A breath of fresh air

 We now have some of the first data showing that zero-emission vehicles, ZEVs, actually improve people's health by reducing air pollution. You can read my OpEdNews post about this new research here.

 

Woman charging her EV

Image by DALLE-2

Seven thousand steps is the new magic number

 If, like me, you've been trying for years to fit those widely recommended 10,000 steps per day into your schedule without great success, you may be able to breathe a sigh of relief. New research published in the prestigious Journal of the American Medical Association (JAMA) shows that just 7,000 steps per day significantly reduces deaths from all causes among middle-aged Americans, regardless of race or gender. 

It's not that taking more than 7,000 steps per day would be bad for you--increasing benefits were found up to 10,000 steps per day. However, the benefits of moderate walking--just 7000 to 9000 steps per day--were massive, a 50 to 70 percent reduction in the risk of dying over the years of the study.

Credit: MabelAmber

"You see this gradual risk reduction in mortality as you get more steps," says Amanda Paluch, an assistant professor of kinesiology at the University of Massachusetts, Amherst, and corresponding author for the JAMA study. "There were substantial health benefits between 7,000 and 10,000 steps but we didn't see an additional benefit from going beyond 10,000 steps."

(It turns out that 10,000 steps per day was not a scientifically determined goal, but a catchy number that gained traction because of an advertising campaign for a Japanese pedometer!)

Paluch and her colleagues utilized data from the Coronary Artery Risk Development in Young Adults (CARDIA) study. The study started in 1983 and is still continuing. It involved over 5,000 men and women from four US states, and is notable for both its duration--now approaching 40 years--and for its racial balance. 

Participants activity levels were measured over the course of one year, and they were re-assessed ten years later. Overall, participants who walked 7,000 to 9,000 steps per day at the start of the study were just 28 percent as likely to die as those who walked fewer than 7,000 steps per day--a more than 70 percent risk reduction. Women and Blacks showed the greatest benefits of higher activity levels, but men and Whites still showed a 60 percent reduction in mortality risk over 7,000 steps per day.

Interestingly, walking faster was not associated with decreased mortality. The number of steps turned out to be much more important than the minute-by-minute intensity of the exercize.

The clear implication is that no matter who you are, you can increase your odds of living a longer and healthier life simply by taking 7,000 or more steps per day. 

"Showing that steps per day could be associated with premature mortality is a new contribution to the field," says Paluch. "Preventing those deaths before average life expectancy--that is a big deal."

Let's all make Professor Paluch happy, and click off those 7,000 steps starting today!

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REA 9/30/21

HOW MUCH IS A FACE MASK WORTH? TRY $3000.

 Every face mask worn consistently in public in the US is worth at least $3000 to society, a new study shows. Or, to put that differently, every American who chooses not to wear a mask is costing the rest of us at least that much.

Every face mask saves society $3000-$6000 / Every refusal to wear one costs society $3000-$6000

Photo Credit: Chad Davis

This eye-opening calculation comes to us from a team of medical, public health and economic experts at Yale University. You can find a preprint of their paper here.

The researchers cite several lines of evidence to arrive at their economic estimate:

--As of the date of their study, countries with pre-existing norms for mask-wearing by sick people experienced a 44 percent slower growth rate in Covid-19 cases and a 48 percent slower growth in the number of deaths than countries without such norms. These effects remained significant even when other possible factors were controlled for statistically.

Although the above statistics indicate that universal mask-wearing would reduce the rate of viral transmission by much more than 10 percent, the authors decided to use a 10 percent reduction as an extremely conservative estimate.

When they plugged that relatively minimal reduction into a widely used model for the progress of the pandemic along with commonly used estimates of the costs to society of premature or excess deaths, the result was a conservative estimate of $3000 to $6000 of benefit to society for every person who wears a mask consistently.

They add that this estimate is extra-conservative since it only looks at excess deaths and doesn't include the costs to society of hundreds of thousands or millions of sick people. ". . . our estimates . . . suggest that the effect of masks could be 5-6 times as large," they write.

The authors provide a separate analysis for the benefit of highly effective N95 masks for front-line health care providers, who, as we've learned, are at particularly high risk of contracting the SARS-NCoV-2 virus and passing it on. In addition, they are absolutely necessary to treat the sick and save lives. "Multiplying these factors together," they write, "the social value of each N95 mask for a healthcare worker could easily be more than a million dollars per mask."

The researchers conclude by pointing out that the availability of this simple, cheap and effective intervention is a rarity. "Outside of crises, policies do not exist where a few dollars of expenditure per person can produce thousands of dollars in benefit. We are in a rare moment when such benefits are achievable--this is an urgent crisis and action is necessary."

As we know, there is still no universal mask-wearing mandate from the federal government, nor is there likely to be one as long as Trump remains in office. However, according to a National Geographic assessment, 44 states have mandated mask-wearing under at least some conditions, and 74 percent of Americans polled say they "always" wear a mask when out. Unfortunately, many Republicans continue to receive the opposite message from the President and from conservative media. As a result, while 84 percent of self-identified Democrats say they always wear a mask, just 66 percent of Republicans say they do. 

The largest gap--a 22 percent difference--is between Democratic and Republican women, reporting 89 and 67 percent mask wearing respectively.

Once again, if every missing mask is costing the rest of us $3000 to $6000, not to mention needless illness and, tragically many lives lost, those differences in willingness to wear face masks in public are costly indeed.

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REA

WANT TO LIVE LONGER? GET A DOG.

Two recent studies show that owning a dog can significantly extend one's life, especially after a major health setback such as a heart attack or stroke. The researchers chalk up the health benefits of dog ownership to reduced social isolation, more exercise and lowered blood pressure.

 Two studies show that dog ownership

provides significant health benefits

Photo credit: Airman 1st Class Isaiah J. Soliz

Tove Fall, a professor at Uppsala University, in Sweden, explains the striking results of a study following nearly 340,000 Swedes aged 40 to 85 after a stroke or heart attack. Heart-attack survivors who lived alone but owned a dog were a remarkable 33 percent less likely to die during the study period than similar patients without a dog. Dog-owning stroke patients living alone were 27 percent less likely to die. The life-extending benefits of dog ownership were somewhat less for people living with others, but still substantial.

"We know that social isolation is a strong risk factor for worse health outcomes and premature death. Previous studies have indicated that dog owners experience less social isolation and have more interaction with other people. Furthermore, keeping a dog is a good motivation for physical activity, which is an important factor in rehabilitation and mental health."

A separate piece of research melded together ten separate studies involving a total of 3.8 million people. This meta-analysis showed that dog owners were 24 percent less likely to die from any cause than non-dog owners. Dog ownership proved especially protective for people recovering from a heart attack--they experienced a huge 65 percent reduction in mortality risk.

The authors of these studies point out that these results don't prove a cause-and-effect relationship between owning a dog and a longer, healthier life. However, they clearly show a powerful correlation and add a new data-supported dimension to the old saw that dogs really are our best friends.

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REA

FEWER STROKES FOR SAUNA FOLKS

It turns out that Finns and other sauna lovers have been right in touting the health benefits of frequent sauna bathing. A long-term study that followed more than 1600 middle-aged Finnish men and women for 15 years found that people who took saunas 4 to 7 times a week had roughly one-third the risk of stroke compared to peers who took just one sauna a week.

That risk reduction was similar for men and women, for people of different ages and social-economic status, and for people with other medical conditions.

Modern sauna

Credit: bainsdumarais.fr

Most people associate saunas with Finland, where it dates back at least to the year 1112 and is still extremely popular. However, we know that the ancient Romans also valued similar heat treatment, as shown in the caldaria  or hot rooms in the public and private baths found throughout the Roman Empire. Many traditional societies also valued heat treatments, often combined with aromatic herbs, as part of healing ceremonies. Examples can be found in the temazcals found throughout Mesoamerica in archaeological sites, codices, and in current use, as well as in the sweat lodges traditionally used by Native Americans.

Prehispanic temazcal

from the Codex Magliabecchi

Reduced stroke risk is not the only benefit from sauna bathing. You can read about a wide range of research-supported physical and mental benefits here and here too. This seems to be one area where ancient and traditional knowledge is holding up under current scientific scrutiny.

I don't know about you, but after my next workout, I'm heading for the sauna.

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TWENTY MINUTES A DAY KEEPS THE DOCTOR AWAY

Busy office workers who spent just 20 fewer minutes per day sitting at their desks maintained more muscle mass and were healthier at the end of a year than their less-active peers. It appears that even a little exercise can go a long way towards staying healthy.

Get up from that desk!

Credit: Phil Whitehouse/Jonund 

Researchers in Finland studied 133 office workers participated in the one-year study. One group was encouraged to set goals and develop personal strategies aimed at spending less time sitting both at work and away. At the start of the study, the participants averaged 9.4 seated hours per day, as measured by accelerometers. The men and women who had set goals initially reduced their sitting time by an average of 21 minutes per day. Even at the end of one year, they were still spending an average of 8 more minutes per day on their feet.

Yet even those few minutes a day up and moving around continued to make a difference. Blood glucose levels, cardiovascular risk and lower-body muscle mass were all better than the more sedentary participants.

Arto Pesola, the study's lead author, points out that the increased activity levels carried over to participants' homes as well, where they could benefit participants and their families. "Parents may think at first that spending time with their children is away from their own physical exercise. However, that way they can reduce sitting time and show a good example to their offspring about a physically active lifestyle. This is motivating, and as shown in the study, may be beneficial for health in the long run."

As I've detailed in several previous posts, this study adds to a growing body of research that convincingly shows multiple physical and psychological benefits from exercise.

 I don't know about you, but I'm getting up from the computer right now!

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PERSISTENT ORGANIC POLLUTANTS ASSOCIATED WITH METABOLIC ABNORMALITIES IN SEEMINGLY HEALTHY PEOPLE

Persistent organic pollutants--POPS--are pervasive in the environment and accumulate in our bodies. Pesticides, pharmaceuticals and many industrial chemicals contribute to this potentially toxic tide.

Some common organic pollutants

Credit CunhaEnviroSci

In an earlier post, I reported on findings by epidemiologist Miquel Porta and his colleagues revealing that ten percent of Americans have 10 or more different POPS in our blood at abnormally high concentrations.

Porta and his team are now studying the impacts of these long-lived organic compounds that many of us unknowingly carry in our bodies and bloodstream.

His most recent findings, reported in the American Journal of Epidemiology, reveal a strong correlation between people's toxic loads and metabolic abnormalities such as high blood pressure, insulin resistance, high blood sugar, unhealthy lipid profiles, and chronic inflammation--factors that increase the risk of metabolic syndrome, diabetes and heart disease.

Porta and his colleagues at the Hospital del Mar Medical Research Institute in Barcelona (IMIM), and the Autonomous University of Barcelona, evaluated 860 people enrolled in the Catalan Health Interview Survey. Participants included obese and normal-weight men and women from the age of 18 to 74. Statistical analyses controlled for the effects of age, sex, BMI, educational level and social-economic status. It's the first study looking at the relationship between POPs and metabolic abnormalities in  normal-weight individuals.

"The take-home message of our study," says Porta, "is that POPs contribute to cause unhealthy metabolic phenotypes as well as the metabolic syndrome."

 Intriguingly, the correlation was stronger for people of normal weight than for obese people. This may help to explain why many people of normal weight turn out to be metabolically unhealthy, and why some obese people remain metabolically normal.

It wasn't  a small effect--people of normal weight carrying high loads of POPs were four times more likely to be metabolically unhealthy than normal-weight peers with low toxic loads. Obese individuals with high toxic loads were 1.4 times as likely to suffer from metabolic abnormalities than those with low levels of toxins in their blood. And regardless of weight, metabolically unhealthy people carried nearly twice the load of toxins than their healthy peers.

A separate research study reports that normal-weight people who are metabolically unhealthy have three times the risk of heart attack, stroke or death compared to their metabolically healthy, normal-weight peers.

Although we are all exposed to organic pollutants from many sources--the air we breathe, the water we drink, furniture, fabrics, food containers and many other sources, the authors point out that fatty animal foods are the biggest source, and one that we can control by what we choose to eat.

They add, however, that individual efforts to eat a healthy diet and maintain a healthy weight are only part of the solution. Government action to minimize the accumulation of POPs and other toxins in the workplace, consumer goods and the environment are also needed, as well as similar efforts by private companies.

"Individual habits play a role, but so do public and private policies," says Porta, "that is, polices of governments and companies that have been shown to decrease 'internal contamination' by POPs."

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You can access the abstract of Porta's journal article at this URL.

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CYCLING TO WORK CUTS CANCER AND HEART-DISEASE RISK NEARLY IN HALF

A five-year study of 260,000 men and women in the UK found that bicycling to work every day reduced their risk of dying by more than 40 percent compared to commuters who drove or used public transport. In addition, the risk of developing cancer fell by 45 percent, and of being diagnosed with heart disease by 46 percent.

"This is really clear evidence that people who commute in an active way, particularly by cycling, were at lower risk," says Jason Gill, a physician-researcher at the University of Glasgow and corresponding author of the study.

New Yorkers bicycling to work
Credit: Streetfilms

Walking to work had a similar but smaller protective effect, probably because people who used bicycles for their commute exercised longer and more intensely than walkers. 

The powerful protective effect of active rather than passive commuting held up even when the researchers controlled for known risk factors such as smoking, weight and diet.

One benefit of bicycling to work, the researchers point out, is that unlike going to the gym or planned workouts, commuting becomes a no-willpower-needed habit. "You need to get to work every day, so if you build cycling into the day it essentially takes willpower out of the equation," says Gill.

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You can read the original article, in BMJ, the British Medical Journal, here.

WANT TO SAVE 52,000 AMERICAN LIVES PER YEAR? REPLACE COAL WITH SOLAR!

Burning coal is a dirty business.  A new study makes it clear just how dirty it is, and how many lives could be saved by generating our electricity from the sun instead.

Coal-fired power plant

(CC0 Public Domain)

In research published in the peer-reviewed journal Renewable and Sustainable Energy Reviews, materials engineer Joshua Pearce and energy policy specialist Emily Prehoda quantify the number of American lives lost every year from respiratory, cardiac and other illnesses caused by pollution from burning coal. It turns out to be a shocking 52,000 lives. That's more than the number killed in car crashes (about 35,000 in recent years) and by firearms (around 12,000 per year) combined.

Pearce and Prehoda arrived at their estimate by comparing coal burning and mortality rates geographically. They found a strong correlation between rates of illness and death and proximity to coal-fired electrical plants. On average, they calculated, there's one additional death from the production of 25 million kilowatt-hours of electricity from coal. Across the US, that means that 52,000 people die every year from coal-caused air pollution.

The researchers point out that with current off-the-shelf technologies, we could generate all the electricity we need from the sun. They also examine the potential health risks from manufacturing and transporting solar panels. These turn out to be a minute fraction of the risks from coal.

It's of course true that replacing all the electricity currently generated by burning coal with solar energy would be a costly investment--about $1,000,000 for every life saved.

However, the authors point out, that doesn't count the economic value of the electricity generated. In many regions, solar energy is already cheaper than electricity from coal or other fossil fuels, and the price of solar energy is continuing to fall rapidly. (Note: wind power is even cheaper). When the monetary savings from generating our power from solar rather than coal are factored in, in most cases switching to solar saves money as well as lives.

"Unlike other public health investments, you get more than lives saved," says Pearce. "In addition to saving lives, solar is producing electricity, which has economic value."

The bottom line--the sooner and faster we make the transition from coal and other fossil fuels to solar and other renewable energy sources the better, for our health, our lives, and our pocketbooks.

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HERE'S TO "WEEKEND WARRIORS"--THE EXERCISE YOU GET IS LIFE-SAVING

We all know that exercise is good for us. Decades of research has shown that even moderate physical activity--such as brisk walking--improves health and lengthens lives.

Based on this, both the US Department of Health and Human Services (HHS) and the World Health Organization (WHO) recommend at least 2 1/2 hours of moderate physical activity or 1 1/4 hours of intense exercise per week, spread throughout the week.

Biking and other exercises add miles--and years--to your life/Credit Connie Ma

Recognizing that many people can't build daily exercise into their schedules, but might hit the streets, the courts or the trails on weekends, a team of British researchers set out to see if even "weekend warriors" are healthier because of the the exercise they do.

The short answer is--you bet they are.

Writing in this week's edition of the prestigious medical journal, JAMA Internal Medicine, Gary O'Donovan and his colleagues conclude that men and women who got the recommended amount of exercise in just one or two outings per week were 40 percent less likely to die from cardiovascular disease, 30 percent less likely to die from any cause, and nearly 20 percent less likely to die of cancer, compared to inactive adults.

The health benefits for weekend warriors were similar to those for people who exercised the same amount, but more regularly during the week.

"The weekend warrior and other physical activity patterns characterized by 1 or 2 sessions per week of moderate or vigorous-intensity physical activity may be sufficient to reduce risks for all-cause, CVD [cardiovascular disease], and cancer mortality regardless of adherence to prevailing physical activity guidelines," the researchers write.

Their study tracked almost 64,000 men and women 40 years and older over the course of 8 years, as part of a long-term English-Scottish health survey. Exercise patterns were determined from self reports while causes of death came from death certificates. The study's findings are particularly useful because of its length and the large number of participants.

Here's the take-home message from O'Donovan:

If you already are a weekend warrior, keep up the good work. If you are thinking of becoming more active, begin with a moderate-intensity exercise like brisk walking. Walking is associated with low risk of injury and it's important to set realistic goals that provide motivation and build confidence. I would recommend that middle-aged and older adults take part in at least 12 weeks of moderate-intensity exercise before introducing any vigorous-intensity exercise.

A new study, published in the prestigious British Medical Journal, analyzed 39 separate studies and concluded that both aerobic and resistance exercise can improve cognitive functioning in people over the age of 50. The exercise can be moderate, yet the cognitive gains are significant.

The bottom line--get up, get out, and exercise, even if you can only manage it once or twice a week.

How much do you know about the state of the nation?

We're constantly exposed to one version or another of the idea of American exceptionalism. The politicians and advertisers remind us over and over again that the U.S. is number one, the richest country in the world, the most powerful, the shining “city on a hill” prophesied by our Puritan founders.

If you’re curious to see how well your knowledge about how the U.S. is doing matches what the statistics say, and if the U.S. still merits that number one spot, take this 20-item quiz.

 1. Among the 23 richest countries (measured by GDP per person), where does the U.S. rank in 
 terms of life expectancy (1 = highest life expectancy, 23 = lowest)?                                                _____                                                               

             2. Among the 23 richest countries, where does the U.S. rank in terms of income

inequality (1 = lowest ratio between top and bottom 20%; 23 = highest ratio)?                                  ____


3. Among the 21 richest countries for which data are available, where does the

U.S. rank on a health-and-social-problems scale that combines measures of

trust, mental illness, drug and alcohol addiction, infant mortality, life expectancy,

obesity, children’s educational performance, teenage births, homicides, rates of

imprisonment, and social mobility (1 = fewest problems, 21 = most problems)?                                    _____

4. Among the 22 richest countries for which data are available, where does the U.S.

Rank on the UNICEF index of child wellbeing, a combination of 40 measures of

children’s health and wellbeing (1 = healthiest for children, 22 = least healthy)?                                     _____


5. Of the 21 richest countries for which data are available, where does the U.S.

rank in terms of the percent of GDP spent on foreign aid (1 = highest, 21 =lowest)?                           _____

6. Of the 12 rich countries for which data are available, where does the U.S. rank

In terms of the percent of the population who have been mentally ill in

The past 12 months (1 = lowest percentage, 12 = highest percentage)?                                                ____

7. Of 22 rich countries for which data are available, where does the U.S. rank in

terms of the United Nations index of illegal drug use (1 = least use, 22 = most use)?                          _____


 8. Among the 23 richest countries, where does the U.S. rank in terms of infant deaths

per 1000 live births (1 = lowest infant death rate, 23 = highest infant death rate)?                                 _____


 9.  Among the 21 rich countries for which data are available, where does the U.S. rank

In terms of the percent of people who are obese—body mass index over 30—

(1 = lowest percentage of obese citizens, 21 = highest percentage of obesity)?                                     _____


10.  Among the 19 rich countries for which data are available, where does the U.S.

rank in terms of the percentage of children who are overweight (1 = lowest

percentage of overweight children, 19 = highest percentage of overweight children)?                            _____

11. Among 22 rich countries for which data are available, how do U.S. 15-year-olds

Rank on an international test of math and reading skills (1 = highest, 22 = lowest)?                           _____

12. Among 21 rich countries for which data are available, where does the U.S. rank

In terms of the number of births among teens aged 15-19 (1 = lowest teen birth

rate, 21 = highest teen birth rate)?                                                                                                       _____

                                                                                                   
13.   Among the 23 richest countries, where does the U.S. rank in terms of homicides

per million people (1 = lowest homicide rate, 23 = highest)?                                                                 _____

14.   Among the 22 rich countries for which statistics are available, where does the U.S.

Rank in terms of the number of people in prison per 100,000 citizens 

(1 = lowest rate of imprisonment, 22 = highest)?                                                                                  _____

                                                                                                                   
15.  Among the 11 rich countries for which data is available, where does the U.S. rank in

terms of social mobility, measured by how different a son’s income at 30 is from his

father’s income when the son was born (1 = high mobility, 11 =low mobility)?                                      _____

16.   Among 21 rich countries for which data are available, where does the U.S. rate

In terms of the percentage of children living with a single parent (1 = lowest

percentage, 21 = highest percentage)?                                                                                                 _____

17.   Among the 22 richest nations for which statistics are available, where does the

U.S. rank in terms of the number of patents issued per 1,000,000 citizens

(1 = highest number of patents per capita, 22 = lowest number per capita)?                                         _____

18.   Among the 11 rich nations for which statistics are available, where does the U.S.

rank in terms of the proportion of waste that gets recycled (1 = highest proportion

of waste recycled, 11 = lowest proportion of waste recycled)?                                                            _____


19.    Among the 23 richest countries, where does the U.S. rank in terms of carbon

dioxide emissions per person (1 = lowest per capita CO2, 23 = highest per capita)?                         _____

20.   Among the 25 richest countries, where does the U.S. rank in terms of the percentage

of children living in relative poverty--defined as below a country’s median income—

(1 = lowest percentage of children in relative poverty, 25 = highest percentage)?                                  _____

You'll find the correct answers below. 

These statistics (except for # 20, which come from UNICEF) are taken from the book The Spirit Level: Why Greater Equality Makes Societies Stronger, by Kate Pickett and Richard Wilkinson. They lay out the case for the idea that, among rich, developed countries, it's not the amount of wealth but the degree of equality or inequality that makes the difference between a physically and mentally healthy, happy, well functioning and secure society and the opposite. They find that, among rich countries, those with high levels of income equality, such as the Scandinavian countries and Japan, do well on these measures of individual and social well being, while those with high levels of inequality, such as the U.S. and the U.K., do poorly. They think there is a cause-and-effect relationship between inequality and social problems, and that the most direct way to address this wide range of issues is to take steps to return the U.S. to a more equitable society.

 Correct answers:
1.  20/23 (4^th lowest in life expectancy)
 2.  22/23 (2^nd highest in income inequality)
3. 21/21 (highest level of health and social problems)
 4. 19/22 (4^th lowest on child wellbeing)
5.  20/21 (2^nd lowest percent spent on foreign aid)
 6. 12/12 (highest prevalence of mental illness)
 7. 19/22 (4^th highest in illegal drug use)
8. 23/23 (highest infant death rate)
 9. 21/21 (highest level of adult obesity)
10.  19/19 (highest percentage of overweight children)
11.   17/22 (6^th lowest math and reading skills at age 15)
12.   21/21 (highest teen birth rate)
13.  23/23 (highest homicide rate)
14.   22/22 (highest imprisonment rate)
15.   11/11 (lowest social mobility)
16.   20/21 (In a three-way tie for the highest level of children in single-parent homes)
17.   19/22 (4^th lowest number of patents per 1,000,000 population)
18.   9/11 (3^rd lowest proportion of waste recycled)
19.   22/23 (2^nd highest per capita CO2 emissions)
20.   25/25 (highest percentage of children in relative poverty)