most common illnesses include:
Heat cramps – These are painful muscle contractions. Though caused by excessive heat, they can also occur when body temperature is normal.
Heat syncope – If the client feels lightheaded or faints due to high heat exposure, heat syncope may exist.
Heat exhaustion – This occurs when the body’s core temperature approaches 104 degrees Fahrenheit. Symptoms of heat exhaustion include nausea, vomiting, headache, and clammy skin.
Heat stroke – If the core body temperature exceeds 104 degrees, heat stroke can occur. This results in feelings of confusion, heart rhythm issues, and vision problems. Immediate medical attention is necessary to help preserve the brain and organs. If untreated, death can result.
Heat stress and heat-related illness are a major concern. Reduce this concern by helping clients acclimate to the heat and humidity common in summer training sessions. Research reveals that the human body goes through certain changes when exercising in a hot environment. Our core body temperature increases, first rapidly then at a slower rate. Metabolic rate increases as well, especially in heat stress conditions. Blood flow is altered to transfer the heat from our internal body to our skin, where it is released via our sweat. These changes are necessary to help prevent the body from overheating.
Though the human body is good at adapting to warmer climates, heat acclimation training improves this response. This enables clients to exercise more safely in hot environments. It also improves their performance. What does an effective acclimation program look like? A study on endurance athletes found that, for those not acclimated to the heat, high intensity exercise increased fatigue and weakened performance. Therefore, a lower-intensity workout regimen is recommended. At least until the client becomes used to the heat and humidity.
Another piece of research noted that 6-7 high-heat exposures are needed to improve adaptation. Each one should be at least 30 minutes in length. If you live in an area that is not particularly hot or it isn’t summer, there are a few ways to add heat to an exercise session. These include using a sauna or working out in heated water. Wearing multiple layers of clothing will also raise the body’s internal temp.
Some gyms and fitness facilities have an athletic chamber. This is a room that enables you to raise the heat and humidity to specific levels. You might also find these rooms at universities and colleges.
Yes, heat acclimation helps boost performance. But its number one goal is to help clients avoid heat illness, heat exhaustion, or heat stroke. Here are a few more safety tips that will help too:
Drink lots of water. Dehydration occurs faster in hot environments because heat increases sweat rate. This makes hydration critical when exercising in hot weather. Harvard University suggests consuming 2-3 cups of water per hour if you’re sweating a lot.
But don’t overdo your water consumption. It’s also important to note that you can drink too much water. This is called water intoxication and reduces the sodium in the bloodstream. This can cause headache, nausea, and vomiting. In severe cases, blood pressure rises, it’s harder to breathe, and the client feels confused.
Consume sports drinks for lengthy trainings. During longer workout sessions, water may not be enough. Because your sweat contains many chemicals and salts, these need replacing. In this case, sports drinks can replenish the electrolytes lost via excessive sweat. Sports drinks also supply a limited level of carbohydrates. This gives your body the energy it needs to continue to work out.
Avoid exercise during extremely high temperatures. If you live in a place where extreme heat is common, exercise when it’s a bit cooler outside. This limits the likelihood that you’ll suffer a heat illness. What’s the best time of day to exercise in this type of environment? Either early in the morning or later in the day.
Pay attention to the humidity. When it is both hot and humid outside, the body responds differently than in dry conditions. Specifically, humidity increases your sweat rate, which impacts your hydration. The Cleveland Clinic suggest not exercising if the humidity is over 80 percent and it’s 80 degrees or higher.
Wear the right clothing. Your body must be able to sweat to better control its internal temperature. Lightweight clothing assists with this. Wearing clothing in lighter colors is preferred as well since they don’t absorb as much heat as dark colors.
Monitor your heart rate. Heart rate increases 10 beats per minute for every degree the body temperature rises. So, wearing a heart rate monitor helps clients better identify whether their cardiovascular system is experiencing heat stress. Heart rate monitors can also signal if dehydration exists.
Lucas Ninno/Getty Images
If that could be improved, the agency said, 76 million lives could be saved between now and the year 2050. “There are some health issues for which we lack knowledge or effective tools,” said Tedros Adhanom Ghebreyesus, the WHO’s director general—who has been open about controlling his own high blood pressure with medication—during a briefing in New York City. “Hypertension is not one of them. We have the tools. Every country can do more to use those tools.”….Continue reading….
