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By John Schieszer
Medical Minutes 

Exercise without the gym; new arthritis drug


February 1, 2023 | View PDF

Making exercise fun and easy

Ongoing research is showing that there are significant cardiovascular benefits at 6,000 daily walking steps at any pace. The evidence-based health benefits of walking are continuing to accumulate, according to ongoing research by researchers at the University of Massachusetts Amherst.

Findings from the latest study led by Amanda Paluch, an assistant professor of kinesiology in the School of Public Health and Health Sciences, show that older adults who walked between 6,000 and 9,000 steps per day had a 40%-50% reduced risk of a cardiovascular event, such as a heart attack or stroke, compared to those who walked 2,000 steps per day.

“We found for adults over 60, there was a strikingly lower risk of a cardiovascular event or disease over an average follow-up of six years,” said Paluch. “When accumulating more steps per day, there was a progressively lower risk.”

Earlier this year, research by Paluch and the Steps for Health Collaborative showed that more movement, even below the highly touted but unscientific “10,000 steps per day,” was associated with longevity benefits. The meta-analysis of 15 studies involving nearly 50,000 people from four continents found that walking between 6,000 and 8,000 steps per day was linked with a lower risk of death from all causes among older adults.

Following those findings, researchers wanted to tackle the less-charted territory of steps per day and cardiovascular disease. The results were similar, in terms of the most beneficial range of steps. While there appears to be a continual additional benefit for those who walk more than 6,000 steps, Paluch said encouraging the least-active older adults to take more steps is perhaps the most important public health message.

“The people who are the least active have the most to gain,” said Paluch. “For those who are at 2,000 or 3,000 steps a day, doing a little bit more can mean a lot for their heart health. If you’re at 6,000 steps, getting to 7,000 and then to 8,000 also is beneficial, it’s just a smaller.”

The meta-analysis of eight studies involved more than 20,000 people from the U.S. and 42 other countries. For younger adults, no link between steps per day and cardiovascular risk was detected. “This is because cardiovascular disease is a disease of aging and often doesn’t come to fruition until we’re at older ages,” said Paluch.

Four of the eight studies the researchers analyzed included data about walking intensity, or how fast the steps were taken. “We did not find any striking association with walking intensity,” said Paluch. “There was no additional benefit with how fast you’re walking, beyond the total number of steps that you accumulated.”

For those who don’t want to go to a gym

New research is suggesting that just three to four one-minute bursts of huffing and puffing during daily tasks is associated with large reductions in the risk of premature death, particularly from cardiovascular disease. It is good news for those who don’t like playing sports or going to the gym. Published in the journal Nature Medicine, this study is the first to accurately measure the health benefits of what researchers have termed ‘vigorous intermittent lifestyle physical activity,’ or VILPA.

VILPA is the very short bouts of vigorous activity (up to one to two minutes) we do with gusto each day, like running for the bus, bursts of power walking while doing errands or playing high-energy games with the kids. The researchers found that just three to four one-minute bouts of VILPA every day is associated with up to 40% reduction in all-cause and cancer-related mortality, and up to a 49% reduction in death related to cardiovascular disease.

“Our study shows similar benefits to high-intensity interval training (HIIT) can be achieved through increasing the intensity of incidental activities done as part of daily living, and the more the better,” said lead author Emmanuel Stamatakis, who is a professor of Physical Activity, Lifestyle and Population Health at the University of Sydney’s Charles Perkins Centre in Australia.

The majority of adults aged 40 and older do not take part in regular exercise or sports, but Stamatakis said the study reveals how incidental physical activity can overcome many barriers.

“Upping the intensity of daily activities requires no time commitment, no preparation, no club memberships, and no special skills. It simply involves stepping up the pace while walking or doing the housework with a bit more energy,” said Stamatakis.

Researchers used wrist-worn tracker data from UK Biobank, a large-scale biomedical database, to measure the activity of over 25,000 ‘non-exercisers’, participants who self-reported that they do not do any sports or exercise during leisure time. Interestingly, a comparative analysis of the vigorous activity of 62,000 people who regularly engaged in exercise found comparable results. This implies that whether the vigorous activity is done as part of structured exercise or housework does not compromise the health benefits.

New drug may benefit those with hand arthritis

The drug talarozole, which increases retinoic acid, could be a promising new treatment for hand osteoarthritis. A new study, published in Science Translational Medicine by researchers at the University of Oxford has identified talarozole as a positive new approach to preventing osteoarthritis.

“Hand osteoarthritis is a common and debilitating medical condition that affects mainly women, especially around the time of the menopause. We currently have no effective treatments that modify their disease,” said study investigator Tonia Vincent, Professor of Musculoskeletal Biology and Honorary Rheumatologist at Oxford’s Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences.

The researchers started by investigating a common gene variant that had been linked to severe hand osteoarthritis. Using patient samples collected at the time of routine hand surgery, as well as a number of experimental models, they were able to identify a key molecule that was especially low in at-risk individuals, called retinoic acid.

More than 40% of individuals will develop osteoarthritis during their lifetime. Hand osteoarthritis is an extremely common form of osteoarthritis and there are currently no disease modifying treatments that effectively relieve symptoms or stop deformity and stiffness of the joints.

“This project was only possible because of the multidisciplinary approach that we took, working with our hand surgical colleagues, geneticists, data scientists and biologists,” said Vincent.

As talarozole has an acceptable safety profile in human subjects, a small proof of concept clinical study is underway to see whether this drug might represent a new disease modifying treatment in patients.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at

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John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.

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